What to know about genital psoriasis
Although there is no cure for genital psoriasis, people with moderate to severe symptoms can take biologic medications if symptoms have not responded to other treatments.
Genital psoriasis often occurs alongside psoriasis of the skin. One study from 2018 estimated that 33–63% of people with psoriasis experience symptoms on the genitals at some point.
In this article, we discuss how to recognize and treat genital psoriasis.
Psoriasis may develop on or around the genitals.
Genital psoriasis can cause ongoing discomfort due to heightened sensitivity in the area.
Inverse psoriasis is the most common type of psoriasis to affect the groin and genital area. Inverse psoriasis causes smooth, dry, red or purple patches on the skin. Inverse psoriasis is often more painful than other types. The affected areas of skin can feel sore and itchy.
Psoriasis causes different symptoms in different areas of the pelvis and thighs, as follows:
This is the area just above the genitals. The skin is more sensitive in the pubis, so doctors typically advise caution when applying treatments to this area.
Psoriasis on the upper thighs consists of small, round patches that are red or purple and scaly. This can lead to irritation, especially in people whose thighs rub together when they walk or run.
Creases between the thighs and groin
Psoriasis appears as non-scaly, red, and white in the creases between the thighs and groin. The skin may also have fissures or cracks.
Those who are overweight or very active might also develop an infection in the folds of the skin that resembles a yeast infection. Both men and women can develop psoriasis symptoms in these creases.
Psoriasis of the vulva often appears smooth, non-scaly, and red or purple. Although it may cause itchy sensations, try not to scratch the area. Scratching can lead to infection and dryness, which can result in thickening of the skin and additional itching.
Genital psoriasis does not typically affect mucous membranes and stays on the outer layer of the vaginal skin.
Many small, red or purple patches on the shaft can signal psoriasis of the penis. The skin may appear scaly or be smooth and shiny.
This condition can occur in all males, regardless of whether they are circumcised.
Anus and surrounding area
Psoriasis on or near the anus is red or purple, non-scaly, and likely to itch. Symptoms might be similar to those of yeast infections, hemorrhoidal itching, and pinworm infestations.
Genital psoriasis of the anus can also cause rectal bleeding, pain while passing stools, and dryness. Heavy scaling and red or purple discoloration might develop in the creases of the buttocks, although the skin is less sensitive and difficult to treat.
Treating flare-ups of genital psoriasis can be challenging. However, they typically respond well to remedies and soothing options. They might even resolve without treatment.
The condition is chronic, however, and a person can never fully cure it. That said, new biologic medications that target the autoimmune cause at the root of psoriasis can provide a long-term solution for symptoms and flares.
People should use topical creams carefully to avoid extra thinning of the skin and the formation of stretch marks.
Relieving an itch can be relatively uncomfortable, but treating lesions is more complicated. People must constantly moisturize the affected area and use topical treatments or ultraviolet (UV) light.
In more detail, some treatments for genital psoriasis include the following:
A doctor may inject biologics to treat moderate to severe psoriasis.
These disease-modifying therapies (DMT) are systemic medications that have an effect across the whole body.
They work to reduce the autoimmune response and could prove to be a key player in current research to develop a full cure.
Doctors administer biologics via infusion or injection.
For genital psoriasis, biologics are not a first-line treatment. However, they can be helpful for people who have genital psoriasis alongside other symptoms or those whose symptoms do not respond to other treatments.
Doctors tend to prescribe low-strength corticosteroids to soothe the symptoms of genital psoriasis. Overusing topical corticosteroids, however, may lead to permanently thin skin and stretch marks.
Using over-the-counter moisturizers can be help keep the area moisturized.
Vitamin D creams and ointments
These types of ointment are the most beneficial. Choosing moisturizers that contain fragrances and perfumes might cause irritation.
In special circumstances, UV light may help treat genital psoriasis. However, the dosage should be lower than what a person would use for a type of psoriasis that produces symptoms elsewhere on the body. This is because overuse can burn the delicate skin of the genitals.
These cover the skin with a protective layer and prevent water loss.
Tacrolimus and pimecrolimus can help treat genital psoriasis without thinning the skin. The Food and Drug Administration (FDA) have only approved these for use in eczema. However, they can also help with the symptoms of psoriasis.
In some cases, doctors might prescribe oral medication. However, genital psoriasis medications can cause some adverse side effects, including:
The exact cause of psoriasis remains unknown, but anomalies in the immune system and genetic factors might play roles in its development.
People with psoriasis develop skin cells at an extremely fast rate, and these build up into scaly lesions, or plaques.
A parent with psoriasis might pass it on to a child in their genes.
Around the same number of men and women develop psoriasis.
According to the National Psoriasis Foundation, at least 10% of people inherit one or more genes that could eventually give rise to psoriasis.
Only 2–3% of the population ever develops the condition, but one-third of people with psoriasis have a family member who also has it.
Psoriasis can also occur in people of any ethnicity, although there are differences in its prevalence among them. For example, 3.6% of Caucasian people have psoriasis, and only 1.9% of African American people have it.
A person who develops psoriasis might have a certain combination of the necessary genes and has undergone exposure to specific external triggers.
Possible triggers of genital psoriasis include:
- previous infections, such as strep throat or skin infections
- injuries to the skin, such as a cut or scrape, bug bite, or severe sunburn
- stress and other environmental factors
- cold weather
- drinking large amounts of alcohol
- some medications, including lithium, high blood pressure medications, antimalarial drugs, and iodides
Contact with certain irritants might cause a symptom flare-up. These irritants include:
- tight fitting clothes
When experiencing symptoms of psoriasis in the genital area or anywhere else, this resource from the American Academy of Dermatology can help people find a specialist near them.
Implications for sexual health
Genital psoriasis can get worse as a result of the friction associated with sexual intercourse. Using a condom might help reduce potential discomfort. It also forms a barrier, preventing skin-to-skin and fluid-to-skin contact and further reducing irritation.
After intercourse, people with genital psoriasis should thoroughly cleanse the area and reapply any medications to assist recovery.
Genital psoriasis may cause the area to look different, and the person may experience some discomfort during sexual intercourse. For this reason, people with genital psoriasis should consider communicating with their partner about the condition openly.
Although sexual intercourse can cause irritation, genital psoriasis is not transmissible and should not interfere with sexual activity.
Genital psoriasis causes red or purple patches of skin and scaly lesions to develop in the genital area.
Treatment options include biologics, vitamin D ointments, UV light, and some oral medications.
A person with genital psoriasis or related symptoms should always talk to a doctor. Not only can talking to a doctor ensure that treatment is safe and effective, but it also helps rule out other conditions, including STIs.
Are any complementary therapies good for genital psoriasis?
It is always beneficial to consult a dermatologist before using any complementary therapies, one of which is mild coal tar (but only if a doctor recommends it).
It can also be helpful to clean the area with a mild, fragrance-free soap and apply a fragrance-free moisturizer to the area after cleaning. It could also be beneficial to use quality toilet paper, wear loose fitting clothes, and consume plenty of fiber.
However, it is always best to stick to the doctor-recommended therapies for this delicate body area.