Psoriasis affecting the buttocks is a form of genital psoriasis. It can form in the crease between the buttocks and the skin around the anus and may appear inflamed, smooth, or scaly. The medical term for the crease of the buttocks is the gluteal cleft.

The gluteal cleft is the groove running between each buttock, from the base of the spine to the perineum, which is the area between the anus and genitals.

Psoriasis can affect the gluteal cleft and is a form of genital psoriasis. Genital psoriasis can also affect the:

  • vulva, scrotum, or penis
  • upper and inner thighs
  • crease between the upper thighs and genital area
  • pubis, which is the skin above the genitals

This article looks at the symptoms and treatment options available.

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Symptoms of genital psoriasis may occur on or around the genitals and surrounding areas, including the gluteal cleft and upper thighs.

If psoriasis affects the gluteal cleft, the skin can appear inflamed. The skin may be scaly or non-scaly.

Psoriasis on and around the anus may appear inflamed and non-scaly. The skin may feel sore and itchy, and it may weep. If the skin splits, fungal or bacterial infections can occur. These can feel uncomfortable and painful.

Genital psoriasis can include inverse psoriasis and plaque psoriasis.

Inverse psoriasis commonly occurs in folds of the body, such as under the arms and breasts and in the groin area. Sweat or chafing in these areas may worsen inverse psoriasis.

Plaque psoriasis consists of a scaly buildup of skin. It usually affects the scalp, elbows, torso, and knees but can also affect the genital area.

Symptoms of inverse psoriasis include:

  • inflamed skin
  • skin that appears smooth and tight, not scaly
  • discomfort and pain
  • severe itching
  • splitting of the skin

Symptoms of plaque psoriasis include:

  • raised, scaly patches of skin that can appear:
    • violet or brown with gray scales on black skin
    • salmon-colored with silvery-white scales on Hispanic skin
    • red or pink, with silvery-white scales on white skin
  • discomfort or pain
  • itching
  • cracking skin

How does it affect other genital areas?

Genital psoriasis may affect the following areas:

  • Groin and thigh folds: Skin folds in the groin and thigh areas may appear smooth and inflamed. People may have cracked, sore skin.
  • Penis: Psoriasis may form on the penis as small patches that may be shiny, inflamed, and non-scaly. Psoriasis may affect the tip or shaft of the penis and can occur in circumcised or uncircumcised penises.
  • Pubis: People may be able to treat psoriasis in the pubis area in the same way as they would treat scalp psoriasis, but they will need to take care, as the skin in the pubis area can be more sensitive.
  • Upper thighs: Psoriasis affecting the upper thighs may appear as small, round, inflamed, scaly patches. The inner thighs may get a lot of friction from movement, which may irritate psoriasis, so emollients may help.
  • Vulva: Psoriasis affecting the vulva may look smooth, inflamed, and non-scaly. In particular, psoriasis may affect the pubic region and the top of the legs, rather than the entrance of the vagina. Emollients may help reduce any irritation of vulva psoriasis.

Psoriasis is an autoimmune condition and results from an overactive immune system causing the body to create excess skin cells.

Psoriasis can run in families, and inheriting certain genes may increase the risk of a person developing psoriasis. Psoriasis can also develop in people without these genes.

Certain triggers may cause psoriasis to first appear, or cause a flare-up, including:

  • stress
  • injuries to the skin, such as a cut or severe sunburn
  • infections, such as strep throat
  • certain medications, such as lithium, prednisone, or hydroxychloroquine
  • certain climates, such as places with cold, dry weather
  • tobacco
  • excessive alcohol consumption

There is no specific cause for genital psoriasis.

Psoriasis is not contagious, and people cannot pass on genital psoriasis by touching someone or through sexual contact.

Jock itch, or tinea cruris, is a fungal infection. Jock itch can develop in warm, moist areas of the skin, particularly if the areas have tight clothing around them.

Jock itch appears as an inflamed, scaly rash that feels extremely itchy. Jock itch may affect the:

  • buttocks and gluteal cleft
  • genitals
  • inner thighs

People are usually able to treat jock itch at home with an over-the-counter (OTC) antifungal cream and by keeping the areas dry.

If a person’s symptoms do not improve with home treatments, they can see a doctor to check if the rash is jock itch or another condition, such as genital psoriasis.

Learn more about how to tell the difference between inverse psoriasis and jock itch.

People can discuss a treatment plan for genital psoriasis with a healthcare professional, such as a dermatologist. Treatments may include:

  • topical medications, such as:
    • corticosteroids
    • mild coal tar
    • calcipotriene
    • pimecrolimus
    • tacrolimus ointment
  • oral medications, such as cyclosporine, methotrexate, or biologics

The American Academy of Dermatology Association (AAD) notes that, in addition to treatment, self-care may help ease a person’s symptoms. A person can:

  • use a mild, fragrance-free cleanser for washing the genital area
  • gently apply a fragrance-free moisturizer, after drying the area
  • use good quality toilet paper to lessen irritation
  • avoid getting any urine or stool on genital psoriasis
  • wear comfortable, loose-fitting clothing around the genital area
  • eat a diet high in fiber to make bowel movements easier

Easing sexual discomfort

Genital psoriasis may make sex feel uncomfortable. The following tips may help ease sexual discomfort:

  • avoid having sex if the skin feels especially raw or sore
  • gently clean the area with psoriasis before sex
  • use a lubricated condom to reduce irritation
  • gently wash the area again after sex and reapply any medication

Genital psoriasis can affect the buttocks, gluteal cleft, genitals, and surrounding areas.

The skin may look inflamed, smooth, or scaly, and may feel itchy and uncomfortable.

People can discuss treatment options with a doctor. The treatments for psoriasis have improved and include topical ointments and creams, oral medications, and biologic injections.