Persistent skin irritation and crusty sores or clusters of papules can indicate genital psoriasis or herpes, and a person may have difficulty distinguishing between them.

In this article, we describe how to identify psoriasis and herpes on the genitals. We also explore each condition’s symptoms, causes, and treatments.

Genital psoriasisGenital herpes
a noncontagious autoimmune disorder
a contagious sexually transmitted infection (STI)
smooth, flushed patches of skin

patches of thick, raised skin that may have silvery scales
clusters of small blisters that may rupture, forming open sores or ulcers
Other symptomsitching, pain, or bothburning or itching, swollen lymph nodes, fatigue, a fever, chills, nausea, stinging during urination, muscle aches, and
lower back pain
the skin above the genitals or the pubis, vulva, penis, or scrotum

the crease between the upper thigh and genitals, buttocks and back of the thigh, or cheeks of the buttocks
the genitals, thighs, buttocks, or anus
topical ointments, light therapy, and prescription medication
antiviral medication and
topical ointments

Psoriasis and herpes are different illnesses, but they can cause similar symptoms that flare up periodically.

Genital psoriasis

Different types of psoriasis can affect the genitals. Plaque psoriasis, for example, is an autoimmune condition that forms thick patches of skin that sometimes have silvery scales. These areas can feel itchy or sore.

Inverse psoriasis develops in skin folds — under the breasts, in the armpits, and around the genitals, for example. It tends to form smooth, flushed patches of skin.

Regardless of the type, psoriasis may develop:

  • in the crease between the upper thigh and genitals
  • in the crease between the buttocks and back of the thigh
  • in the skin between the cheeks of the buttocks
  • in the skin above the genitals
  • on the vulva, penis, or scrotum

Genital herpes

Genital herpes is an STI that develops after a person comes in contact with the herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2).

According to the Centers for Disease Control and Prevention (CDC), this infection is common, affecting approximately 1 in 6 people between the ages of 14–49 in the United States.

The symptoms of both conditions are as follows:

Genital psoriasis

Psoriasis on the genitals can cause:

  • swollen patches of skin that may be crusty or smooth
  • skin with white or silvery scales
  • dark patches of skin that appear gray, purple, or dark brown
  • smooth, reddened skin
  • discomfort or pain in the genital region
  • painful open cracks, known as fissures, in the skin
  • fungal and bacterial skin infections
  • pain or discomfort during sex

As the American Academy of Dermatology (AAD) point out, the appearance of psoriasis can vary. On white skin, the patches may be red or pink. On black skin, psoriasis can appear violet, gray, or dark brown. On Latinx skin, it can be pinkish and silvery-white.

Learn more about psoriasis on black skin here.

Genital herpes

According to the World Health Organization (WHO), most people with oral or genital herpes are asymptomatic.

If symptoms of genital herpes do appear, the first outbreak happens 2–4 weeks after exposure to the virus.

The initial outbreak involves sores forming on or near the genitals, buttocks, and anus, as well as:

  • burning or itching in the area
  • swollen, tender lymph nodes
  • fatigue
  • a fever
  • chills
  • nausea

Reoccurring outbreaks involve:

  • clusters of small, fluid-filled blisters
  • open sores that release fluid
  • crusty sores
  • stinging or burning while urinating
  • pain in the lower back
  • muscle aches

Below, learn what leads to each condition:

Genital psoriasis

A 2018 systematic review found that about 63% of people with psoriasis develop genital psoriasis.

Psoriasis is a noncontagious inflammatory condition that occurs when the immune system triggers rapid skin cell growth.

The exact cause of psoriasis is still unknown, but researchers have identified regions in the human genome that may make a person more susceptible to the condition.

As the AAD report, psoriasis runs in families. A person has a higher risk if they have a parent, grandparent, or sibling with psoriasis. However, a family history does not guarantee that a person will develop the condition.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases explain that the following factors can trigger psoriasis flares:

  • infections
  • stress
  • temperature or humidity changes that dry out the skin
  • certain medicines
  • skin injuries, such as cuts or sunburns

Genital herpes

Genital herpes is an STI that occurs due to the HSV-1 and HSV-2 viruses.

HSV-1 infections typically spread through oral contact and can cause painful, open sores, known as cold sores, to form around the mouth. The infection can spread to the genitals through oral sex.

HSV-2 infections spread through sexual contact.

A person can get genital herpes if they come into contact with the HSV-1 or HSV-2 through:

  • an active herpes sore
  • the saliva or genital secretions of a person with an oral or genital herpes infection

There are various ways of easing the symptoms of both conditions.

Genital psoriasis

There is no cure for psoriasis, on the genitals or elsewhere, but the following can help manage the symptoms:

  • creams containing salicylic acid
  • creams containing calcipotriene (Dovonex) or calcitriol (Vectical)
  • topical corticosteroids
  • biologics, such as adalimumab (Humira) and etanercept (Enbrel)
  • oral retinoids
  • ultraviolet light therapy
  • immunosuppressive drugs, such as methotrexate

Genital herpes

There is likewise no cure for genital herpes.

But, as the CDC observe, antiviral medications can relieve the symptoms and shorten the duration of outbreaks. Some of these medications include:

  • acyclovir
  • valacyclovir
  • famciclovir

There are ways to avoid contracting genital herpes, and there are also ways to prevent symptoms of psoriasis from flaring up.

Genital psoriasis

The following may help prevent genital psoriasis flare-ups:

  • managing stress levels
  • treating any injuries quickly
  • avoiding scratching the skin
  • avoiding alcohol
  • avoiding smoking
  • using gentle, fragrance-free moisturizers and cleansers

Learn more about preventing psoriasis flare-ups here.

Genital herpes

To help prevent genital herpes, try:

  • using barrier methods of protection, such as condoms or dental dams, during all sexual activity
  • getting regular STI screenings
  • avoiding risky behaviors, such as overusing drugs or alcohol

If a sexual partner has genital herpes, avoid anal, vaginal, and oral sex while their symptoms flare up.

Taking antiviral medications can also reduce the chances of transmitting the virus.

See a doctor or dermatologist if any new skin problem crops up, especially it leads to significant discomfort or seems infected.

Let the doctor know if there may have been exposure to herpes or if any herpes symptoms are present.

Psoriasis is a noncontagious autoimmune condition that can affect the skin in the genital region. Genital herpes is an STI that results from a viral infection.

Both conditions can cause uncomfortable skin changes, and neither is curable. However, many treatments can relieve symptoms and prevent flare-ups.

See a doctor if either condition seems likely or if psoriasis symptoms change.