A woman in her underwear and a shirt standing in front of a mirror with her hand covering/feeling her butt. There is visible psoriasis on her groin and butt.

Inverse Psoriasis Was the Pain in My Butt I Never Knew I Had

Living with a host of health issues since childhood, I chalked my sore behind up to frequent trips to the bathroom. After all, I have Crohn’s disease (a form of inflammatory bowel disease) and pretty active Irritable Bowel Syndrome.

The severe Crohn’s flare I’ve been trying to drag myself out of started way back in 2012. Around this time, skin issues I had always dealt with began to intensify and skin issues that I never experienced before began to creep up.

Connecting the pains of psoriasis

I’ve always dealt with a certain level of scalp psoriasis. Picking and peeling at the scales behind my ears and the base of my skull until I drew blood became second nature. When I wasn’t picking at the scales, I was picking at my nails and cuticles.

As I became more educated on Crohn’s disease, I would often come across medical articles on psoriasis. It still never dawned on me that the pain in my behind was related.

When the pain in the butt began

I remember vividly the first time I discovered the painful textured skin below. I was traveling for the first time since my Crohn’s flare. In that time painful, crippling arthritis had set in my hands and feet. Along with that came inflamed skin between my legs and pelvis and under my arms, and then my behind. I had chalked the painful skin up to travel, at first.

The only thing I could think to do was create a safe and comfortable barrier with coconut oil. I used it as a conditioner if I felt raw from too many trips to the bathroom. It helped create a comfortable moisturizer between my skin, clothing, and underwear. The coconut oil made sitting in a car, let alone a seat on a plane, tolerable.

A few months later while at a well women’s Visit, my gynecologist flatly stated, “Hey, you got a touch of Psoriasis down here, and here, and here and there.” The “there” was my behind. Well, okay then!

Finding the right doctor

That’s where it ended though. Nothing was prescribed topically aside from sitz baths. Finally, after starting a biologic treatment the painful skin inflammation in those cracks and crevices would come and go. You may be wondering why I didn’t go to a doctor for it? I kind of did.

I showed my PCP and GI the red inflamed skin under my arms. I shared how my skin would die down after the biologic and as the next treatment drew near, it would come back again. I told them it was in other places.

At one point when it looked like the same thing was happening near my navel, an MRE was ordered stat in fear that fistula was forming. Nope, it was just inverse psoriasis manifesting somewhere else. Once again, coconut oil on a sterile swab came to the rescue.

Treatment for psoriasis on the buttocks

I don’t know why it never occurred to me to go to a dermatologist sooner. I scheduled an annual skin check and listed psoriasis on the paperwork along with my other health issues. After my head-to-toe cancer screening, the doctor asked if I wanted some steroid cream for my psoriasis.

While I was wary of steroids overall, a cream felt logical and necessary. She sent in a prescription and sent me home with some samples to start with. Holy cow, what a difference this silly little sample tube made.

Steroid creams come with their own set of warnings. They can discolor and thin skin making it more susceptible to tearing. I always tried to apply carefully and only use it when truly necessary.

No longer a pain in the butt

When I moved to my second biologic my lower extremity inverse psoriasis subsided more. By the time I moved to my fourth and most successful treatment, I will only have tiny flares. To this day, I still try to treat with coconut oil first before resorting to the steroid cream.

I recognize I am very lucky to be able to manage to treat this painful and uncomfortable issue. My best advice if you think you have a case of inverse psoriasis is to not sit on it! Pun intended. Please go to your Dermatologist.

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