Psoriasis is a chronic inflammatory autoimmune condition which can cause symptoms in various places on the skin, including the genitals and genital areas. Genital psoriasis can be caused by the same psoriasis that affects other parts of the body. Genital psoriasis that only affects the genitals is rare: almost everyone with genital psoriasis will have plaques or lesions in other parts of their bodies as well.
The type of psoriasis that most commonly affects the genitals or genital area is called “inverse psoriasis1.” Inverse psoriasis usually occurs in or around folds in the skin, and can affect similar areas such as the armpits, for example, as well as the genitals.
Genital psoriasis can affect both adults and children, and men and women, although it is most common in men. Researchers estimate that between 29%-40% of people with psoriasis have symptoms on the skin. Genital symptoms are more common among people with inverse psoriasis1. The exact cause of genital psoriasis is not yet fully known. However, researchers think that it may be related to the types of bacteria and yeast that are often present in the genital area. Like other types of psoriasis, genital psoriasis may also be triggered by injury to the skin in that area.
Living with genital psoriasis symptoms can have a big impact on a person’s quality of life. The symptoms can be very uncomfortable, and it can cause embarrassment in a person’s sexual life and relationships. However, there is a range of treatments available that can help to manage the symptoms and make life easier2.
Symptoms of genital psoriasis
Inverse psoriasis causes symptoms around the genitals that look a bit different than psoriasis that occurs in other areas of the body. The symptoms first appear as smooth, pink or red, shiny areas that can be itchy and tender. However, unlike the other parts of the body, Genital psoriasis patches are relatively thin plaques with little or no scaling1.
There are many different areas in the genital region that can be affected by genital psoriasis symptoms. Skin in the pubis (the area over the male and female genitals) can be affected, as well as the upper thighs3. In both of these areas, genital psoriasis symptoms look more like symptoms in other parts of the body, and can usually be treated in similar ways too. However, skin in the upper thighs, in particular, can become irritated during normal activities.
The skin folds and creases between the thighs and the groin area are another common location for psoriasis symptoms. In this area, the lesions do not usually have scales, but fissures (cracks) may develop deep in the creases and cause pain. Similarly, psoriasis can develop in the area between the buttocks causing plaques that can sometimes have heavy scaling, or no scale at all.
Men can develop psoriasis on the penis, which can cause symptoms of small, red, plaques on the head of the penis, the shaft, and the scrotum. Genital psoriasis can affect the penis whether the man is circumcised or not. In some men, the plaques can be scaly, and in others they are smooth and shiny1,3.
Women can develop psoriasis symptoms on the vulva, which is the outer skin of the vagina. Genital psoriasis rarely occurs inside the vagina or the urethra. Genital psoriasis on the vulva is usually red, smooth, and shiny, but is not usually very scaly3.
The anus and the skin surrounding it is another area where symptoms can occur1. They are usually red and not scaly, but can be very itchy and uncomfortable. Anal psoriasis can cause pain and bleeding during bowel movements.
When the symptoms of genital psoriasis go away, they do not leave scars.
How is genital psoriasis treated?
Treating genital psoriasis is complicated because the skin in that area is very sensitive. However, many people find that treatment can be very effective. It is important to be open and honest with your healthcare providers about your symptoms, so they can help you to find the best treatment plan for your personal symptoms.
Topical treatments are most commonly recommended for genital psoriasis symptoms. Topical treatments are applied directly to the affected area. Topical corticosteroids may be needed to clear the lesions in genital areas. A biopsy might be needed for atypical lesions or persistent plaques to exclude squamous cell carcinoma or extramammary Paget disease.1
Healthcare providers will usually recommend a lower strength corticosteroid treatment because of the sensitivity and thinness of the skin in that area. It is important to use corticosteroids exactly as instructed because they can cause serious side effects if used incorrectly3.
Other types of topical treatments are coal tar preparations and creams made from Vitamin D analogues (such as calcipotriol). However, they must be used with care to avoid irritation. It is important to watch out for infections in the genital area during treatment, and let your healthcare provider know if you have any new symptoms3.
Tips for managing genital psoriasis
Living with genital psoriasis symptoms can be very difficult, but there are things you can do to treat them. Using moisturizers can help with dryness and itching, but be sure that the cream doesn’t contain any perfumes or other substances that can cause irritation2.
It can also help to avoid prolonged contact with other irritants such as urine or feces. It can help to use high-quality toilet paper, and to wash and dry the area thoroughly and carefully after bowel movements2. Some people find that wearing looser fitting clothes can make them more comfortable.