Psoriasis can show up in the most unexpected places. Typically, psoriasis affects the knees and elbows but can be found on any part of the body, including the genitals.
Genital psoriasis can show up in the genital areas, upper thighs, or in the crease in your buttocks. It is generally symmetrical but the appearance can be different, based on the area where it is located.
- When in the genital area, it often appears as inverse psoriasis. You might have patches of red, shiny skin that are highly sensitive, painful, and itchy.
- Psoriasis on the upper thighs may appear as small, round patches that are red and scaly. It can become inflamed because of irritation from your thighs rubbing together or from tight pants.
- When it appears in the skin folds, such as between the thigh and the groin, it is often smooth and reddish-white in color. In these areas, you might notice skin fissures or cracks in the skin that can become inflamed and infected.
- On the penis, psoriasis can appear as small, red patches. It can affect both circumcised and uncircumcised males. It might look similar to contact dermatitis.
- When located in the crease of the buttocks, it shows up as red patches, with or without scales.
Genital psoriasis should be diagnosed by a medical professional. It can sometimes look like contact dermatitis.
Genital psoriasis is treated with either topical creams or Ultraviolet light therapy. Because there isn’t a cure for psoriasis, treatment is aimed at lessening the intensity and frequency of flares, and reducing the itching and stinging that accompany the rash.
Your doctor might prescribe a low-dose topical steroid cream. This is because genital psoriasis occurs in areas that are usually covered by clothing, which makes treatment more effective. Stronger doses can cause problems with thinning skin and stretch marks. If you do require higher doses, your doctor might ask you to come in more often for office visits to check for possible skin damage.
According to the National Psoriasis Foundation, having genital psoriasis “increases the severity of psoriasis, and it recommends discussing systemic or biologic treatments, especially skin it has not responded to topical treatments.
Because genital psoriasis is located in moist areas of the body, you might be more susceptible to developing yeast and fungal infections. If this happens, your doctor might suggest adding antifungal or antibacterial agents to your topical steroids.
Women might also notice an increase in vaginal infections. This is sometimes hard to discern, especially if you believe the pain or itch is due to the psoriasis. Genital psoriasis can appear on the labia and the vulva but it rarely occurs inside the vagina. If you experience pain or itching inside the vagina, talk with your doctor.
Sex during an outbreak might be painful. Irritation from rubbing and skin-to-skin contact can cause discomfort. Using a lubricated condom might help. Make sure to tell your partner if you are using any topical treatments so they can notice and treat any skin reactions.
Tips for home care
Use moisturizers liberally. Look for products that don’t contain perfumes or other additives that can irritate your skin. Your doctor can also prescribe emollients that can help you feel more comfortable.
Talk to your doctor about vitamin D creams you can directly apply to affected areas. Watch for irritation, however. The Psoriasis and Psoriatic Arthritis Alliance indicates that while some vitamin D creams are helpful, some can cause further irritation.
Use high quality, soft toilet paper. If clean-up after defecation causes irritation, consider a fiber supplement to make stools softer.
Wear loose-fitting underwear. For males, boxer shorts and for females, boy shorts are the best choice.
Wear soft, loose-fitting clothes to avoid rubbing and irritation.