9 Things You Should Know About Genital Psoriasis

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Genital psoriasis, which typically presents as red patches on and around the genitalia, can be embarrassing and isolating. Whether you think you have genital psoriasis or have received a diagnosis, educating yourself about this inflammatory skin disease can help you develop a long-term management and treatment plan and cope with the effect it may have on your relationships.


It’s often misdiagnosed

“Genital psoriasis is often confused and misdiagnosed as infections or sexually transmitted diseases,” said Jennifer Clay Cather, M.D., medical director of Mindful Dermatology & Modern Research Associates in Dallas. Speaking with HealthCentral in an email interview, Dr. Cather said she recommends a full skin exam to look for lesions in the more common areas, such as the scalp, elbows, knees, and nails, to confirm a diagnosis.


Doctors don’t know what causes it

There is no identifiable cause for genital psoriasis. According to the National Psoriasis Foundation, a person with psoriasis must have a combination of the genes that cause psoriasis, and also be exposed to specific external factors known as triggers, which include strep throat, skin infections, injury to the skin, stress, cold weather, smoking, heavy alcohol consumption, and certain medications, such as lithium, beta blockers, and iodides.


It’s not confined to the genitals

According to the National Psoriasis Foundation, the most common type of psoriasis in the genital area is inverse psoriasis, which presents as smooth, red, dry lesions and doesn’t have the scales typical of plaque psoriasis. As well as the penis and vulva, genital psoriasis can affect the pubis (the area immediately above the genitals), upper thighs, anus, and the creases between the thigh and groin and the buttocks.


Honesty is key

It’s natural to be embarrassed about genital psoriasis, but it’s important to be open and honest with your healthcare provider in order to establish the most effective treatment.

“You have a medical condition which requires an open dialogue with your dermatologist,” said Dr. Cather.

Remember, medical professionals deal with sensitive areas and issues as part of their daily work and have seen it all before.


It can affect your sleep

Some genital psoriasis symptoms, such as itching, may be worse at night, making it difficult to sleep. Scratching your skin in your sleep may cause pain and bleeding. Some patients find that a lack of sleep makes their genital psoriasis worse, leading to a frustrating vicious circle. If your psoriasis flares up when you overheat, decrease your room temperature or try a lower-tog duvet. Speak to your dermatologist about other ways to reduce itching and discomfort at night.


You can still have sex

“Patients with genital psoriasis may avoid sex due to pain or itching prior, during, or after sexual activity,” said Dr. Cather. “Additionally, if lesions are visible and bleeding, they may be isolating.”

However, you can still have an active sex life if you plan carefully. Use a lubricant or a lubricated condom to help prevent friction injuries, and let your sexual partner know if you’re using a treatment in the genital area so they can watch for potential skin reactions.


It’s not contagious

It’s important to know that genital psoriasis is not a sexually transmitted disease (STD) and cannot be transmitted through sexual activity. Before sexual contact with a new partner, take the time to explain your condition to ease stress and reduce uncertainty for you both. Being in a supportive, understanding relationship can help you cope with the emotional and psychological impact of genital psoriasis.


Protection is crucial

A high level of self-care is necessary when you have genital psoriasis. The genital area is at risk for friction from clothing and bowel movements, as well as sexual activity. Wear loose-fitting underwear; use soft, high quality toilet paper; avoid antibacterial soaps and body washes on the affected area (use only mild, fragrance-free skincare products instead); and consider a fiber supplement if defecation causes a flare-up.


Many treatment options exist

Genital psoriasis can be difficult to treat, but there are many treatment options. The American Academy of Dermatology recommends mild topical steroids, calcipotriene, and topical immune modifiers. While doctors generally don’t prescribe systemic medications for genital psoriasis alone, they may do so if the psoriasis is severe or resistant to topical therapy. Don’t forget that response times may vary greatly among individuals. If your treatment isn’t working, ask your doctor about alternatives.