Genital And Anal Psoriasis
Plaque psoriasis at the genitals is sometimes called genital psoriasis. A study from 2017 in the journal Dermatology & Therapy reported the prevalence and effect on quality of life of people with plaque psoriasis who had genital involvement. Researchers found that 70% of the study participants had genital involvement.
Among these study participants, 100% reported itch and discomfort, 95% reported redness, burning, and stinging, 85% reported pain, and 75% reported scaling. Many of the study participants reported that itch, stinging, and burning were the most bothersome symptoms.
Inverse psoriasis is a rare form of psoriasis that affects between 3% and 7% of people with psoriasis. It often affects the genital and anal areas at areas where the skin folds or creases.
It can cause ongoing discomfort to the upper thighs, pubis, the folds between the thighs and groin, the vulva, penis, anus, and buttocks. Inverse psoriasis causes dry, red, inflamed patches on the skin of these sensitive areas.
Upper thighs: Inverse psoriasis can cause red, inflamed patches on the upper thighs. This can be especially irritating when the thighs rub together with walking or running.
Pubis: The pubis, also called the pubic bone, is located just above the genitals. In this area, the skin is very sensitive. Itching and scratching can make this area even more inflamed and sore.
What If Those Psoriasis Treatments Dont Work
If psoriasis doesnt improve, your healthcare provider may recommend these treatments:
- Light therapy: UV light at specific wavelengths can decrease skin inflammation and help slow skin cell production.
- PUVA: This treatment combines a medication called psoralen with exposure to a special form of UV light.
- Methotrexate: Providers sometimes recommend this medication for severe cases. It may cause liver disease. If you take it, your provider will monitor you with blood tests. You may need periodic liver biopsies to check your liver health.
- Retinoids: These vitamin A-related drugs can cause side effects, including birth defects.
- Cyclosporine: This medicine can help severe psoriasis. But it may cause high blood pressure and kidney damage.
- Immune therapies: Newer immune therapy medications work by blocking the bodys immune system so it cant jumpstart an autoimmune disease such as psoriasis.
How Is Psoriasis Diagnosed
Doctors usually diagnose psoriasis by examining the skin, scalp, and nails. They’ll also ask whether someone else in your family has psoriasis and if you recently had an illness or started taking a new medicine.
Rarely, doctors might take a skin sample to check more closely. A can tell the doctor whether it’s psoriasis or another condition with similar symptoms.
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Between 21 30 Percent Of People Living With Psoriasis Develop Inverse Psoriasis
Did You Know?
Inverse psoriasis appears on skin of color as lesions of purple-ish, brown or darker than the surrounding skin, in body folds. On Caucasian skin it appears as bright red lesions in body folds. It may appear smooth and shiny. Many people with inverse psoriasis have another type of psoriasis elsewhere on the body at the same time.
Prevalence Of Inverse Psoriasis
Contrary to the most common form of psoriasis , which accounts for about 90% of all psoriatic cases, there is not all that much accurate data available for inverse psoriasis.
According to different studies and populations, the prevalence of IP is highly variable, ranging from 3 to 36%, because of the lack of precise diagnostic criteria and of the consensus whether genital localization is considered part of the disease
It is estimated that it occurs in between 3 to 7% of people already suffering from psoriasis.
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What Should I Do If I Have Genital Psoriasis
Genital psoriasis may also affect the surrounding area in the groin. It rarely appears in the vagina. If you develop psoriasis of the genitalia, you should always consult your doctor. Do not be embarrassed.
Genital psoriasis can sometimes look similar to a fungal or bacterial infection, or even contact dermatitis, so your doctor may need to check the diagnosis with a laboratory test before starting any treatment. The delicate skin in the genital area may mean you need a weaker psoriasis treatment than elsewhere on your body. You should bear in mind that you may be susceptible to irritation and allergic reactions from any substance applied to the skin. Sensitisation most commonly occurs from perfumes and preservatives in over-the-counter wash products and topical local anaesthetics. It is important to keep personal hygiene as uncomplicated as possible and avoid fragranced products.
It is also important to remember that your psoriasis is not due to an infection and is not catching. So, when you are in a loving relationship with a partner who knows about your psoriasis, it should not interfere with your sex life. If you are with a new partner, take the time to explain your condition before you become intimate, to reduce stress and needless worry for you both.
This article is adapted from the Genital psoriasis leaflet.
Treatment For Penile Psoriasis
Penile psoriasis occurs in the most sensitive areas of your penis. These areas are also highly responsive to treatment, but it has to be done gently to get symptoms to clear up completely. Early treatment is vital for this condition since it can reduce the severity of the symptoms. The doctor or a dermatologist may prescribe oils and moisturizers to help in controlling and relieving symptoms of this condition.
The following are common treatments administered for this condition
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What Else Should I Ask My Healthcare Provider
If you have psoriasis, ask your healthcare provider:
- How can I prevent outbreaks and control symptoms?
- What medication will work best for me?
- What else should I do to improve symptoms?
- What are my options if creams dont work?
- Will psoriasis ever go away?
A note from Cleveland Clinic
Psoriasis, an itchy skin condition, can come and go throughout your life. Its related to an overactive immune response and is not contagious. If you have skin changes that arent going away, talk to your healthcare provider. There is no cure for psoriasis, but psoriasis treatments can improve symptoms. Your provider may prescribe a special cream or moisturizer or medications. Other therapies are available if creams or medicines dont work. Maintaining your overall health will also help improve symptoms.
Last reviewed by a Cleveland Clinic medical professional on 10/17/2020.
What Treatment Is Available For Genital Psoriasis
A treatment plan may include:
Medium-strength or potent corticosteroid
Mild coal tar
Pimecrolimus cream or tacrolimus ointment
Stronger medicine such as cyclosporine, methotrexate, or a biologic
If you follow the treatment plan and it fails to work, tell your dermatologist. No one treatment works for everyone. You may need different treatment to get relief.
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Intimacy Can Still Be Possible
If you are feeling anxious about sexual activity because of psoriasis, talk to your partner and educate them about psoriasis. Let them know that psoriasis isnt contagious and help to put them at ease. It is always a good idea to discuss psoriasis before you are intimate, so it is not a surprise.
To reduce friction and pain during sexual activity, use lubricants during sex. Choose products labeled cooling over warming lubricants. Warming lubricants often contain ingredients that inflame sensitive skin and might trigger psoriasis flares.
You can also make your own lubricant using olive oil, aloe vera, or coconut oil. However, oil-based lubricants should not be used with latex condoms, as they can degrade the latex and lead to condom failure.
The American Academy of Dermatology recommends the following ways to reduce irritation with sexual intercourse.
- Postpone sex when the skin around the genitals is raw or inflamed.
- Before sex, gently cleanse intimate areas using mild, fragrance-free cleansers.
- During sex, use lubricated condoms to reduce irritation in intimate areas affected by psoriasis.
- After sex, gently wash and dry intimate areas to reduce irritation.
- Reapply topical medications after sexual intercourse.
Following your treatment plan and taking your medications as prescribed can help to improve psoriasis symptoms regardless of where they are located on the body.
What Does Inverse Psoriasis Look Like
Inverse psoriasis is known for its red, shiny, smooth rash. Unlike the scales, pustular spots, and crusting skin associated with other forms of psoriasis, the rash caused by inverse psoriasis is neither raised nor dry.
Inflamed patches of skin are sometimes moist to the touch. You may feel irritation, itching, or both in areas that are affected by inverse psoriasis.
Youre also at risk to develop a yeast infection in the skin folds due to the moist environment. The red lesions generally cover very large areas within your skin folds.
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Causes Of Inverse Psoriasis
Inverse psoriasis is caused by an abnormality in your immune system, just like other autoimmune diseases. But moisture and friction can trigger the symptoms of this particular type of psoriasis.
If youve got psoriasis and are overweight, youre at a higher risk of also developing inverse psoriasis. Thats because extra body weight produces excess skin and deeper skin folds.
There are several different treatment methods available for inverse psoriasis:
Psoriasis On Penile Shaft
Psoriasis on the penile shaft may appear as small, red patches, which may be scaly or smooth and shiny. This condition can affect both circumcised and uncircumcised males, but there is not an identifiable cause of this psoriasis in that area. It is, however, important to note that it cannot be transmitted through sexual contact.
Psoriasis in this region is very difficult to control, but it can be easy to relieve symptoms such as itch and discomfort. Treatments of this condition are quite easy since any treatment can be absorbed.
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What Is Inverse Psoriasis
Inverse psoriasis, sometimes called hidden psoriasis or intertriginous psoriasis, is a form of psoriasis that affects skin folds. These are areas of your body where skin rubs against skin.
Inverse psoriasis can occur under your arms, under a womans breasts, or in the groin or inner thigh area.
People who have inverse psoriasis often have another form as well, like plaque psoriasis, on other parts of their body. While raised lesions of dry, scaly skin a key sign of plaque psoriasis often cover large sections of your body, inverse psoriasis tends to appear in smaller patches.
Types Of Psoriasis On The Penis
There are five different types of psoriasis, with plaque psoriasis being the most common. Sometimes plaque psoriasis does appear on the penis, with red patches that appear scaly. The type of psoriasis usually found on the penis, though, is inverse psoriasis. Affected areas are very red but instead of appearing scaly, they are smooth and shiny. Follow this link to see a picture of inverse psoriasis.
Inverse psoriasis usually develops in between folds of skin or in other areas where body parts rub together, like in the armpits, under the breasts, and in the groin area. The moisture and friction in those areas usually prevent scales from building up.
The constant friction can cause severe irritation, however, and makes inverse psoriasis quite uncomfortable. Add that to the fact that it often occurs in very sensitive areas, like the groin area, and you can see why people with the condition are desperate for relief. Not only can psoriasis in this area cause constant discomfort, but it can also make sexual activity unpleasant or painful, as well, which can interfere with relationships.
People with penile psoriasis may have psoriasis on other areas of the body or it may be confined to just the genitals. Sometimes they have inverse psoriasis in the genital area and plaque psoriasis on other parts of the body.
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How Is Psoriasis Treated
Psoriasis is usually treated by a dermatologist . A rheumatologist may also help with treatment. Treatments can include:
- ultraviolet light from the sun or from home or office treatments. But in some people, sunlight can make psoriasis worse.
- creams, lotions, ointments, and shampoos such as moisturizers, corticosteroids, vitamin D creams, and shampoos made with salicylic acid or coal tar
- medicines taken by mouth or injected medicines
A doctor might try one therapy for a while and then switch to another. Or a doctor may combine different therapies. It’s all about finding one that works for each person.
Sometimes what works for a while might stop working. This is one reason why it’s important to work closely with a doctor. Trying out new treatments can get a little frustrating, but most people eventually find one that works.
What Else Should I Know
Making healthy choices can help with psoriasis. Here are some things you can do:
- If you smoke, quit. Smoking can trigger outbreaks of psoriasis in some people.
- Avoid alcohol. It can make psoriasis treatments less effective.
- Eat healthy foods. Eating a lot of fruits and vegetables can help fend off diseases that might trigger psoriasis.
- Stay at a healthy weight. This decreases the risk of inverse psoriasis.
- Keep skin clean and well moisturized. Bathing daily with bath salts or oils and then applying moisturizer can help ease the symptoms of psoriasis.
People who have psoriasis may feel self-conscious about how it looks. That’s one reason why some people turn to a therapist or join a support group of people who understand what they might be going through.
The key to psoriasis treatment is keeping up on whatever your doctor prescribes. If that means applying an ointment twice a day, then find a way to remind yourself to do it so you don’t forget. Psoriasis is one of those things that you need to stay focused on treating, even when you’re feeling OK.
Whether your psoriasis is mild or severe, learn all you can about it. Talk to your doctor or check websites like:
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Home Treatment For Psoriasis
There are some home remedies that may help minimize outbreaks or reduce symptoms of psoriasis:
- Exposure to sunlight.
- Apply moisturizers after bathing to keep skin soft.
- Avoid irritating cosmetics or soaps.
- Do not scratch to the point you cause bleeding or excessive irritation.
- Over-the-counter cortisone creams can reduce itching of mild psoriasis.
A dermatologist may prescribe an ultraviolet B unit and instruct the patient on home use.
Causes And Risk Factors
Researchers dont know exactly what causes psoriasis or what causes it to spread to the anal or genital areas. They do know that genes and the immune system play a significant part in the development of psoriasis. Many family-based studies have found that about one-third of people with psoriasis have a first-degree relative with the condition.
In addition to genes, certain environmental factors can increase your risk of psoriasis. These include:
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What Treatments May Or May Not Be Used In Genital Psoriasis
Psoriasis in the genital region is very difficult to control. While it is easy to relieve the symptoms of itch and discomfort, treating the lesions effectively is more challenging. When treating genital psoriasis it is important to keep the affected areas moisturised. When using moisturisers, any irritation that occurs may be due to your sensitivity to some of the ingredients.
Below is a summary of topical treatments, some of which may be recommended for your particular circumstances. Others are unsuitable for use in the genital area. If you develop genital psoriasis, you should discuss it with your doctor, who will be able to advise you on suitable treatments.
Emollients are an important part of the daily care of psoriasis on all parts of the body, including the genitalia. They help to make the skin more comfortable. There is also a range of topical treatments available – creams and ointments – that your doctor can prescribe. See Emollients and Psoriasis.
Topical vitamin D creams and ointments are effective in treating psoriasis and the newer types are less likely to cause irritation. However, some do have the potential to irritate sensitive areas such as the genitalia. Some doctors recommend cautious use of vitamin D analogue creams and ointments on genital skin.
Treatment should never be stopped abruptly as this may trigger a rebound flare of your psoriasis.
Genital Psoriasis Penis Scrotum
- Symptoms: Shiny rashes, itching, stinging or scales
- Color: Typically red
- Location: Genital areas, upper thighs, skinfold, buttocks crease
- Treatment: Topical creams or UV light therapy
Genital psoriasis is psoriasis that develops around the genitals. The condition is not contagious and usually inherited. It can be triggered by yeast infections, and those with a genetic predisposition are more susceptible to psoriasis. Psoriasis usually manifests around age 20.
Usually, if you have genital psoriasis, you also have the more typical psoriasis on knees and elbows, for some it may be the only type you have.
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The Horror Of Penile Psoriasis
The horror of penile psoriasis is hard to describe to those that dont have it. Imagine your sexy, noodly appendage looking like its just been pulled through a paper shredder. Even if youre into S& M and like your sausage being butchered, its not a fun look, let me tell you!
Now imagine slicing this with a butchers knife.
Thankfully so far, knock on wood I havent had problems with P on the peepee.
Penile psoriasis, like psoriasis in general, can appear anywhere on your love vegetable from the base of the shaft all the way to the top of the glans. Even if youre circumcised or uncircumcised, it can get you. However, unlike the common plaque psoriasis, the skin looks smooth NOT rough and dry.