Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentSelf-Care TipsSex
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Self-Care Tips
Sex
Genital psoriasis is a form ofpsoriasis, a chronic skin condition, that occurs on or around the genitals. Red, itchy patches can form on the penis, scrotum, testicles, labia, vulva, clitoris, and other parts of the genitalia.
Although genital psoriasis can develop on its own, it most often accompanies psoriasis on other parts of the body, such as the knees, elbows, orscalp.
This article discusses genital psoriasis, its symptoms, causes, and treatment. It also offers suggestions on how to cope when you have this form of psoriasis.
Symptoms of Genital Psoriasis
Itching and dandruff-like flaking are common. When scratched, the plaques will easily bleed and worsen. Over time, the plaques can consolidate and create large areas of dry, cracked skin.
Genital psoriasis doesn’t always look like psoriasis you get on other parts of your body. Scales may not be seen because they tend to flake away with movement. Instead, the affected patches of skin may look bright red and smooth.
Your symptoms may vary depending on the type of psoriasis you have:
Where Plaques Can Form
Genital psoriasis can appear on the:
The lining inside the vagina or rectum is typically unaffected.
The skin on these parts of the body is very delicate and rich in nerve endings. Abrasions, cracks, and bleeding can easily lead to secondary infections.
To complicate matters, some of the topical drugs used to treat psoriasis on other parts of the body can cause pain or discomfort when applied to the genitals.
Sexual Problems
Genital psoriasis can interfere with your sex life due not only to the physical symptoms but the embarrassment of having to explain the condition to a sexual partner.
Weeping and inflamed skin can often be misread as asexually transmitted infectionsuch as herpes or genital warts. Rather than face rejection, some people simply avoid sex, leading to isolation and depression.
According to a 2015 study, no less than 43% of people with genital psoriasis report decreased sexual intercourse as a result of their physical and emotional symptoms.
Genital psoriasis has no impact on pregnancy, sexual function, or menopause.
For reasons poorly understood, the immune system will suddenly attack normal cells and tissues. With psoriasis, the assault is primarily focused on keratinocytes, a type of skin cells that makes up 90% of the epidermis.
When this happens, the ensuing inflammation causes overproduction of keratinocytes, leading to the formation of plaques.
It has been proposed that past infections or skin traumas may increase the density of keratinocytes in genital tissues, providing more “targets” for the autoimmune assault.Further research is needed to support this hypothesis.
Genetics and Genital Psoriasis Triggers
However, the actual expression of the disease may require an environmental trigger, such as an infection, for symptoms to manifest.
Like psoriasis on other parts of the body, genital psoriasis may flare up in response to triggers like illness or stress.It’s often hard to know what triggers flare-ups, however, which can make them difficult to prevent.
How Common Is Genital Psoriasis?
Genital psoriasis is common. According to a 2018 study, 33% to 63% of people with psoriasis will develop genital psoriasis at some point in their life.
It can affect both men and women, though there is no clear explanation as to why some people develop genital psoriasis and others don’t.
Psoriasis: Causes and Risk Factors
Genital psoriasis is diagnosed based on a review of your symptoms and medical history. Certain conditions or a family history may place you at an increased risk for psoriasis or reveal alternate explanations for your condition (such ascontact dermatitis).
Unlike some autoimmune disorders, there are no blood tests or imaging studies that can definitively diagnose psoriasis.
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How Do You Get Rid of Genital Psoriasis?
Medicationused to treat psoriasis on the scalp or elbows, for example, is too harsh and/or concentrated to be applied to the labia or scrotum. These creams would penetrate the thin, sensitive skin of the genitals more profusely, increasing the risk of side effects.
Over-the-Counter (OTC) Treatments
Low-potency topical medications are typically used in the first-line treatment of genital psoriasis. This is to reduce the risk of side effects and damage to already-affected skin.
Mild genital psoriasis is typically treated with a short course of an over-the-counter 1.0% hydrocortisone ointment. Higher-dose hydrocortisone can be irritating and may cause irreversible skin thinning (atrophy) if overused, increasing the risk of painful intercourse (dyspareunia).
Mildcoal taris another, though less common, OTC option. It can be used alone or alongside hydrocortisone cream on the external genitalia only.
Prescriptions
Protopic (tacrolimus)andElidel (pimecrolimus)are topical immunosuppressants that are reserved for people who fail to respond to hydrocortisone or Dovonex.
If the skin becomes infected,topical antibioticsmay be prescribed.
Your healthcare provider may also recommend applyinglubricantsoremollientsto relieve or prevent skin dryness and cracking when using these drugs.
Other prescriptions may be considered if these treatments prove ineffective.
Options for Severe, Stubborn Cases
If these options don’t work, prescriptiontopical steroidsmay be used under the supervision of a dermatologist.
The prolonged use of steroids can also cause irreversible skin thinning. This is especially worrisome in women, as it could lead to the “drooping” of the labia and the partial obstruction of the genital hiatus (the gap between the vagina, urethra, and rectum).
If your symptoms are severe, systemic treatment may be required. Generally speaking, these oral and injectable drugs are reserved for when psoriasis involves more than 10% of the body surface area, rather than just the genitals alone.Options include:
Phototherapy, a technique involving UV light exposure and drugs that activate in response to it, is not commonly used to treat genital psoriasis but may be explored if larger areas of skin are involved.
How Psoriasis Is Treated
In addition to treatment, there are strategies that can help you cope and/or prevent the recurrence of genital psoriasis. Among some of the more useful self-help tips:
Verywell / Laura Porter
Sex With Genital Psoriasis
When it comes to sex when you have genital psoriasis:
Summary
Genital psoriasis is a form of psoriasis that appears on the genitals, such as on the penis, scrotum, or vulva. It is similar to psoriasis that appears elsewhere, though you may not notice scales since these often flake off with movement.
Treatment for genital psoriasis is different than treatment for other forms of the disease. This is because the skin around the genitals is thinner and more sensitive than it is on other parts of the body.
16 Sources
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