Psoriasis is a chronic (long-term) inflammatory condition that causes red, itchy patches on the skin. It can appear anywhere on the body, but when it affects the genitals, it is called genital psoriasis.
About 3% of people in the United States have psoriasis, and more than 60% of them will have genital psoriasis at some point. It is rare for psoriasis to affect only the genitals. Usually, someone with genital psoriasis will also have other areas of the skin affected.
Symptoms of genital psoriasis may come and go over time. The condition can be physically uncomfortable, but it can also affect you emotionally, for example during intimate moments. Although there is no cure for genital psoriasis, there are several treatments that help improve symptoms and quality of life.
Different types of psoriasis can affect the genitals. The two most common types are inverse psoriasis and plaque psoriasis.
Inverse psoriasis is a rash that develops between body folds or where the skin rubs against itself, including the genitals, armpits and under the breasts. Inverse psoriasis can be made worse by sweating in the affected area or when skin folds rub together.
Plaque psoriasis is the most common type of psoriasis overall. Although it can more commonly affect the scalp, knees, elbows and torso, it can also affect the genitals.
Genital psoriasis symptoms can vary depending on the type of psoriasis affecting the area.
Genital psoriasis caused by inverse psoriasis looks smooth, tight and shiny. People with lighter skin tones may have bright red lesions, and people with darker skin tones may have purple lesions. The affected area may split or be very itchy. It can also cause discomfort and pain. Lesions can sometimes produce an unpleasant odor.
Genital psoriasis caused by plaque psoriasis can cause different patches, the color of which depends on your skin tone. For people with lighter skin, the spots will appear red with a buildup of silvery, white skin cells on top. For people with darker skin tones, the discoloration will appear darker, potentially purple, gray or dark brown. You may also experience discomfort, pain, itching and cracked skin.
Inverse psoriasis is more common in the genital area than plaque psoriasis because it is usually too moist for plaque to form.
Genital psoriasis can form in the following locations:
- A fold between the thigh and the genital area
- Vulva, penis or scrotum
- The fold between the buttocks, including the skin around the anus
- Skin above the genitals
- Inner and upper thigh
If you have genital psoriasis, you may notice lesions on other parts of your body. You can also have other types of psoriasis, such as plaque psoriasis, at the same time.
Psoriasis is caused by an immune reaction that causes your body to produce more skin cells than normal. Extra skin cells sit on top of your skin, leading to psoriasis symptoms.
Psoriasis is a complex condition with many contributing factors. Experts are still trying to understand the exact cause of psoriasis, but they believe that autoimmunity, genetics and the environment play a role.
When you have an autoimmune condition, your body mistakes healthy tissue as foreign and attacks it. In psoriasis, your immune system mistakenly attacks healthy skin cells. Genetics may play a role in your psoriasis, but you can also develop it without a family history.
Psoriasis can also develop after an injury to the skin.
Risk factors
Certain risk factors make it more likely that you will develop psoriasis (such as genital psoriasis) or make your symptoms worse. This includes:
- Stress
- Cold weather
- Smoking
- Medicines such as beta-blockers
- Infections
- obesity
- Alcohol consumption
Genital psoriasis is usually diagnosed by a primary care physician or a dermatologist (a doctor who specializes in skin, nail, and hair conditions).
They will complete a physical exam and may be able to diagnose psoriasis based on appearance alone. To help confirm the diagnosis, they may ask about any symptoms you have, such as itching or joint pain.
Your doctor may also complete tests for sexually transmitted infections such as syphilis or take a small sample of skin for testing (biopsy) to rule out any other conditions.
There is no cure for genital psoriasis, but many treatment options are available to help manage the condition.
Because of the location, treating genital psoriasis can be a delicate and complex process; your healthcare team will help you navigate your treatment options.
Some treatments your healthcare team may recommend for your genital psoriasis include:
- Topical corticosteroids such as hydrocortisone
- Local immunomodulators such as calcineurin inhibitors
- Vitamin D
- Coal tar
Topical treatments applied directly to the skin are usually the first to be recommended for genital psoriasis. Because the skin around the genitals is thin, topical treatments usually work quickly. They can help moisturize the area, relieve pain and itching, reduce inflammation, or slow the growth of skin cells.
Biologics are given through a vein to prevent the immune system from attacking healthy skin. Providers may prescribe biologics and oral medications in certain cases.
Both options work throughout your entire system, so they’re usually only prescribed if you have psoriasis in other locations that hasn’t responded to other treatments.
There is no known way to prevent the development of genital psoriasis.
You may be able to prevent flare-ups, which is the period when the disease is active and symptoms are present. You can try the following to avoid genital psoriasis:
- Avoid or find alternatives to medications that make your psoriasis worse
- Avoid or quit smoking
- Maintain an optimal weight determined by you and your healthcare provider
- Reduce stress
- Less alcohol consumption
- Limit exposure to a cool, dry environment
Although its effect is most visible on the skin, psoriasis is an inflammatory disease that can also affect other parts of the body. If you have psoriasis, including genital psoriasis, you may be at a higher risk of developing other health conditions, including:
- Metabolic syndrome: This is the most common condition associated with psoriasis. Metabolic syndrome is a group of conditions that increase the risk of cardiovascular disease, diabetes and stroke. You may have metabolic syndrome if you have three of the following five factors: a large waistline, high blood pressure, high blood sugar, high triglycerides, and low high-density lipoprotein (HDL) cholesterol.
- Psoriatic arthritis (PsA): This type of arthritis is common in people with psoriasis. PsA creates inflammation in the joints, leading to pain and swelling. Most people have psoriasis before PsA, but some may have PsA first.
- Anxiety and depression: Mental health conditions affect up to 50% of people with psoriasis.
- Cardiovascular diseases: This refers to a group of conditions related to the heart and blood vessels. You are 50% more likely to develop cardiovascular disease if you have psoriasis.
Genital psoriasis can be a challenging condition to navigate. Because of the location, it can have a greater impact on the quality of life.
Genital psoriasis can affect your willingness to be intimate, leading to relationship problems or feelings of isolation. Try to be open with your partners about psoriasis, explaining what it is and that it is not contagious.
Talking to a mental health professional can help. The National Psoriasis Foundation offers resources and opportunities to connect one-on-one with other people living with psoriasis.
Your genitals also have more sensitive skin than other areas, so treating genital psoriasis with topical treatments can sometimes be difficult. Talk to your doctor about the best treatment for sensitive skin.