Genital psoriasis is a common skin condition that affects the genital area. Research shows that psoriasis frequently affects the genital skin, though it’s often overlooked in treatment (1). Many people with this condition feel uncomfortable discussing it with their doctors, which can delay proper treatment.
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What is Genital Psoriasis?
Genital psoriasis is a form of psoriasis that appears on or around the genital area. This includes the pubic region, upper thighs, skin folds between the thigh and groin, and the area between the genitals and anus. Like other types of psoriasis, it happens when your immune system causes skin cells to grow too quickly.
The genital area’s sensitive skin makes this type of psoriasis particularly challenging to treat. The skin in these areas is thinner and more prone to irritation than other parts of your body.
Symptoms of Genital Psoriasis
The symptoms of genital psoriasis can vary from person to person. Unlike psoriasis on other body parts, genital psoriasis usually appears as smooth, red patches without the typical scales.
Common symptoms include:
- Red, smooth patches of skin in the genital area
- Itching that can range from mild to severe
- Burning or stinging sensations
- Pain during sexual activity
- Skin that may crack or bleed
Studies show that itching is one of the most bothersome symptoms. In clinical trials, patients with genital psoriasis reported significant improvements in symptoms when treated with newer medications (2).
Who Gets Genital Psoriasis?
Genital psoriasis can affect anyone who has psoriasis. Many people with psoriasis elsewhere on their body also develop it in the genital area.
People with inverse psoriasis (psoriasis in skin folds) are particularly likely to have genital involvement. About 71% of patients using pimecrolimus cream achieved clear or almost clear skin after 8 weeks of treatment for inverse psoriasis (3).
Impact on Quality of Life
Genital psoriasis significantly affects quality of life, particularly sexual health and relationships.
Sexual Function and Relationships
Research shows that genital psoriasis has a major impact on sexual activity. Patients report avoiding sexual activity due to their symptoms. Studies found that treatment with ixekizumab led to significant improvements in sexual activity avoidance from week 4 onward (2).
Many people also experience difficulties in their personal relationships. Treatment can help improve these issues. Clinical trials show that effective treatment improves both symptoms and the impact on sexual health (4).
Emotional and Psychological Effects
The location of genital psoriasis can cause significant emotional distress. Many patients feel embarrassed or anxious about their condition. This can lead to avoiding intimate relationships or medical examinations.
Treatment Options for Genital Psoriasis
Several treatment options are available for genital psoriasis. The sensitive nature of genital skin requires careful selection of treatments.
Topical Treatments
Topical medications are usually the first treatment option for genital psoriasis.
Topical Corticosteroids: These are often the first choice for treating genital psoriasis. Research suggests that weak topical corticosteroids are the first-line treatment (1).
Calcineurin Inhibitors: These medications are particularly useful for genital psoriasis because they don’t cause skin thinning. Studies show that topical calcineurin inhibitors are effective and generally well-tolerated for facial and genital psoriasis (5).
Both tacrolimus and pimecrolimus have shown good results. About 65% of patients using tacrolimus ointment achieved clear or almost clear skin after 8 weeks of treatment (6).
Vitamin D Analogues: Calcitriol ointment has been studied for sensitive skin areas. It was found to be better tolerated than calcipotriol in treating psoriasis in sensitive areas like the genitals (7).
Systemic Treatments
For moderate to severe genital psoriasis, or when topical treatments aren’t enough, systemic medications may be needed.
Biologic Medications: Newer biologic drugs have shown excellent results for genital psoriasis. Ixekizumab treatment led to clear or almost clear genital skin in 73% of patients at week 12, with improvements maintained at week 52 (8).
Oral Medications: Apremilast, an oral medication, has been tested specifically for genital psoriasis. In clinical trials, 39.6% of patients taking apremilast achieved clear or minimal genital psoriasis compared to 19.5% on placebo (9).
Combination Approaches
Sometimes combining treatments works better than using one treatment alone.
Research shows that adding corticosteroids to vitamin D treatments can improve both effectiveness and tolerability. In facial psoriasis (which has similar sensitivity to genital areas), combining hydrocortisone with calcipotriol was significantly more effective than calcipotriol alone (10).
Managing Daily Life with Genital Psoriasis
Living with genital psoriasis requires special attention to daily care and lifestyle choices.
Skin Care Tips
Proper skin care is essential for managing genital psoriasis:
- Use gentle, fragrance-free cleansers
- Pat the area dry instead of rubbing
- Wear loose, breathable cotton underwear
- Avoid harsh soaps and bubble baths
- Keep the area moisturized with gentle, unscented products
Lifestyle Modifications
Several lifestyle changes can help manage symptoms. Maintaining a healthy weight through proper diet and avoiding triggers can reduce flare-ups. Some people find that certain vitamins and supplements help their overall psoriasis symptoms.
Natural remedies and herbs may provide additional relief, though they should not replace medical treatment. Many people also explore home remedies as complementary approaches to their prescribed treatment plan.
Conclusion
Genital psoriasis is a common but often hidden aspect of psoriasis that significantly impacts quality of life. While it can be challenging to discuss and treat, effective options are available.
Treatment typically starts with gentle topical medications like weak corticosteroids or calcineurin inhibitors. For more severe cases, systemic treatments including biologics and oral medications have shown excellent results in clinical trials.
Remember that genital psoriasis is a medical condition that deserves proper treatment. Don’t let embarrassment prevent you from seeking help. With the right treatment approach and ongoing care, most people with genital psoriasis can achieve significant improvement in their symptoms and quality of life.
If you have psoriasis and notice symptoms in your genital area, talk to your dermatologist. They can develop a treatment plan specifically designed for this sensitive area of your body.