How can I treat genital psoriasis?

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Genital psoriasis can be treated successfully: You apply most treatments for genital psoriasis directly to the psoriasis.

If you have psoriasis on or around your genitals, you have genital psoriasis. Many people who have psoriasis will have a flare in this area. Even children get genital psoriasis.

As embarrassing as this may feel, it is important to tell your dermatologist if you have psoriasis on (or around) your genitals. The right treatment can help:

  • Get rid of the itch, pain, and burning
  • Clear (or nearly clear) the psoriasis

If you are already treating psoriasis, it’s still important to tell your dermatologist about genital psoriasis. The skin in this area is thin and sensitive, so you’ll likely need a different treatment plan — and possibly different medicine.

What treatment is available for genital psoriasis?

A treatment plan may include:

  • Mild corticosteroid (with or without calcitriol ointment)
  • Medium-strength or potent corticosteroid (used for a short time)
  • Mild coal tar (Use this only if a doctor recommends it)
  • Calcipotriene cream
  • Pimecrolimus cream or tacrolimus ointment
  • Stronger medicine like 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.

8 ways to avoid irritating genital psoriasis

To get the best results from treatment and avoid flares, you want to avoid irritating genital psoriasis. The following can help you do just that:

  1. When treating genital psoriasis, use the treatment that your dermatologist prescribed for this area. Psoriasis treatment that you’re using on another part of your body can be harmful in the genital area. Tazarotene can irritate the area, making genital psoriasis worse. Any type of phototherapy (UVB, PUVA, or laser treatments) can increase your risk of developing genital cancer. Strong coal tar therapy may also increase the risk of genital cancer.

    If you have sex with someone who has psoriasis, you will not get psoriasis. Psoriasis is not contagious. It’s not a sexually transmitted disease.

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  2. Tell your dermatologist if the treatment irritates any skin in your genital area. That includes the skin on:

  3. Use a mild, fragrance-free cleanser. When bathing, you want to avoid deodorant or antibacterial soaps and body washes. These can irritate the delicate skin, causing genital psoriasis to flare.

  4. Moisturize. Gently applying a fragrance-free moisturizer to the psoriasis after bathing and when the area feels dry can reduce chaffing and irritation.

  5. Use quality toilet paper: This can help reduce irritation.

  6. Avoid getting urine or feces on genital psoriasis: These can cause psoriasis to flare.

  7. Wear loose-fitting underwear and clothing: Tight-fitting clothing can cause friction, which can worsen genital psoriasis.

  8. Get plenty of fiber in your diet: Eating a high-fiber diet or taking a fiber supplement will ease bowel movements.

How to be intimate when you have genital psoriasis

If you have genital psoriasis, you can still be intimate. Following this advice can help reduce irritation:

  • When the skin on or around your genitals is raw, postpone sex.

  • Before sex, gently cleanse the area: Be sure to use a mild, fragrance-free cleanser. Cleansing will also help prevent psoriasis medication from rubbing onto your partner.

  • Men: Use a lubricated condom: Whether a man or woman has genital psoriasis, this lessens the risk of irritating the inflamed area.

  • After sex, gently wash the area. This helps reduce irritation. If you are using medicine, apply it. 

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References
Bergstrom, KG, Kimball AB. (2011) 100 questions & answers about psoriasis. Sudbury, Mass: Jones and Bartlett.

Meeuwis KA, de Hullu JA, et al. “Genital psoriasis awareness program: Physical and psychological care for patients with genital psoriasis.” Acta Derm Venereol. 2015 Feb;95(2):211-6.

Ryan C, Sadlier M, et al. “Genital psoriasis is associated with significant impairment in quality of life and sexual functioning.” J Am Acad Dermatol. 2015 Jun;72(6):978-83. 

Turner J. “Inverse psoriasis.” National Psoriasis Foundation webinar, presented September 16, 2015. 


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