What to Do About Genital Psoriasis

Genital psoriasis can be hard to live with, especially when it comes to sex, but treatment can help. Get the facts and some genital psoriasis treatment tips.

By Chris Iliades, MD

Medically reviewed by Farrokh Sohrabi, MD

When it comes to uncomfortable and embarrassing conditions, genital psoriasis would make most people's lists. But that need not be the case.
“Many people with genital psoriasis go undiagnosed for a long time. People may be too embarrassed to tell their doctors about their symptoms. Doctors may be too embarrassed to look," said Jeffrey I. Ellis, MD, a dermatologist at North Shore University Hospital in Manhasset, N.Y. Jeffrey I. Ellis. "This is especially true when genital psoriasis is the only type of psoriasis."
Usually, if you have genital psoriasis, you also have the more typical psoriasis on knees and elbows. But for some, genital psoriasis may be the only type you have.

Genital Psoriasis Information: How It's Different

Genital psoriasis usually does not have the thick scales and silvery plaques associated with other psoriasis. Up to 7 percent of people with psoriasis will have genital psoriasis; for 2 to 5 percent of them, it's the only type they have. It can show up in the pubic area, upper thighs, groin creases, anal area, or on the genitals.
“Genital psoriasis looks like a red rash with sharp borders," said Dr. Ellis. "When it appears in the groin area, it is often mistaken for a fungus, like jock itch. When it appears on the genitals, it may be mistaken for a sexually transmitted disease."
Because of this, "we often see patients who have been diagnosed and treated incorrectly," he said. "A skin biopsy may be needed to make the diagnosis of genital psoriasis.”
Symptoms of genital psoriasis like soreness, burning, and itching are often made worse because the groin area is constantly exposed to friction, warmth, and moisture. “One of the characteristics of psoriasis is the tendency for it to get worse with any kind of skin trauma," Ellis said. "In the groin area, tight clothing, skin rubbing on skin, athletic activity, and sexual activity can all make symptoms worse."

Genital Psoriasis Treatment

Genital psoriasis occurs on skin that is both thinner and more sensitive than psoriasis that occurs in other areas of the body. “Genital psoriasis is more sensitive, but also more responsive to treatment. You have to treat gently, but you can often get symptoms to clear up completely,” Ellis said. Genital psoriasis treatments may include:
A 2012 case report published in the journal Dermatology and Therapy described a case of genital psoriasis that resisted other psoriasis treatments but responded well to the oral drug Dapsone. Better known as a drug to treat leprosy, Dapsone cleared the genital psoriasis completely in four weeks and was continued for 10 months, and the patient remained free of genital psoriasis for at least two years, according to the report.
“All the same treatments that we use for other psoriasis may be used for genital psoriasis," Ellis said. "Dapsone may be used as an alternative to other treatments." He said it's available as a pill or a cream.

Genital Psoriasis Management Tips

“The most important tip is to find a dermatologist that you feel comfortable with and can work closely with," said Ellis. "Self-care includes avoiding skin trauma and excessive dryness. Skin hydration is an important part of management."
Tips for skin hydration include:

Tips for Genital Psoriasis and Sex

Genital psoriasis can make your sex life more complicated, but it's important to know that it does not interfere with sexual function. Start by sharing with your partner that genital psoriasis is not contagious.
Other helpful psoriasis sex tips include:
“Sometimes it helps for a patient and his or her partner to come to a doctor visit together," Ellis said. "Knowledge is the key to living with psoriasis. Genital psoriasis is not contagious, and it is nothing you need to be ashamed about. Let doctor know if you have any symptoms. We have amazing treatments."