When people hear the word psoriasis, they tend to think of the patches of thickened, red, silvery skin that most often appear on the elbows, knees, back and scalp. But psoriasis manifest as a number of different skin symptoms, and can appear anywhere on the body, including the genitals and the skin around the genitals.
As with all other forms of psoriasis, genital psoriasis is an autoimmune disease. It is not an infection or a contagious disease, but is caused by a combination of genetics and environmental factors.
What is genital psoriasis?
Psoriasis on the pubis, vagina, penis, scrotum, anus, creases between the groin and thighs, upper thighs and the crease between the buttocks are all classified as genital psoriasis. Since psoriasis affects the outer layers of the skin and not the mucus membranes (except in rare cases), symptoms do not affect the inside the vagina or the urethra.
Symptoms are typically different in appearance than plaque psoriasis, and genital psoriasis most commonly manifests as something called inverse psoriasis. Inverse psoriasis is a type of psoriasis that affects areas of the body where there are folds of skin, and causes smooth lesions that are bright red and many appear shiny. Sweat and skin rubbing against skin irritate these lesions and can make symptoms worse. Besides the genitals, other areas of the body commonly affected by inverse psoriasis are the underarms and the skin underneath the breasts.
Genital psoriasis can cause significant physical discomfort. Some of the most commonly reported symptoms are itching, pain, discomfort, stinging, burning and scaling of the skin. Some patients also experience cracks or fissures in the affected skin.
In addition to physical discomfort, genital psoriasis also can have a severe negative impact on a person’s quality of life and sexual health. Patients with psoriasis symptoms on the genitals score lower on quality of life questionnaires than patients with psoriasis on other areas of the body. Though it is not a contagious disease—and the factors that cause psoriasis are generally beyond a person’s control—symptoms may be embarrassing, have a stigma attached to them and can be mistaken for sexual transmitted infections. Patients often report that the condition impairs their ability to have sex and enjoy sex, and many report that they avoid sexual relationships. Some also report that sexual activity can make symptoms worse. However, it is important to remember that multiple treatments are available to help control symptoms and improve quality of life.
How common is genital psoriasis?
There are no official statistics on the number of people who are affected by genital psoriasis, but it seems to be more common than most people realize. If you have genital psoriasis, you are not alone. A few published studies have found that genital psoriasis may affect between 33 and 63 percent of psoriasis patients at some point. Unfortunately, research has also shown that a significant number of people with genital psoriasis do not discuss their symptoms with their healthcare provider.
How can genital psoriasis be treated?
The first step to treating genital psoriasis is speaking to a healthcare provider. While discussing any symptoms that affect the genitals can be emotionally stressful and embarrassing, it requires a different treatment approach than psoriasis on other areas of the body. If you are already being treated for genital psoriasis and your treatment is not working, talk to your healthcare provider about what other treatment options are available. The most commonly prescribed treatments for genital psoriasis are topical treatments and UV light therapy, though systemic treatments like DMRADs (disease-modifying antirheumatic drugs) and biologics may also be used in some cases.
