Could the Skin Changes on Your Privates Be From Psoriasis?

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 referred to as genital psoriasis.

About 3% of people in the United States have psoriasis, and more than 60% of them will have psoriasis on their genitals at some point. It is rare for the psoriasis to affect only the genitals. Usually, someone with genital psoriasis will have other areas of their skin affected, as well.

Genital psoriasis symptoms can come and go over time. The condition can be physically uncomfortable, but it may also affect you emotionally, such as during intimate moments. While there’s no cure for genital psoriasis, several treatments are available to help improve symptoms and quality of life.

Different types of psoriasis can affect the genitals. Two of the more common types are inverse and plaque psoriasis.

Inverse psoriasis is a rash that develops between body folds or places where the skin rubs against itself, including the genitals, underarms, and under the breasts. Inverse psoriasis can worsen due to sweat in the affected area or when skin folds rub together.

Plaque psoriasis is the most common type of psoriasis overall. While it may more commonly affect the scalp, knees, elbows, and torso, it can also affect the genitals.

Genital psoriasis symptoms can differ based on the type of psoriasis that’s 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 severely itchy. It may also cause discomfort and pain. The lesions can sometimes produce a foul-smelling odor.

Genital psoriasis caused by plaque psoriasis can cause distinct patches, the color of which depends on your skin tone. For people with lighter skin, the patches will look 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 since it is typically too moist for plaque to form.

Genital psoriasis may form in the following locations:

The crease between the thigh and genital areaVulva, penis, or scrotumThe crease between the buttocks, including the skin around the anusThe skin above the genitalsInner and upper thigh 

If you have genital psoriasis, you may notice lesions on other parts of your body. You may also have other types of psoriasis, like plaque psoriasis, at the same time. 

Psoriasis is caused by an immune reaction that leads your body to produce more skin cells than normal. The extra skin cells sit on top of your skin, leading to the symptoms of psoriasis.

Psoriasis is a complex condition with multiple contributing factors. Experts are still trying to understand the exact cause of psoriasis, but they believe that autoimmunity, genetics, and environment play a role.

When you have an autoimmune condition, your body mistakes healthy tissue as being foreign and attacks it. With psoriasis, your immune system mistakenly attacks healthy skin cells. Genetics may play a role in your psoriasis, but you may also develop it without any family history.

Psoriasis may also develop after an injury to the skin. 

Risk Factors

Certain risk factors make you more likely to develop psoriasis (like genital psoriasis) or worsen your symptoms. These include:

StressCold weatherSmoking Medications like beta-blockers Infections Obesity Alcohol consumption

Genital psoriasis is usually diagnosed by a primary care provider or dermatologist (a doctor specializing 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’re experiencing, such as itchiness or joint pain.

Your provider may also complete tests for sexually transmitted infections like syphilis or take a small sample of the 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 treatment options.

Some treatments your healthcare team may recommend for your genital psoriasis include:

Topical corticosteroids like hydrocortisoneTopical immunomodulators like calcineurin inhibitors Vitamin DCoal tar

Topical treatments placed directly on the skin are typically the first ones recommended for genital psoriasis. Since the skin around the genitals is thin, topical treatments usually work quickly. They can help moisturize the area, relieve pain and itch, reduce inflammation, or slow the growth of skin cells.

Biologics are administered through a vein to help block 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 are usually only prescribed if you have psoriasis in other locations that haven’t responded to other treatments.

There is no known way to prevent genital psoriasis from developing in the first place.

You may be able to prevent flares, which are times when the disease is active and symptoms are present. You can try the following to avoid flares of genital psoriasis:

Avoid or find alternatives for medications that worsen your psoriasisAvoid or quit smoking Maintain an optimal weight determined by you and your healthcare providerReduce stress Lower alcohol consumption Limit exposure to cold, dry environments

Although its effect is most visible on the skin, psoriasis is an inflammatory disease that can affect other parts of the body. If you have psoriasis, including genital psoriasis, you may be at greater risk for developing other health conditions, including:

Metabolic syndrome: This is the most common condition related to psoriasis. Metabolic syndrome is a group of conditions that increases your risk of cardiovascular disease, diabetes, and stroke. You may have metabolic syndrome if you have three of the following five factors: 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, which leads 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 disease: 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 quality of life.

Genital psoriasis can affect your willingness to be intimate, leading to relationship issues or feelings of isolation. Try to be open with your partners about psoriasis, explaining what it is and that it’s not contagious.

Speaking with a mental health specialist can help. The National Psoriasis Foundation offers resources and opportunities to connect one-on-one with other people living with psoriasis.

Your genitals also tend to have more sensitive skin than other areas, so treating genital psoriasis with topical therapies can sometimes be tricky. Talk with your healthcare provider about the best treatment for sensitive skin.