Psoriasis is an autoimmune skin disease that is marked by raised, red, scaly patches on the skin area. The condition can occur anywhere on the body, including the genitals.
It can range from mild to severe in terms of seriousness.
Symptoms of genital psoriasis
Genital psoriasis is one of the most uncomfortable forms of psoriasis because the genital area is so sensitive. Inverse psoriasis is the most common type of psoriasis found in the groin and genital area. A person, who has inverse psoriasis, will usually develop smooth, dry, and red patches on their skin. Inverse psoriasis is often more painful than other types of psoriasis and the areas may be sore and itchy.
Various regions of the genital area may be affected by psoriasis:
Pubis: Region on male and females above the genitals.
Upper thighs: Psoriasis consists of many small round patches that are red and scaly. Psoriasis in this area is easily irritated, especially in those people whose thighs rub together when they walk or run.
Creases between thigh and groin: Psoriasis appears as non-scaly and reddish-white in the creases between the thigh and groin. The skin may have fissures or cracks. Those who are overweight or athletic may also develop an infection that resembles a yeast infection in the folds of the skin.
Psoriasis can affect the genital area of both men and women.
Psoriasis of the vulva typically has a smooth appearance and non-scaly redness. Scratching the area can cause an infection and create dryness, which can result in thickening of the skin and additional itching. Genital psoriasis typically affects the outer skin of the vagina. In most cases, psoriasis does not affect mucous membranes.
Psoriasis of the penis may present as many small, red patches on the glans or shaft. The skin may appear scaly or be smooth and shiny.
The condition can also affect the anus and surrounding skin. Psoriasis on or near the anus is red, non-scaly, and is commonly prone to itchiness. Symptoms can be confused with yeast infections, haemorrhoidal itching, and pinworm infestations.
If any of these other conditions are present, they can complicate psoriasis treatment. Rectal examinations and skin cultures can help to confirm these conditions. Psoriasis in the buttocks crease may be red and non-scaly, or red with very heavy scales.
Treatments and sexual health
Genital psoriasis can be difficult to treat in some cases, but typically it responds well to most treatment options. Skin in the genital area tends to be very thin and sensitive, so people with genital psoriasis should take special care when considering treatment options. Individuals should use topical creams carefully to avoid the skin becoming thinner and prevent stretch marks forming.
It is easy to relieve the itching and discomfort but treating lesions is more difficult. The affected area must be kept moisturized and topical treatments or ultraviolet (UV) light may be used.
Treatments for genital psoriasis include:
Topical medications: Low-strength corticosteroids are used in the genital area. Prolonged use of topical corticosteroids can lead to permanently thin skin and stretch marks. Over-the-counter moisturizers can be helpful in keeping the area moisturized. People should avoid moisturizers with fragrances and perfumes as they may cause irritation. Vitamin D creams and ointments are less likely to cause irritation.
Emollients: Applying emollients will cover the skin with a protective layer and prevent water loss.
Calcineurin inhibitors: Tacrolimus and pimecrolimus are helpful in treating genital psoriasis and do not cause the adverse side effects such as thinning of the skin. They can, however, cause an uncomfortable burning sensation and reactivate sexually transmitted infections, such as herpes or viral warts.
In some cases, doctors may prescribe oral medication. Genital psoriasis medications can cause some adverse side effects, such as irritation, headache, insomnia, fever, and diarrhoea. A person with genital psoriasis or any symptoms related to it should always talk to a doctor. This is to not only to ensure proper treatment but also to rule out other conditions including sexually transmitted diseases.
Genital psoriasis may get worse as a result of friction during sexual intercourse. Contact with certain irritants may also cause a flare up.
These irritants include:
- Tight-fitting clothes
Using a condom during intercourse may help to reduce potential discomfort. It also forms a barrier to avoid skin-to-skin and fluid-to-skin contact, which reduces irritation further.
After intercourse, people with genital psoriasis should cleanse the area and reapply any medications to help with recovery.
Since the area can look different and the person may experience some irritation, it is best for those suffering from genital psoriasis to be honest and explain their condition to their partner. Though sexual intercourse can cause irritation, genital psoriasis cannot be transmitted and should not interfere with a person having a healthy sex life.
Causes of psoriasis
There are several different types of psoriasis and it typically occurs after something has triggered it. It is not known exactly what causes psoriasis, but defects in the immune system as well as a person’s genetics play a key role in the development.
The immune system leads to an increase in healthy skin cells, T cells, and other white blood cells. This on-going cycle causes new skin cells to move to the outermost layer of the skin in days rather than weeks. The body doesn’t have time to shed the old cells, so the layers build up.
According to The National Psoriasis Foundation at least 10 percent of people inherit one or more genes that could eventually lead to psoriasis. Only 2-3 percent of the population develops the disease but one-third of people with psoriasis have a family member that also has the disease.
It is thought that a person who develops psoriasis has a certain combination of the genes and has been exposed to specific external triggers.
Psoriasis triggers include:
- Infections such as strep throat or skin infections
- Injury to the skin, such as a cut or scrape, bug bite, or severe sunburn
- Stress and other environmental factors
- Cold weather
- Heavy alcohol consumption
- Some medications including lithium, high blood pressure medications, such as beta blockers, antimalarial drugs, and iodides
Actual symptoms of psoriasis vary from person to person but a few common signs include:
- Red patches of skin covered with silvery scales
- Small scaling spots, which are commonly seen in children
- Dry, cracked skin that may be prone to bleeding
- Itching, burning, or soreness
- Thickened, pitted, or ridged nails
- Swollen and stiff joints
Source: Medical News Today