Psoriasis is an inflammatory autoimmune condition that could affect the skin anywhere on your body. Genital psoriasis develops around your genital area. The condition isn’t contagious, and may be managed effectively.

Anyone can get psoriasis, but researchers do not know the exact cause. It’s not clear why some people with psoriasis get it around their genitals either, which may flare up:

  • on the vulva or penis
  • on the upper thighs
  • in the folds of skin between your thigh and groin
  • between your buttocks

According to a 2018 review, about 63 percent of people with psoriasis get genital psoriasis at least once in their lifetime.

If you have psoriasis, you might go a long time without symptoms and then have a flare-up. Flare-ups may be triggered by factors such as stress or illness, but it can be hard to identify those triggers and avoid them.

Psoriasis is thought to be caused by genetics and your environment. Therefore, it may run in families. However, it is not contagious. The condition can be managed effectively, but there’s currently no cure.

In general, psoriasis looks like patches of red skin with thick white scales when it’s on light to fair skin tones. When it develops in the genital area, the patches may be a brighter red, but you usually will not see the classic scales of psoriasis.

When it occurs within the folds of your skin, also known as inverse psoriasis, the color may be more of a reddish-white or reddish-gray. Your skin can become cracked and sore and may bleed. When it occurs in the skin folds, psoriasis can also look a lot like a yeast infection.

Psoriasis can look different depending on your skin tone.

On medium skin tones, psoriasis can appear salmon-colored with silvery-white scales. On darker skin tones, psoriasis could look violet with gray scales. Or, it can also appear dark brown and difficult to see. Psoriasis patches on Black skin may also be more widespread, which can make it difficult to distinguish from other conditions.

Learn more about what inverse psoriasis looks like.

The genitals are a sensitive area, so your skin is likely to be tender. Genital psoriasis can cause itching, burning, and discomfort. It can even become painful.

Many items can aggravate symptoms, including:

  • tight clothes
  • rough toilet paper
  • period products, such as pads or tampons
  • anything that rubs against your skin or causes friction, including sexual activity
  • using scented products, such as soaps or detergents

It can be hard to tell the difference between genital psoriasis, contact dermatitis, and some types of infection. Even if you have psoriasis, it’s not a given that a genital rash is due to psoriasis.

Learn more about the various causes of genital rash.

If your skin cracks, you’re more susceptible to bacterial or fungal infections. It’s possible to have both genital psoriasis and an infection at the same time. This may require a combination of treatments.

The skin around your genitals is delicate. If you develop a rash on or around your genitals, contact a doctor for a diagnosis before you try to treat it.

Treating the condition sooner rather than later will give you a better chance of finding relief.

The causes of genital psoriasis are the same as the causes of psoriasis elsewhere on the body. Although it is not clear what causes psoriasis, it’s generally believed that your immune system and genetics can play a role.

Other triggers of psoriasis may include:

  • stress
  • heavy alcohol consumption
  • infection
  • some medications
  • injury
  • smoking
  • humidity
  • certain foods

Genital psoriasis is not a sexually transmitted disease (STD). STDs, such as genital herpes, develop due to infection and are transmitted through vaginal, oral, and anal sex.

Psoriasis is an autoimmune skin disease, not an infection. You cannot get it through physical contact or by being near someone who has it.

The short answer is yes, if it feels good. It all depends on the severity of your flare-up and your personal preference. Genital psoriasis does not spread by sexual contact, nor does it affect fertility.

If you’re having a genital psoriasis flare-up, friction from sexual contact can feel painful and might worsen your symptoms. Ask a doctor if condoms or lubricants are advisable and which kinds are best. After having sex, gently clean and pat the area completely dry.

Natural remedies and flare-up prevention

If you notice a rash forming in your genital area, these tips may help keep your rash from getting worse:

  • Avoid personal hygiene products with fragrances or other harsh ingredients.
  • Keep the area clean.
  • After bathing or showering, use a soft towel and gently pat yourself dry.
  • Avoid rubbing.
  • Use soft, absorbent toilet paper.
  • Minimize friction by wearing cotton underwear or boxers, and avoid tight thongs.
  • Choose loose-fitting, breathable clothing.
  • Use very mild unscented soap — avoid antibacterial soap.
  • Keep your skin moisturized with an unscented cream to prevent chafing.

According to a 2017 survey, dietary changes may also help prevent flare-ups of genital psoriasis. These dietary changes include:

  • eating fresh fruits and vegetables
  • eating whole grains
  • eating fat-free or low fat dairy
  • reducing alcohol consumption
  • eating lean proteins, like salmon, poultry, shrimp, walnuts, and soybeans
  • avoiding trigger foods, like red meat and foods high in saturated fat
  • maintaining a moderate weight

Medical treatments

If a doctor confirms that you have genital psoriasis, there are a variety of treatments available. It may take some time to find the medication that works for you. Sometimes a combination of medications works best.

Be sure to consult with a doctor before using over-the-counter (OTC) or prescription medications on your genitals.

Topicals

Some OTC topical medications that may help treat psoriasis include:

  • creams
  • ointments
  • lotions
  • solutions
  • coal tar topicals

According to the National Psoriasis Foundation, two active OTC ingredients are approved by the Food and Drug Administration (FDA) to treat psoriasis. They are salicylic acid and coal tar.

Some OTC topicals may contain a mild corticosteroid.

Note

Other ingredients that are traditionally used to treat psoriasis are not usually recommended for genital psoriasis because they have the potential to irritate delicate skin. These ingredients include:

  • capsaicin
  • anthralin
  • topical vitamin A
  • retinoids

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Other treatments for genital psoriasis include:

Biologics and biosimilars

If your psoriasis has not responded well to other treatments, a doctor may consider biologics. Biologics are given by injection or infusion. Some of these are:

  • certolizumab pegol (Cimzia)
  • etanercept (Enbrel)
  • adalimumab (Humira)
  • infliximab (Remicade)
  • ustekinumab (Stelara)
  • secukinumab (Cosentyx)
  • brodalumab (Siliq)
  • ixekizumab (Taltz)
  • tildrakizumab-asmn (Ilumya)
  • risankizumab-rzaa (Skyrizi)
  • guselkumab (Tremfya)

A biosimilar is similar to the biologic drug it references. It’s not an exact replica, but there are no meaningful differences in safety or effectiveness.

Research on treating genital psoriasis with biosimilars is limited. The following are some biosimilars used to treat psoriasis:

Biosimilars to adalimumab (Humira)

  • adalimumab-adaz (Hyrimoz)
  • adalimumab-adbm (Cyltezo)
  • adalimumab-afzb (Abrilada)
  • adalimumab-atto (Amjevita)
  • adalimumab-bwwd (Hadlima)
  • adalimumab-fkjp (Hulio)

Biosimilars to etanercept (Enbrel)

  • etanercept-szzs (Erelzi)
  • etanercept-ykro (Eticovo)

Biosimilars to infliximab (Remicade)

  • infliximab-abda (Renflexis)
  • infliximab-axxq (Avsola)
  • infliximab-dyyb (Inflectra)
  • infliximab-qbtx (Ixifi)

Most of the time, a doctor can make a diagnosis just by looking at your skin. Sometimes, further testing may be needed to rule out bacterial or fungal infections.

A doctor may recommend taking a biopsy if they’re unsure of your diagnosis from a physical exam alone.

While there is currently no cure for psoriasis, it can be managed with treatments and lifestyle changes.

Speak with a doctor if you think you may have genital psoriasis. They can guide you through the diagnosis and treatment process.