The social stigma of psoriasis isn’t what it used to be. Celebrities with this inflammatory skin condition have stepped up to become much more vocal about how psoriasis affects them, and, in turn, more people understand that psoriasis isn’t contagious or something to be feared. What’s not so readily talked about is the fact that psoriasis can affect more than the skin that’s visible to others—yes, we’re talking about the genitals.
Research suggests 63% of people with psoriasis will have symptoms on and around their genital area during their lifetime, according to a 2018 study published in the journal Dermatologic Therapy.1 There is also a small percentage of people with psoriasis who see plaques only on their genitals. Genital psoriasis (sometimes called penile psoriasis, vaginal psoriasis, or vulvar psoriasis) can occur in any age group. It can also affect any skin type and skin color.
Despite all of this, some people continue to have huge misgivings about discussing genital psoriasis, even feeling hesitant about showing it to their dermatologist. But, it’s really important that you do if this is something that affects you. From the physical side of things to the mental side, this condition can have a huge impact on your self-esteem and your relationships. Here’s everything you should know.
What is psoriasis in general?
Psoriasis is a chronic skin condition that impacts at least 8 million people in the United States alone, according to the National Psoriasis Foundation. When you have psoriasis, your immune system speeds up your body’s production of skin cells. This leads to a buildup of dead cells on your skin’s surface, and that buildup turns into red, gray, or purple plaques that may burn or itch. How psoriasis looks depends on your skin tone, with lesions appearing red, pink, or salmon-colored on lighter skin tones, and purple or gray-ish on darker skin tones.
These areas, also called plaques, often show up on your scalp, elbows, and knees, but they can appear pretty much anywhere on your body. Plaques are typically described as “scaly,” meaning that they feel hard to the touch and peel away from the skin.
Psoriasis flares are driven by inflammation that’s happening in your body. That means that while plaques are the most visible symptom of psoriasis, they certainly aren’t the only symptom. Psoriasis is linked to other inflammatory conditions, including psoriatic arthritis, according to a 2015 study published in the journal Anais Brasilieros de Dermatologia.2
The severity of psoriasis is often assessed according to how much of your body area is covered with plaques. You can have what’s considered “mild to moderate” psoriasis but still feel like your symptoms have a serious impact on you. The clinical diagnosis of your psoriasis and how much it affects you are two different things. That’s why it’s important to consider the mental health aspects of having psoriasis. According to an older study published in the journal Health and Quality of Life Outcomes, 75% of people with psoriasis say that the condition has had a moderate to large negative impact on their life, including interfering with daily activities.3
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What types of psoriasis can affect the genitals?
There are several different types of psoriasis, and the categorization is based on how the plaques appear on your skin. All of them can affect the nether regions, however, inverse psoriasis and plaque psoriasis are the two types most likely to impact the genital area, Marisa Garshick, MD, a board-certified dermatologist based in Manhattan and assistant clinical professor of dermatology at New York Presbyterian Weill Cornell Medical Center, tells SELF.
Inverse psoriasis takes the form of inflamed, smooth plaques in the folds of your skin. This type of psoriasis can be found in areas where your skin rubs together, like under your arms and under your breasts. Inverse psoriasis often shows up in genital areas like the folds between your groin and inner thigh, according to a 2019 study published in the journal Clinical, Cosmetic, and Investigational Dermatology.4
Plaque psoriasis patches are dry, raised, and typically reddish, purple, or gray.5 When plaque psoriasis does affect the genitals, it may not have the same extensive scaling seen on plaques elsewhere on the body, Dr. Garshick says. For this reason, a skin biopsy—in which tissue is taken from the area and examined in the lab—may be necessary to determine whether it’s psoriasis or something else.