Do you have a skin problem in your private area? Let's learn about Genital Psoriasis?

Have you ever had a problem with your private area, that is, some areas around your genitals that are sometimes red, itchy, and sometimes painful? This is something that many people find embarrassing and difficult to talk about. But this is a condition called Genital Psoriasis . It is just like other psoriasis, but the location is different. Let's talk about this in a little more detail and in a friendly way today.

What is Genital Psoriasis? Simply put...

Simply put, genital psoriasis is a skin condition that affects the skin on or around your genitals . It's a condition that belongs to the larger category of psoriasis. What happens is this: Our body's immune system suddenly goes into overdrive, telling your own healthy skin cells to "grow new ones, fast!" That's when the problem begins.

This causes painful, smooth or sometimes scaly, discolored (red, pink, purple or dark brown) and itchy patches of skin. There is a slight difference from psoriasis in other areas; that is, these patches in the genital area are usually moist , rather than dry, scaly like in other areas. But the cause is the same.

This is also called:

• Vulvar psoriasis occurs when it affects the vulva of women.
• Vaginal psoriasis is a condition that affects the vagina.
• The condition affecting the penis in men is called ``Penile psoriasis.''

Who gets this? How common is it?

Genital psoriasis usually occurs in people who have psoriasis . This means that it doesn't matter if you are a man, a woman, or a child, anyone can get it.

Just think, in some countries of the world, more than 3% of the population is said to have psoriasis. Also, more than half of those with psoriasis experience symptoms in these genital areas at some point in their lives. So this is not something that is unheard of. A significant number of people with psoriasis in Sri Lanka may have this experience.

Are there types of genital psoriasis?

Yes, there are several types of psoriasis that can affect the genital area. The most common types are:

• Plaque psoriasis: This is the most common type. It causes red, slightly raised patches of skin with a silvery, scaly layer.
• Inverse psoriasis: This is most common in areas where the skin rubs together, such as the armpits, groin, under the breasts, and genitals. The skin is smooth, red, and shiny. There is less scaling.
• Pustular psoriasis: This is characterized by small, white, pus-filled blisters on the skin. These appear on reddened skin.
• Guttate psoriasis: This is characterized by small, red, water-drop-like patches that appear all over the body, sometimes in the genital area. It often begins after a sore throat infection.

What is the difference between Genital Psoriasis and Eczema?

This is something that many people get confused about. Both psoriasis and eczema are skin conditions that can affect the skin in the genital area. However, there are some slight differences:

• Psoriasis: Usually appears as smooth (sometimes scaly), moist, discolored patches.
• Eczema: It often presents as dry, rough, blister-like, discolored, and intensely itchy lesions.

Although psoriasis can also cause itching, eczema is usually more itchy.

What are the symptoms? How do you feel?

Okay, now let's see what symptoms a person with Genital Psoriasis exhibits:

• It may look like a thin patch of skin.
• A change in skin color (often from pink to red, purple, or dark brown).
• Smooth, shiny spots or spots with silvery coral .
• The skin may be streaked .
• Itchy skin.
• You may feel pain or discomfort .
• Depending on the location of the genital area, the skin may be dry or moist .

Usually, when we think of psoriasis, we think of a skin condition that looks like scales. However, these scales are not always seen in the genital area. This is because the dead skin cell layer is removed due to clothing or skin rubbing against each other (`friction`). Therefore, sometimes a smooth, shiny appearance is seen.

Where do these characteristics primarily affect?

As the name suggests, genital psoriasis affects your genital region. This means:

• The skin above your genitals (pubis).
• In women, the area around the mouth of the vagina (`vulva`) is called the vulva.
• In men, the skin around the penis or scrotum.

Can blisters occur?

Yes, sometimes this condition can be accompanied by blisters. It's called pustular psoriasis . It causes painful, pus-filled blisters on the skin. It's not contagious , but it can resemble the symptoms of sexually transmitted infections (STIs), so it's best to see a doctor right away if you notice anything like this.

Why does genital psoriasis occur?

As I mentioned before, this is actually an autoimmune condition / overactive immune system . To be precise, our skin cells start to regenerate much faster than they should. This is when old cells die and accumulate, which causes these symptoms, which is inflammation and a layer of dead cells on the surface of the skin.

The exact cause of this is not yet clear. However, it is believed that there may be a genetic factor . This means that if someone in your family has psoriasis, you may also be at risk of developing it.

What are the triggers?

There are certain things that can suddenly make genital psoriasis worse, or "flare up." We call them 'triggers.' For example:

• Increased growth of yeast infections: especially a type of yeast called Candida albicans.
• A skin wound or scratch: Even a small wound is enough.
• Friction from wearing tight clothing or during sex: This can further injure the skin.
• Some allergens or irritants .

Is this contagious? Is it sexually transmitted?

This is something that is very important to remember: Genital Psoriasis is not a contagious disease at all!

A person with this condition cannot spread it to another person through touch or sexual intercourse. So don't be alarmed. During sex, the skin may be slightly more damaged and the symptoms may worsen, but this does not spread it to the other person . This is not a sexually transmitted infection (STI).

How does a doctor recognize this?

A doctor will usually diagnose genital psoriasis by looking at your symptoms and doing a physical exam. In most cases, it can be diagnosed by the appearance of the symptoms.

However, sometimes, if the symptoms are similar to those of another skin condition, a skin biopsy may be needed to confirm the diagnosis. It is best to see a dermatologist for a proper diagnosis and treatment.

How is this treated? Can it be cured?

Because the skin in the genital area is very sensitive, some medications used on other parts of the body may not work. Because the skin is thin, harsh medications cannot be used. Therefore, your doctor will choose a gentle treatment that is right for you. Some of the main treatments used for this are:

• Topical medications:
• Mild corticosteroid creams or ointments.
• Creams containing `coal tar` (these have a slight scent, some people may not like them).
• Calcipotriene cream (made from vitamin D).
• Pimecrolimus cream.
• Tacrolimus ointment.
• `Topinarof` cream.
• `Roflumilast` cream.

• For severe cases:
• Sometimes, if the disease is severe, oral medications (e.g., Cyclosporine, Methotrexate) or special vaccines (Biologics) may be given.

The most important thing is that what works for one person may not work for another. Therefore, you should take treatment as directed by a doctor. Before starting a new medication, talk to your doctor about its side effects and whether it will interact with other medications you are currently taking.

How quickly will I feel better after treatment?

How long it takes to feel better after starting treatment varies from person to person. Sometimes symptoms subside within a few weeks or months . However, psoriasis is a chronic condition that is difficult to completely cure and can last a lifetime . Therefore, it can recur even after treatment.

To heal quickly, it is very important to use the medication prescribed by the doctor correctly, stay away from triggers, and keep the skin clean.

What should someone with genital psoriasis expect?

It is common for people with psoriasis to experience symptoms in this genital area. There is treatment for it, so don't worry. But you should understand that this is a temporary condition that can recur. It may take a few days or weeks for the symptoms to subside with treatment.

Some people may feel very uncomfortable, embarrassed, and have a low confidence level about their appearance, especially during sexual intercourse. This is very normal.

If you are having such a problem, talking to a mental health professional can be a great relief. It is not something to be ashamed of.

Can you have sex with genital psoriasis?

This is also a problem for many people. Yes, a person with genital psoriasis can have sex. Remember, it is not contagious. However, it is good to be aware of these things when you have symptoms:

• Talk to your partner: Explain to them that this is not contagious. If you feel any pain or discomfort during sex, tell them. It is very important to talk openly.
• Reduce skin-to-skin friction: If you don't have a lubricant, use lubricated condoms. Skin-friendly, "cooling" lubricants are better than "warming" ones, which can further irritate the skin and worsen symptoms.
• Clean your skin after sex: Wash with lukewarm water and a mild, unscented soap/cleanser, dry thoroughly, and apply a cream prescribed by your doctor, if available.

How can this be prevented or reduced?

There is no way to completely prevent psoriasis from developing. However, there are things you can do to reduce the frequency of flare-ups of genital psoriasis:

• Use a mild, fragrance-free soap or cleanser to cleanse your skin daily. Avoid harsh soaps.
• Apply a moisturizer daily, as soon as your skin feels dry. Choose a gentle, unscented moisturizer.
• Use soft toilet paper to clean the private area after using the toilet. Do not rub vigorously.
• Wear loose, non-constricting clothing . Clothes made from natural fabrics like cotton are best. Avoid wearing tight underwear.

When should I see a doctor?

In this case, you should definitely see a doctor, especially a dermatologist:

• If your symptoms get worse .
• If there is severe pain, itching, or discomfort .
• If you feel pain when going to the bathroom or having sex .
• If you see blister-like things coming out (it could be `Pustular psoriasis`).

The best thing to do is to show it to a doctor without being ashamed or hiding the problem.

What questions should you ask the doctor?

When you see a doctor, don't forget to ask questions like these:

• Can I have sex if I have genital psoriasis? Are there any special instructions?
• How many times a day should I apply these topical medications? How long should I apply them?
• What are the side effects of this medicine?
• What kind of moisturizer do you recommend? What kind of soap?
• What else can I do to reduce the chance of this happening again?

Finally, the most important thing (Take-Home Message)

Okay, so, let me ask you to remember some of the most important things we've talked about.

Genital psoriasis is a common symptom of psoriasis that can occur in the genital area. Even if you feel embarrassed or embarrassed to talk about it, it is very important to talk to a doctor about it . Because there are treatments for it, and you can reduce the discomfort you feel.

The most important thing is that this is not a contagious disease. So you can have normal sexual intercourse with your partner. However, it is better to be a little careful not to break the skin during sexual intercourse.

I hope this information is helpful to you. Remember, you are not alone. You can get help with these kinds of problems.

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