For many of us, a doctor’s visit is right up there with taking the trash out on a cold, rainy night or sitting through your child’s favorite animated movie for the thousandth time. The waiting room is a drag, those paper gowns are never fun, and bringing up issues involving a sensitive area may make you feel uncomfortable or self-conscious.
This is especially true when it comes to psoriasis in the genital area. Just as psoriasis can appear on your elbows, hands and scalp, psoriasis pops up around the genitals, pubis, buttocks and upper thighs around 24 percent of the time.
Sometimes called inverse psoriasis, if it appears in the folds of the skin, the lesions characterized in genital psoriasis typically involve small, red round plaques. Genital psoriasis brings the same symptoms as non-genital psoriasis: itchiness, burning, pain and worsening lesions due to external triggers.
Treatments for genital psoriasis, like other types of psoriasis, include low-potency topical steroids for mild to moderate cases and systemics and biologics for more extreme cases. You can get genital psoriasis under control with proper treatment and careful monitoring. The biggest hurdle may be a reluctance to seek medical advice.
Speak Up (Even If You’re Embarrassed)
According to an August 2017 study published in the Journal of Drugs in Dermatology, 45.8 percent of psoriasis patients did not discuss their genital psoriasis with a health care provider. The top reason: embarrassment.
Dermatologist Abby S. Van Voorhees, M.D., chair emeritus of the NPF medical board and a co-author of the study, says that physicians have a hard time treating something they don’t know about – or can’t examine – due to a patient’s inability to speak up.
“I’ll ask patients if they have any psoriasis on the genitalia or on the rectum and then they will look at me a little sheepishly and say, ‘Actually, I do.’ I then say, ‘May I see it?’ They then usually hesitate and ask, ‘Well, do I really have to? I’m embarrassed.’ ”
Van Voorhees, professor and chair of dermatology at Eastern Virginia Medical School in Norfolk, says she often must convince patients that she does need to see their genital psoriasis so that she can properly diagnose it and prescribe the appropriate treatment.