Skin in your genital area is thinner and more tender than skin in other parts of your body. So some common psoriasis treatments may be too strong for those sensitive places. But you still have many choices for relief.
For example, your doctor may prescribe a low dose of strong medicine for a short time.
Tell your doctor if your treatment isn’t working, your skin burns or stings when you put something on it, or you get an infection.
Even if you’re doing fine, it’s important to check in with your doctor from time to time. Some treatments for genital psoriasis shouldn’t be used long-term.
For your genital psoriasis, only use the medicine your doctor prescribes. You may need to try different treatments before you find the right one. This can take some time. Keep in mind that creams and ointments need a few weeks to start working.
You may try:
Low-dose steroid cream: Doctors often prescribe this first because it’s one of the best treatments for psoriasis. But you have to use steroids with care. Thin skin absorbs medicine easier, so you're more likely to have side effects. Steroid cream can also make your skin even thinner and cause stretch marks and broken blood vessels if you use it too long.
Your doctor will probably prescribe a low-dose steroid cream for a very short time or to treat a flare.
Mild vitamin D creams: These have fewer long-term side effects than steroids, and you can use them longer. Sometimes they’re mixed with a mild steroid so they’re less irritating. Not all vitamin D creams are good for sensitive skin, so only use the one your doctor prescribes.
Calcineurin inhibitors: One is an ointment, tacrolimus (Protopic) and the other is a cream, pimecrolimus (Elidel). Normally, these treat skin problems like eczema. But they can also work for genital psoriasis.
These medicines don’t contain steroids, so they’re safe to use on your penis and vagina. You might have some stinging and burning when you first put them on.
Dapsone (Aczone): Doctors use this antibiotic gel to treat acne and leprosy. Your doctor may try it for psoriasis if other treatments haven’t worked. It can cause anemia and other side effects, so you need to have blood and liver tests every so often while you use it.
Moisturizer: This is a key part of daily care for psoriasis on your whole body, including sensitive areas. A lighter texture is better for delicate skin. So use cleansing milks or balms instead of soap to wash your face and body. And be sure to choose ones that are fragrance- and alcohol-free.
Systemic medicines: These are different types of strong medications that can affect your whole body, not just your skin. You take some of them as a pill. Others are given as a shot or an IV. Your doctor may prescribe them if your psoriasis is very severe or makes it hard to live a normal life. They include:
- Retinoids, which are made from vitamin A and affect the way your skin cells grow and go away.
- Methotrexate, which slows the growth of skin cells by powering down your immune system.
- Cyclosporine slows your immune system as well. You’ll take this by mouth when other treatments haven’t worked.
- Apremilast (Otezla), a medicine that comes in pill form and slows reactions that lead to inflammation.
- Biologics, which target specific parts of your immune system. They block cells or proteins that help cause psoriasis. They’re injectable; some you’ll give yourself, and others you’ll get by IV. Examples include:
- Adalimumab (Humira)
- Brodalumab (Siliq)
- Certolizumab pegol (Cimzia)
- Etanercept (Enbrel)
- Guselkumab (Tremfya)
- Ixekizumab (Taltz)
- Infliximab (Remicade)
- Secukinumab (Cosentyx)
- Tildrakizumab-asmn (Ilumya)
- Ustekinumab (Stelara)
Of course, talk with your doctor about which treatment may be best for you.