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How to Handle Psoriasis in Sensitive Areas

Reviewed by Neha Pathak, MD on November 03, 2020

Your skin is thinner and more sensitive in some places, like your face, genitals, and the skin folds under your breasts and buttocks and in your groin. Psoriasis flares here can be more embarrassing, painful, and harder to treat.

Some common ways to deal with psoriasis -- like managing your stress, not smoking, putting on moisturizer after a shower or bath, and getting plenty of rest -- are good for these areas, too. But others are too harsh for tender skin.

You'll need to consider where your patches are when you make decisions about what to do. Keep these things in mind to protect your sensitive skin and make living with your psoriasis easier.

Treatments

Work closely with your doctor to find a way to control your symptoms. Let them know if anything you put on your skin burns or stings, or if you get an infection.

Low-dose steroid cream. Doctors often prescribe it first because it's one of the best treatments. When you have an infection, the medicine to treat it might be mixed with a steroid. But you have to use steroids with care.

Continued

Thin skin absorbs medicine more easily, so you're more likely to have side effects. A steroid cream can also make your skin even thinner and cause stretch marks or broken blood vessels if you use it too long.

Your doctor will likely prescribe a low-dose steroid cream for a short time.

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 to make them less irritating. Only use the one your doctor prescribes, since not all vitamin D creams work well for sensitive skin.

Light treatments (phototherapy). UVB rays in sunlight slow the growth of skin cells and help many kinds of psoriasis. Artificial UVB light works on most parts of the body, but not your genitals.

Infection Prevention for PsoriasisCracks in your skin can invite bacteria in, but there are several ways to prevent infection and keep the area clean.152

[MUSIC PLAYING]

PURVISHA PATEL: In psoriasis,

there's a hyper-proliferation

of the keratinocytes,

or the uppermost layer of cells

in the skin.

And when the skin gets heaped

upon itself and it's not

shedding-- or it is shedding,

but it's turning over so fast--

you can get cracks

in the surface of the skin,

just like you would see cracks

in something dry,

like a dry pavement.

It cracks open.

These cracks in the skin

also make you more

susceptible to infection,

because our blood cells are

exposed.

And also, we have little wounds

on the surface of the skin.

So bacteria and organisms have

more of a chance of going

into the skin

and creating skin infections.



Here is where we use

the topical medications,

or the keratolytics.

Keratolytics are medications

or topical ointments

and salves that we use

to actually break down

the heaping of keratinocytes,

or cells, on the top

of the skin.

And that sloughing can stop

the cliff-like surface of cells

that are cracking,

and also helps smooth the skin.



Staying moisturized is very

important as well, extremely

important when we have

micro-cracks in the skin,

because it kind of smooths

the surface of the skin

and fills in all the cracks

so that there's less

inflammation,

but also less chance

of microorganisms coming

in and creating infection.



Another step in preventing skin

infections would be to maintain

good hygiene.

I know we're washing our hands

more now, but it would be

important to wash our bodies.

When you do take

too-hot showers,

that can be

detrimental to your psoriasis,

because hot water evaporates

faster from the surface

of the skin

and can actually cause the skin

or the psoriasis plaques

to dry out.

So taking lukewarm showers

would be important,

and moisturizing afterwards

and using

your dermatologist-prescribed

medications.



It is important, though, to not

wear too-tight fitting clothing,

because it can lead to more

irritation or maceration

of the skin.

There is a condition called

inverse psoriasis, where people

get psoriasis in their armpits

or in their genital area.

And when it is in a warm moist

environment, that can lead

to increased risk of skin

infection.

Purvisha Patel, MD <br>Dermatologist, Advanced Dermatology & Skin Cancer Associates/delivery/aws/a8/35/a8351cb8-7a27-48aa-80af-810779cfa541/091e9c5e82076145_funded-expert-feature-psoriasis-infection-prevention_,4500k,2500k,1000k,750k,400k,.mp411/20/2020 12:00:0018001200funded expert psoriasis infection prevention/webmd/consumer_assets/site_images/article_thumbnails/video/funded_expert_psoriasis_infection_prevention_video/1800x1200_funded_expert_psoriasis_infection_prevention_video.jpg091e9c5e82076145

Skin Care

Moisturize. 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. Go fragrance- and alcohol-free.

Continued

Ceramides, lipids, and hyaluronic acid will help replace the natural moisturizers in your skin. Some people swear by oils like olive, coconut, and jojoba, too.

Go soapless. Use natural cleansing milks, oils, or balms to wash your face and body instead of soap. If you do use soap, choose one without deodorant.

Baby your skin. Creases and folds in your skin can get warm and damp, making them more prone to infection. Dust baby powder or baking soda under your breasts and in your groin to help skin stay cool and dry.

Peeling creams. The best products to soften and remove scales have salicylic acid, lactic acid, urea, or phenol. Some over-the counter (OTC) peels may be too strong, so check with your doctor before you use them.

Avoid peels on cracked or bleeding skin. Use an OTC antibiotic that you put on the area to help heal it.

On and Around Your Face

A light foundation makeup is often all you need. Even when you're trying to cover severe psoriasis, choose a formula specifically meant for your face. Pick something that's not too slippery, so it sticks to your skin, but not so dry that it makes flakes worse. Match your normal skin tone; don't go darker or lighter. You may have better luck finding items at a beauty products store.

Continued

It might be worth it to have a makeup artist give you some tips about what things to use and how to apply them. For example, many professionals recommend using a primer after your moisturizer and before your foundation to help even out your skin.

Since your hair can touch your face and neck, your styling products could be causing irritation. Look for fragrance- and alcohol-free ones. Products with fewer ingredients, that are natural rather than chemical, are safer.

Clothing

Wear loose-fitting clothes and underwear, like boxers or boy shorts. Tight clothes rub on sensitive skin and can make symptoms flare.

Choose natural fabrics. Clothes made from cotton or silk are kinder to your skin than synthetics. Avoid scratchy wool.

Change your clothes right after exercise so sweat doesn't stay close to your skin and irritate it. Although it may sound like a good idea, workout gear made of "moisture-wicking" fabrics might stick to affected skin.

In the Bedroom

Sometimes, especially to the untrained eye, genital psoriasis can look like an STD. Assure your partner that your skin rash isn't contagious.

Use non-latex condoms to avoid problems with psoriasis treatments that make latex condoms less effective. You can find them in most supermarkets and pharmacies.

Lubricants can make sex more enjoyable for both men and women. Clean your genital area afterward, and apply more medication if you need to.

Let your partner know when it's not comfortable to have sex, but don't shut them out. Tell them where you do want to be touched and what feels good to you.

Lose Weight

Extra pounds can create more skin folds where psoriasis could show up. When you're heavy, you're also more likely to sweat, which can make your symptoms worse.

Losing a few pounds may make a big difference to your comfort and the health of your skin.

WebMD Medical Reference

Sources

SOURCES:

National Psoriasis Foundation.

Psoriasis and Psoriatic Arthritis Alliance: "Psoriasis and Sensitive Areas."

Psoriasis Association (UK): "Psoriasis in Sensitive Areas."

Guglielmetti, A. Dermatology and Therapy, December 2012.

New York Times: "Weight Loss May Ease Psoriasis," May 30, 2013.

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