Treatment tips
Genital psoriasis can be difficult and frustrating to treat because of the nature of the affected skin. However, by keeping up with the treatment regimen recommended by your doctor, you may find relief and clear your psoriasis. Genital psoriasis usually responds well to various topical treatments; however, caution should be taken due to the sensitive nature of the skin in this area. It is important to remember that response times to treatments vary among individuals. You may want to make a follow-up appointment with your doctor so he or she can evaluate your response to the treatment and make necessary changes or modifications.
Protopic and Elidel
Protopic and Elidel are two topical immunosuppressant prescription drugs that are approved for treating eczema. These drugs can be effective for treating genital psoriasis. Both of these drugs reduce skin inflammation much as topical steroids do, but they do not cause thinning of the skin. They may, however, cause some irritation when they are first used. These products also do not promote yeast or bacterial growth, which may further help with inflammation and itching.
Ultraviolet (UV) light
UV light can be used to treat some genital psoriasis, but only in special circumstances and in doses much lower than are normally used to treat psoriasis on other areas of the body. Overexposure to UV light can burn the skin. There is an increased risk of burning genital skin because it is thin. UV exposure and burning may also increase the risk of developing skin cancer.
Psoriasis in the pubic area may respond well to UV light treatment if the pubic hair is cut short or shaved.
For psoriasis in the crease between the thigh and the groin, a doctor may prescribe UV light treatment. Individuals must position themselves carefully to adequately expose the skin in the creases to the light.
The American Academy of Dermatology (AAD), the nation's largest professional organization of dermatologists, recommends that male patients undergoing any kind of ultraviolet light therapy protect the penis and the scrotum. Studies indicate that skin on the male genitals should not be exposed to UV radiation, particularly PUVA (the light-sensitizing drug psoralen plus UVA light), because of the possibility of an increased risk of skin cancer. Men should wear briefs or athletic supporters to protect their genitals while sunbathing or receiving UV light treatment on other parts of the body.
 More information about using UV light as a treatment for psoriasis
Dovonex
Dovonex, a prescription topical and synthetic form of vitamin D3, is not generally recommended for use on the genitals because of the potential for irritation. However, some doctors recommend cautious use of Dovonex on genital skin, because it does not have any of the drawbacks of topical steroids. Mixing Dovonex with petroleum jelly may minimize irritation. Other doctors have recommended rotating the use of Dovonex with a low-strength steroid on alternating nights. Using the cream version of Dovonex may be less irritating than its ointment formulation.
More information about Dovonex
Tazorac
Tazorac, a prescription topical vitamin A derivative, is not recommended by its manufacturer for use on the genitals because of the potential for irritation. And it should be used carefully and sparingly in skin-fold areas. However, on occasion it is used cautiously for genital psoriasis, under a doctor's supervision. An alternating regimen of Tazorac (usually 0.05% strength) and a low-strength topical steroid has been suggested by some doctors. Using the cream formulation of Tazorac may be less irritating than Tazorac gel.
Patients should wash their hands carefully after applying Tazorac to avoid transferring it inadvertently to other areas of sensitive skin.
More information on Tazorac
Steroids
Only low-strength topical steroid preparations should be used in the genital area. Skin in the genital area tends to be more sensitive and thin, and steroids should be used only with careful direction from your doctor. Prolonged use of topical steroids can permanently thin the skin and cause stretch marks. Furthermore, psoriasis may become resistant to clearing with continuous long-term use of steroids. They should be used with caution due to their potential to cause irreversible damage to the skin. Since the genital area can be warm and moist, this can lead to increased steroid absorption, which can increase the likelihood of the steroid's negative side effects.
More information about steroids
Over-the-counter (OTC) moisturizers
It is also important when treating genital psoriasis to keep the skin in the affected areas continuously moisturized. Caution should be taken, as ingredients in some topicals may be irritating to the genital area's sensitive skin. Moisturizers with fragrance and perfumes may be especially irritating.
If you read the labels of various moisturizers, you will find most moisturizers contain a combination of the same general ingredients. They may, however, differ in consistency. Facial moisturizers tend to be thin, while hand moisturizers tend to be thick, and body moisturizers fall somewhere in between. The most important thing is to find a moisturizer that provides the skin with the moisture it needs.
Updated June 2004
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