Health & Medicine

Drs. Oz and Roizen: Psoriasis can occur ‘down there’

Q: I’m dating a great guy and he knows I have psoriasis, but recently I had a flare-up and it was, well, genital.

Pamela A., Bristol, Connecticut

A: First of all, psoriasis in the genital area needs to be properly and quickly diagnosed, so get over to your dermatologist pronto and have him or her take a good look at what’s going on down there.

Psoriasis affects up to 8.5 million people in the U.S., and about a third have or will have to deal with flare-ups in the genital area; women and men are affected equally.

The most common kind of psoriasis is called plaque psoriasis, and usually affects the elbows, knees and scalp. Genital psoriasis is referred to as “inverse psoriasis,” or “IP”; you can have both types at the same time. Inverse psoriasis causes very red, smooth, shiny lesions in body folds in areas such as the groin and genitals.

If you get a confirmed diagnosis for IP, you’ll probably be prescribed a corticosteroid for limited use. Follow your doc’s directions exactly. Sometimes doctors suggest phototherapy or even off-label use of medications for eczema, such as pimecrolimus or tacrolimus. When IP is severe, you might need systemic medications, so discuss all options with your dermatologist.

Now, about your relationship. Let your partner know that genital psoriasis is not contagious. It usually affects only the outer skin of the vagina (not mucous membranes) and generally does not cause sexual dysfunction. You might have to modify your intimate activities, but handling this together can help you build a more trusting relationship.

Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic.