Psoriasis is a common, chronic skin disease that affects up to 5% of people around the world. But while most people are familiar with the red, angry-looking patches associated with psoriasis (plaques), you may not know that between 7% and 40% of people with the condition can also have severe psoriasis in intimate areas like the genitals. The most common type is called inverse psoriasis. Inverse psoriasis is usually found where skin meets skin. Genital psoriasis can be painful, yet embarrassment may cause a delay in diagnosis. Recognizing genital psoriasis allows you to seek treatment and reduce the discomfort. Where Genital Psoriasis Develops Genital psoriasis can appear anywhere in the genital area. Like psoriasis on other parts of the body, the patches can come and go. Unlike the most common type of psoriasis, though, the spots affected by genital psoriasis are generally smooth, red and dry, without the scaly appearance. Genital psoriasis symptoms can occur in these areas: Creases between the thigh and groin, and upper thighs Crease between the buttocks Pubis, the area just above the genitals Vulva Outer skin of the vagina Glans or shaft of the penis Anus Genital psoriasis may also cause psychological distress. It is not contagious, but it may cause concern to sexual partners if they don’t understand the condition. Genital Psoriasis Symptoms The symptoms of genital psoriasis are different from the more common plaque psoriasis. They may include: Deep red patches and rashes in the folds Sharp borders along the rash Shiny and smooth appearance Area moist to touch Area painful to touch Diagnosing Genital Psoriasis Getting a genital psoriasis diagnosis may be difficult at first because the rash or patch can be confused with other types of genital rashes, such as contact dermatitis or fungal infections. However, most people with genital psoriasis also have a history of psoriasis elsewhere on their body. It’s important you speak with your doctor about your concerns if you have any signs of genital psoriasis so you can begin treatment. Since your genitals tend to be moist and there can be irritation, it may be easier for infections to occur. Your doctor may make a diagnosis based your history and a physical examination, although a swab of the site may be sent for testing to rule out other diagnoses. The skin in the genital area is thinner and more delicate than elsewhere on the body, so even if you are already using treatment to treat psoriasis elsewhere, you may be given a different treatment for the genital area. For example, some steroids used for plaque psoriasis are too strong to treat genital psoriasis, as are other medications, such as coal tar. For more severe cases of genital psoriasis, your doctor may prescribe an oral or injectable medication, like a biologic; biologics are drugs derived from living organisms that target the root cause of psoriasis inflammation in order to reduce symptoms. It can be uncomfortable speaking with your doctor about rashes in your genital area. However, the best way to get proper treatment is to be open and honest, discussing the problem and explaining the impact it is having on your life.