Psoriasis is a chronic skin condition that occurs when your body produces too many skin cells too rapidly. The thick, scaly, red patches of psoriasis are often found on exposed areas of the body, like your knees and elbows. However, studies suggest that more than a third of people with psoriasis will also develop lesions on their genitals at some point during the course of their disease. Inverse psoriasis is the most common type of genital psoriasis. It appears in the folds of your skin, like the groin or between the buttocks, and may look more smooth than scaly. But before you reach for your tube of corticosteroid cream, here are some important things you should know about treating genital psoriasis. Understanding Topicals Topical treatments for psoriasis are often the first to be prescribed by your doctor to help decrease inflammation and soothe the affected areas. But topicals are different for genital psoriasis because the skin in your genital area is thin and sensitive. Since it’s covered by clothing, topical treatments are also absorbed more easily, making them even more potent. For these reasons, lower-strength and extra gentle treatments should be used. Your doctor may order a low-dose corticosteroid cream for your genital psoriasis to avoid complications like thinning of the skin. Ultraviolet Light Treatment with ultraviolet (UV) light, also called phototherapy, has been effectively used for psoriasis for many years. It isn’t commonly used for genital psoriasis, but in some cases, your doctor may consider you a candidate. When used for genital psoriasis, the UV light will be delivered at a lower dose than for other areas of the body. Talk to your doctor about continuing any other treatments during therapy. Some treatments may increase your risk for developing skin cancer and should not be used at the same time as UV light therapy. Oral Medications Researchers think psoriasis is caused by an overactive immune system response, leading to increased inflammation within your skin cells. Some oral medications have been developed to combat this inflammation and relieve uncomfortable symptoms. If your genital psoriasis isn’t responding to topical treatments, your doctor may suggest taking an oral medication. This is a type of systemic treatment, meaning the medication travels through your bloodstream to act on the cells throughout your body. Examples include: Methotrexate (Trexall): This medication suppresses your entire immune system with the goal of improving inflammation associated with your psoriasis in the process. Cyclosporine (Sandimmune): Like methotrexate, this medication suppresses immune system activity to reduce inflammation. Apremilast (Otezla): This newer medication blocks an enzyme in your cells that controls inflammation. Acitretin (Soriatane): This is an oral form of vitamin A. It’s believed to slow down the development of the cells involved with psoriasis. Since these medications can affect your immune system, be sure to ask your doctor about the risks involved, including infection risk and potential damage to your organs. Biologics Newer medications known as biologics are created from living organisms. Given by injection or an infusion into your vein, biologics block certain proteins and cells known to cause the inflammation that leads to psoriasis symptoms. Ixekizumab (Taltz) is a biologic that has been specifically approved as a treatment for genital psoriasis, but many other biologic medications are also available to treat moderate-to-severe psoriasis all over the body. These include ustekinumab (Stelara), guselkumab (Tremfya), secukinumab (Cosentyx), etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), and abatacept (Orencia). Just like some of the oral medications, biologics can alter the way your immune system works, so talk to your doctor about how to recognize signs and symptoms of infection and other serious side effects of the medication. Some people are uncomfortable bringing up the topic of genital psoriasis to their doctor, and on the flip side, some doctors don’t always ask if their patients have psoriasis in their genital area. But don’t do yourself a disservice by ignoring it. There are many treatment options to explore.