Male genital psoriasis does not have the typical appearance of thick scaly plaques that are seen in other psoriasis prone areas on the body. Genital psoriasis appears as bright red, shiny patches with no scale because friction between skin surfaces in the groin areas rubs off the scales. Psoriasis redness (erythema) occurs because the blood vessels within the skin layers are more dilated due to inflammatory cell activity in the dermis (middle skin layer). Psoriasis is a condition of dermal hyper-activity and hyper-permeability.
Topical treatment for genital psoriasis requires extra focus because the skin folds and thinness of the skin in the groin area affects the action of creams and ointments. Essentially, there is a tendency for increased absorption of the medication through the skin thereby intensifying its effect. In addition, the potential for a cream or ointment to cause irritation is increased when two skin surfaces rub together.
The following is a summary of topical treatments which may (or may not) be used for genital psoriasis in men.
● Moisturizers are an important part of the daily care of psoriasis in all parts of the body, including the genitalia. A therapeutic moisturizer maintain’s the skin’s natural internal hydration which keeps the skin functioning and comfortable. In general, if irritation occurs when using a moisturizer this is often due to sensitivity to an ingredient in the skin cream; such as chamomile/ragweed, glycerin and/or preservatives. Maállo is a medicinal ointment (not watery cosmetic type body cream) that maintains the skins internal hydration. Info about Maállo is provided below.
● Vitamin D prescription creams and ointments (Dovonex/calcipotriol and Vectical/calcitriol) are effective in treating psoriasis. However, these vitamin D analogs are synthetic and have potential to irritate the skin of the scrotum and penis. Calcipotriol application is not indicated for the face or skin folds.
● Topical steroid creams may be recommended for sensitive areas. However, care should be taken with their use as the potential for increased absorption may lead to side effects such as skin thinning (atrophy). For this reason low strength topical steroids are preferred for use in the genital area.
In general, topical steroids are for short term and intermittent treatment. Prolonged use of steroid creams/ointment can cause epidermal atrophy, degeneration of the dermal structure and collagen deterioration. Additionally, ongoing use of topical steroids contributes to a reduction in antimicrobial peptides (the skins natural protectors). This makes the skin more vulnerable to bacterial and/or fungal infections. Additionally, with ongoing use people can develop resistant to topical corticosteroid medications.
● Vitamin A derivatives (retinoids) are not usually recommended for use in skin folds (flexures) because of their tendency to cause irritation.
● Coal tar preparations are not usually recommended in genital areas because they can cause irritation, especially to the areas of the penis, the scrotum, the vulva or cracked skin.
● Calcineurin inhibitors (tacrolimus and pimecrolimus) are effective in treating genital psoriasis and don’t have the side effect of thinning the skin that limit the use of topical steroids. They do however often cause an uncomfortable burning sensation when applied and can reactivate sexual transmitted infections such as herpes and viral warts. Calcineurin inhibitors are not suitable for people with weak or compromised immune systems (cancer, HIV/AIDs). The United States FDA currently recommends pimecrolimus and tacrolimus as second-line agents given potential cancer risk.
● UV light treatment is not usually recommended for genital psoriasis due to an increased risk of skin cancer in this area. Men with psoriasis undergoing UV light treatment are specifically advised to cover the genital area during treatment to reduce the risk of cancer in this area.
Above Material Above Adapted From:
Psoriasis and Psoriatic Arthritis Alliance, St Albans, Hertfordshire UK
Maállo is a non-steroid skin ointment to help calm symptoms of mild psoriasis. Maállo is formulated with natural bio-compatible ingredients and is suitable for symptoms of genital psoriasis in men (scrotum, penis, inner thighs, buttocks). As a daily maintenance therapeutic Maállo helps suppress the stimulus of psoriasis symptoms and supports the skin layers to enhance repair capacity and reduce dependency on topical corticosteroids. CLICK HERE to learn more about Maállo Skin Ointment.
Keep in mind, topical steroids are not a cure and do not effect the underlying cause of the skin condition. The difficulties encountered with topical corticosteroid therapy include adverse reactions associated with prolonged continuous use and tachyphylaxis (a diminished therapeutic effect with continued application).
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DISCLAIMER: Kátha Soma Consumer Healthcare manufactures and distributes skin care therapeutics. Kátha Soma does not provide medical advice, diagnosis or treatment. The information provided is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition. Kátha Soma USA 2017