How did you get rid of genital psoriasis?

August 9, 2015 7:26 PM

You had genital psoriasis. You managed to get rid of it. What did you do?

I've seen a dermatologist, who told me that the skin irritation on my vulva is genital psoriasis.

I've followed all his treatment instructions

- Hydrozole cream
- Dermeze ointment
- organic cotton undies
- dab gently with soft hypoallergenic facial tissue instead of using toilet paper
- avoid having baths, have showers instead
- wear skirts to reduce heat instead of trousers

and it's not getting any better. I'm going to see a different dermatologist, but am wondering what I can try in the meantime.

It's really bad - it hurts when sitting down, and I can't have sex.

posted by Hot buttered sockpuppets to Health & Fitness (14 answers total)

I have psoriasis, but not on my genitals, and I don't know if the two are treated differently. However, when I flared for the first time, the ONLY thing that cleared me was phototherapy. Now I do the occasional spot treatment with Clobex spray. Phototherapy was a lifesaver.
posted by sevensnowflakes at 7:57 PM on August 9, 2015 [3 favorites]

Have you seen an allergist and/or your gyno, or are they who referred you to the dermatologist?

IME a LOT of dermatologists (especially male derms) aren't all that skilled at diagnosing anything that isn't textbook like a wart or a regular pimple. You may find more success with the head of gynecology or allergy at your clinic.
posted by Hermione Granger at 7:59 PM on August 9, 2015

Not genital psoriasis specifically, but for the psoriasis I get on my face, I've found Martina Gebhardt Naturkosmetik Black Mud lotion (more runny) and cream (thicker) more helpful than any other product I've used. I've never been able to get phototherapy, though.
posted by monkeymonkey at 7:59 PM on August 9, 2015

Phototherapy cleared psoriasis up for a family member of mine. I don't know where all it was located on the body, but they said it worked like a charm, much better than anything else. The machine that was purchased was a full-body one, and it was expensive, but I think insurance helped cover it.
posted by SpacemanStix at 8:16 PM on August 9, 2015

For years I had really bad psoriasis pretty much everywhere, and what made a big difference for me was going on methotrexate and, eventually, Enbrel. I'm not 100% clear, but desonide on the occasional spot on delicate skin (both face and genitalia) does a great job of keeping things under control.

Good luck, and feel free to MeMail me if you have questions about the drugs.
posted by asterix at 9:20 PM on August 9, 2015

I know someone who had genital psoriasis and successfully went the phototherapy route (tanning salon with awkward physical positioning.)

I know someone else who successfully used a (prescribed) combination of potent topical corticosteroids (thinly applied) and potent topical antifungals (thickly applied over the top of the steroid prep), but she is still not sure it was her psoriasis that produced the problem.

For pain relief while you wait to see the new derm, cool washcloths or (well-wrapped) icepacks might help.
posted by gingerest at 9:55 PM on August 9, 2015

I get psoriasis (although never on my genitals) and I have found the Moo Goo range of products life changing. I just apply a dab of their Eczema and Psoriasis Cream to the area when it starts to develop and it always clears up within a couple of days and relieves the pain/itching immediately. Because it's natural you can apply as much as you want, unlike steroids, and it isn't greasy or smelly. I've heard really good things about phototherapy too.

I hope you find something that works for you, it's a horrible condition and it always comes back.
posted by Wantok at 10:13 PM on August 9, 2015 [3 favorites]

I had psoriasis as a child and teen. As a child, on my scalp. It cleared up entirely in my very early 20's when I got rid of my very horrible mother, so I disagree it always comes back. 25+ years free!

I have an ex with a very serious case. He also had remarkle results with phototherapy.
posted by jbenben at 10:57 PM on August 9, 2015

Make sure the dermatologist you see is a genital dermatologist! That subspecialty exists -- the ones I've heard of were associated with an academic medical center.
posted by vitabellosi at 4:19 AM on August 10, 2015

Enbrel has more or less 100% cleared up my psoriasis, but it's so expensive I don't think I'd be able to afford it if it weren't covered under my benefit plan. Before that phototherapy definitely helped.
posted by The Card Cheat at 8:41 AM on August 10, 2015

I have psoriasis everywhere, and have had success with a combination of calcipotriene ointment (vitamin d) and a corticosteroid when things are rough. my dermatologist also suggested probiotics, which can't hurt! I have also heard many success stories with phototherapy, but I can't personally vouch for it since my insurance wouldn't cover it. booo!
posted by sandwiches at 7:41 PM on August 10, 2015

I'm really surprised that your dermatologist didn't offer you a topical cortisteroid. I use desonide cream to treat stress-triggered psoriasis/eczema (have been diagnosed with both at various times) flares on my face and neck, which are sensitive areas with thinner skin. Before that I was using a different low-intensity topical steroid, and I saw visible healing within a few days with both. Desonide has a pretty good safety profile and I was cleared to use it up to twice daily for 2 weeks on my face.

I've also been prescribed various antifungals for psoriasis/seborrheic dermatitis on my scalp, and they didn't seem to help. What helped for me was Clobex shampoo, which is a very HIGH-intensity topical steroid (I wash it away after a few minutes which minimizes exposure) that also comes in other formulations but is definitely not a first-line steroid treatment.
posted by serelliya at 11:13 AM on August 12, 2015

Response by poster: serelliya: Hydrozole cream is a topical steroid, combined with an antifungal - my dermatologist prescribed it.
posted by Hot buttered sockpuppets at 1:45 AM on August 13, 2015

I had genital psoriasis and my approach was that I would Nope out of it by any means necessary. It's one thing to have an STD that flares up intermittently. It's another to have an incurable, permanent disease that is always there, covering your genitals in scales. The thing I love/d most was sex, and this surprise disease at age 32 was the most absolutely Nope thing I could imagine at that time, for a single woman.

I've been psoriasis-free now for 5 years following a 40 day water fast (only drank water for 40 days), which is an old biblical cure for psoriasis. Not joking -- I said I'd try anything. A fast has the double effect of turning off your immune system, and also killing bacteria/fungi that might be hiding out in your body and making your immune system normally hyperactive. It worked completely.

If the fast hadn't worked, my arsenal included tacrolimus and pimecrolimus (both of which could be applied with tazarotene to improve absorption), fluorouracil, and topical cyclosporine. You can ask your doctor about these lesser known, but high efficacy, topical treatments.

Fluorouracil is a topical chemotherapy agent that targets rapidly dividing cells, which psoriasis cells are. It has a nearly 100% cure rate in the few studies that have been tried, but it's painful with potentially serious systemic side effects in rare cases (though much safer than whole body lifelong treatments like humira or stelara). Tacrolimus, pimecrolimus, and cyclosporine are topical immunosuppressants. Tacrolimus is the most efficacious, and has been shown about 50% effective in studies, while avoiding the the skin problems and rebound effects of corticosteroids.

Topical corticosteroids are only a temporary cure, and they cause skin problems over time and rebound flare ups that may be worse than what you started with. I'd caution against cortiocosteroids for what is a permanent condition.

I AM NOT A DOCTOR, METAFILTER IS NOT A DOCTOR, AND THIS IS NOT MEDICAL ADVICE. YOU SHOULD ASK YOUR DOCTOR BEFORE ANY TREATMENT.
posted by omg_parrots at 5:07 PM on January 8, 2016 [1 favorite]