6 Tips to Gently Treat Psoriasis on Sensitive Body Parts

It’s possible to get psoriasis on any part of the body, but some areas are a little harder to treat than others. Sensitive areas of the skin, for instance, where the skin is thinner or where two skin surfaces are in contact with each other, tend to require different treatments or application methods.

“It’s really a question of absorption,” says board-certified dermatologist Sandy Skotnicki, M.D., an assistant professor in the department of dermatology at the University of Toronto. “The skin is thinner in certain areas, like the groin, the genitals, the face and the eyelids, so topical treatments are more readily absorbed.”

Other sensitive body parts are those with skin folds, such as the armpits, between the buttocks and under the breasts. These areas are sensitive because the skin is typically touching, which increases absorption and irritation due to sweat, Skotnicki says. Inverse psoriasis (also known as intertriginous psoriasis or flexural psoriasis), which presents as very red, smooth, shiny lesions, is most common in these areas.

Every psoriasis patient is different, and what works for someone else might not be the right treatment for you. But experts agree that gentle is best when treating psoriasis on sensitive body parts.

Avoid Strong Steroids

A good starting point is knowing what you probably shouldn’t use. Skotnicki doesn’t recommend using strong topical prescription steroids on sensitive areas. The skin in sensitive areas tends to be thinner, and so the risk of side effects from steroids is higher than if used on other parts of the body. Instead, Skotnicki typically prescribes a non-steroid topical anti-inflammatory cream like pimecrolimus or tacrolimus.

Both these topicals are approved by the U.S. Food and Drug Administration for the treatment of eczema but are often prescribed for psoriasis. They’re intended for short-term use only and should be applied in a thin layer. If your dermatologist prescribes either of these for your psoriasis, follow their directions for use.

Check Ingredient Labels

Just as you might have a different prescribed medication for psoriasis in sensitive areas, you might want to opt for different skincare products. Moisturizing is an important part of daily skincare for psoriasis wherever it appears on the body, including sensitive areas. However, many over-the-counter products designed to soften and remove psoriatic scales contain salicylic acid, lactic acid, phenol or urea, which may be too strong for the delicate skin on your face and other places.

Board-certified dermatologist Rhonda Q. Klein, M.D., of Modern Dermatology of Connecticut in Westport, recommends using Vanicream Moisturizing Ointment. “This can be safely used near the eyes, nose and mouth,” she says. “It may help to soothe dryness and itchiness, while helping to loosen plaques and hydrate the skin below.”

Kristin M., 35, from Santa Barbara, California, uses Era Organics Tea Tree Cream on her chin and around her mouth. “It helps to reduce redness without causing irritation,” she says.

Be Careful with Intimate Areas

When it comes to the groin and genitals, moisturizer may not stay in place due to the natural moisture in these areas, Klein explains. “Also, these are areas of friction from skin-on-skin as well as clothing, which can cause cracks in compromised psoriatic skin and lead to fungal or bacterial infection,” she says. To avoid aggravating these sensitive parts, she recommends dressing in loose-fitting, breathable, cotton clothing.

Topical treatments commonly used to treat genital psoriasis include low-strength corticosteroids, calcipotriene (vitamin D derivative) and tazarotene (vitamin A derivative), according to the National Psoriasis Foundation. If non-steroid anti-inflammatory creams and over-the-counter moisturizers aren’t working for you, ask your dermatologist about other options.

Soak in a Soothing Bath

A medicated bath may soothe discomfort during an active psoriasis flare-up in sensitive places. Klein suggests adding sea salt, oatmeal or a bath gel containing coal tar to the water, then soaking for 15 minutes. “Make sure your water is lukewarm and not too hot, which can further irritate plaques,” she says. Bath products she recommends are CLn Body Wash and Robathol Bath Oil, both of which are gentle on sensitive areas of the body.

Moisturize with Natural Oils

After a bath, Jo P., 28, from Newport, Rhode Island, applies coconut oil to her psoriasis lesions in her armpits and under her breasts. “I sometimes use olive oil or jojoba oil, but coconut is my favorite,” she says. “I make sure my skin is completely dry, then apply a small amount of oil to my skin—a little goes a long way—before putting loose cotton pajamas on.”

Keep in mind that skin folds with psoriasis may be prone to yeast and fungal infections. To help reduce the risk of infection in those sensitive places, Jo swears by another pantry staple: baking soda. “If my skin folds seem particularly warm or damp, I give them a dusting of baking soda to help them stay cool and dry.”

Seek Medical Treatment

In some cases, treating psoriasis in sensitive areas of the body can require specialized care. For instance, Klein often treats flares in the groin and genitals with systemic oral or injectable treatments. If your psoriasis isn’t responding to gentle treatments, don’t suffer in silence. Your dermatologist can help you figure out a treatment plan to reduce your symptoms without unduly aggravating those sensitive spots.

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