Psoriasis on the buttocks is a type of genital psoriasis. Most people living with this skin condition will experience a psoriasis flare-up on their genital area or buttocks at least once in their life. Genital psoriasis affects two-thirds of people with psoriasis, according to the National Psoriasis Foundation.

The symptoms of psoriasis on the buttocks can be difficult to deal with. One member of MyPsoriasisTeam shared that they “had a bad flare-up on my buttocks where it hurt to just sit down.”

This article will review what psoriasis on the buttocks looks and feels like and how to relieve your symptoms.

What Does Psoriasis Look Like on the Buttocks?

Psoriasis on the buttocks may look the same or completely different from psoriasis on other areas of your body. The most common presentation of psoriasis in the genital and buttocks region is thin, discolored plaques without scaly patches of skin. It may look different because the skin around the buttocks tends to be warm and moist and is susceptible to increased friction from clothing.

The most common types of psoriasis on the buttocks are inverse psoriasis and plaque psoriasis.

Plaque Psoriasis

Plaque psoriasis is the most common form of psoriasis. Skin affected by plaque psoriasis might appear:

• Raised
• Inflamed
• Darker than the surrounding skin
• Red with silvery white buildup on lighter skin
• Purple or grayish on darker skin
• Thicker than other skin on the body

Inverse Psoriasis

Inverse psoriasis affects 21 percent to 30 percent of people with psoriasis. It is also known as intertriginous psoriasis. It’s called inverse psoriasis because its appearance is opposite — or the inverse — of how psoriasis usually appears. Instead of appearing thick and scaly, skin affected by inverse psoriasis will usually look smooth and shiny.

You may be affected by inverse psoriasis on your buttocks even if you have another type of psoriasis on other parts of your body. Inverse psoriasis usually occurs in skin folds, creases, and other areas where skin touches other skin, such as:

• Armpits
• Groin
• Between the buttocks
• Top of the buttocks
• Underneath the breasts

Young children can experience a type of inverse psoriasis called a “napkin eruption” of well-defined discolored plaques in the diaper area.

What Does Psoriasis Feel Like on the Buttocks?

Many people with genital psoriasis say that the symptoms on their buttocks are different and more intense as compared to other areas of their bodies.

The most common symptoms of genital psoriasis are:

• Itching
• Discomfort
• Discoloration
• Stinging or burning
• Pain
• Scaling
• Cracking

For some, these symptoms can be so severe that they have an impact on a person’s quality of life, mood, physical activity, and relationships with friends and family.

How Is Psoriasis on the Buttocks Diagnosed?

There is no single test to diagnose psoriasis. Your doctor will ask you questions about your health history and perform a physical examination to diagnose psoriasis on the buttocks.

Your dermatology provider may run tests or take a biopsy (small skin sample) to rule out other diseases that can cause a rash on the buttocks, such as fungal infections or sexually transmitted diseases.

How Is Psoriasis on the Buttocks Treated?

Treating psoriasis on the buttocks will be specific to your individual needs. Although biologics and oral treatment options can be effective for treating psoriasis on the buttocks, they are usually not necessary if the buttocks are the only area of the body needing treatment.

In general, psoriasis on the buttocks is treated the same as other parts of the body. Your doctor may prescribe a topical cream or ointment. However, there is limited evidence on the safety and efficacy of psoriasis treatments used on the buttocks.

Low or moderate-potency topical corticosteroids like hydrocortisone, triamcinolone (Kenalog), or desonide (Desonate) can be used to help clear symptoms. When using a topical steroid, use the medication exactly as prescribed to help clear your symptoms while avoiding side effects.

The skin on and around the buttocks is usually thinner and is often covered by clothes. This may increase the risk of side effects from topical corticosteroids, such as:

• Irritation
• Thinning of the skin
• Bruising
• Dilated blood vessels
• Discoloration
• Increased absorption into the bloodstream through the skin

Other treatment options for psoriasis on the buttocks include:

• Coal tar derivatives such as Psoriasin
• Calcipotriene cream such as Dovonex or Sorilux
• Immunomodulators

Treatments To Avoid on the Buttocks

The skin around the buttocks is very sensitive, so treatments that may cause irritation or have a risk of dangerous side effects should be avoided. These include:

• High-potency steroids
• Dithranol (Zithranol-RR)
• Tazarotene (Tazorac)
• Ultraviolet light therapy
• Laser treatments

4 Tips To Manage Psoriasis on the Buttocks

Although psoriasis flare-ups on the buttocks can be very uncomfortable, there are steps you can take to improve your symptoms and prevent them from coming back.

1. Keep the Area Clean

Urine, feces, and sweat on the affected areas can cause irritation and worsen your symptoms. Use high-quality toilet paper or a bidet after using the toilet. Keep the area clean with a mild, fragrance-free cleanser. Avoid deodorants, soaps, or body washes with fragrances and harsh chemicals, as those may irritate your skin further.

2. Reduce Friction

Friction irritates sensitive skin. Wear loose-fitting, breathable undergarments and clothing to reduce friction. Using a fragrance-free moisturizer or barrier cream can also help reduce friction.

3. Get Fiber in Your Diet

Fiber helps you maintain healthy bowel movements. It can reduce your risk of constipation and diarrhea, both of which can worsen psoriasis symptoms around the buttocks. Make sure you’re getting the daily recommended amount of fiber in your diet — at least 21 to 25 grams for women and 30 to 38 grams for men — to help regulate bowel movements.

Good sources of fiber include:

• Fruits such as raspberries and pears
• Vegetables including green peas and broccoli
• Grains such as barley and bran
• Legumes, nuts, and seeds including lentils, black beans, and chia seeds

You may also consider trying fiber supplements to help regulate your bowel movements. It’s best to start with small amounts to reduce problems with gas. If you have a history of intestinal problems, such as inflammatory bowel disease (IBD), speak with your doctor before starting a fiber supplement.

4. Ask for Help

Some people find it difficult or embarrassing to talk about psoriasis in sensitive areas like their buttocks. Remember that your health care team is there to help you. Be honest and direct with your health care provider and dermatologist about your symptoms. Know that you are not alone: Many people living with psoriasis experience similar symptoms.

You can let your provider know you are nervous about talking about it by using phrases like, “I’ve never discussed this before.” It may also help to write your symptoms down.

Don’t worry about using the right terms. Talk about your symptoms in the way that makes you feel most comfortable. You could also try bringing a trusted friend or family member to your appointment if you need support when having this conversation with your doctor.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. On MyPsoriasisTeam, more than 114,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.

Have you experienced psoriasis on your buttocks or genitals? How have you treated it or managed your symptoms? Share your experience in the comments below, or start a conversation by posting on your Activities page.