Human papillomavirus (HPV) infects an estimated 14 million people annually, making it the most common sexually transmitted infection in the United States. Research has shown that HPV can trigger some types of psoriasis, and people with psoriasis may be at an increased risk of contracting HPV. Knowing how to prevent and manage this common virus is worth understanding if you are living with psoriasis.

In this article, we examine the relationship between psoriasis and HPV. We also look at risk factors, symptoms, and treatments. If you have questions about psoriasis and HPV, schedule an appointment with your health care provider or a doctor specializing in dermatology or immunology.

Understanding Psoriasis and HPV

Psoriasis is an autoimmune disease. It develops when an overactive immune system spurs skin cells to grow faster than necessary, creating a buildup of cells on the skin. There are several types of psoriasis. The most common type is plaque psoriasis, which causes raised skin patches, or plaques, that tend to itch, burn, or sting and can be dry, flaky, or scaly. While psoriasis often develops on the elbows, knees, and torso, it can also affect the fingernails, toenails, scalp, and genitals.

Psoriasis is a common skin disease that affects more than 7.5 million adults in the United States. It’s not contagious, meaning you cannot catch it from another person. Risk factors for psoriasis include having a family history of the disease and smoking tobacco, but anyone can develop the condition. While psoriasis has no cure, many people are able to manage it with medical care and lifestyle changes.

Human papillomavirus is a highly contagious virus that spreads through skin-to-skin contact. It can affect the hands, feet, face, genitals, and other areas. More than 100 types of HPV exist, including some that cause genital warts. Although all warts are HPV, not all strains of HPV cause warts.

Most HPV infections are harmless, but high-risk strains such as HPV16 and HPV18 are oncogenic, which means they can cause cancer. According to the Centers for Disease Control and Prevention (CDC), HPV is responsible for almost all cases of cervical cancer. Health experts have also linked it to squamous cell carcinoma and anal, penile, vaginal, and vulvar cancers, although these types are rarer.

There is no cure for HPV, but a healthy immune system may be able to eliminate the virus in a year or two. You can reduce your risk by getting the HPV vaccine (Gardasil 9) and practicing safer sex. Your doctor can tell you if the HPV vaccine is right for you, as well as how often you should schedule a follow-up for a Pap smear or HPV test.

The Relationship Between Psoriasis and HPV

Anything that causes a psoriatic flare-up is called a trigger. While triggers vary from person to person, common psoriatic triggers include stress, cold weather, skin injuries, smoking, and heavy alcohol consumption. Research has shown that viral infections, including HPV, can also set off psoriasis symptoms.

After HPV-related psoriatic lesions were first reported in 1982, researchers went to work to try to understand the connection. An observational study — in which researchers simply observe rather than treat participants — found that an HPV infection can trigger plaque psoriasis. How and why this happens is unknown, but some experts suspect an HPV infection triggers inflammation, which activates T cells, keratinocytes, and other cells linked to the inflammatory response that leads to psoriasis symptoms.

Studies have also shown that the skin of people with psoriasis is more prone to HPV infection than is the skin of people who don’t have psoriatic disease. Furthermore, a cohort study — in which researchers follow individuals with similar characteristics over many years — concluded that people with HPV may be twice as likely to develop psoriasis as the general public.

What does this mean for you? If you have psoriasis and are sexually active, you should discuss the risks of HPV with your doctor and ways to protect yourself from it — or, if you already have HPV, how to manage it.

Symptoms of Psoriasis and HPV

Not all human papillomavirus types, or strains, cause symptoms. Those that do tend to produce visible warts on the hands, fingers, and genitals. If HPV warts develop in places you frequently experience psoriasis flare-ups, you may have difficulty seeing a significant difference between the two. Your health care provider is your best resource if you have questions about infectious diseases, HPV, and psoriasis, but here are a few ways to tell if you have HPV-related lesions.

Psoriasis lesions are often dry, cracked, flaky, or scaly and may:

• Look pink or red on lighter skin and purple and gray on darker skin
• Be raised
• Itch, burn, or feel sore
• Bleed
• Flare for a few weeks and then subside

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HPV warts may:

• Appear as small bumps that resemble cauliflower
• Be flat or raised
• Itch or ache
• Bleed

Not all HPV warts cause discomfort. The number of warts you have may grow or stay the same, and they sometimes go away on their own.

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Having any or all of these symptoms doesn’t mean you have psoriasis or HPV. Only a trained medical professional can make an accurate diagnosis. If your health care provider suspects an HPV infection after a physical exam, a Pap smear, or an HPV test, they may want to follow up with a cervical biopsy to confirm the diagnosis.

Living With Psoriasis and HPV

Psoriasis is not curable, but many people manage it with the help of a medical professional. Most psoriasis treatments fall into a few main categories:

• Topicals — Lotions, creams, or ointments applied to skin
• Systemics — Medications that work internally to hold back the immune system (called immunosuppression) and are taken by mouth, injection, or intravenous infusion
• Phototherapy — Exposure of skin to ultraviolet light
• Complementary or integrative — Acupuncture, mindfulness, and other therapies not used in conventional or Western medicine

HPV is also not curable. Treatments can eliminate warts, abnormal cervical cells, and other HPV-associated lesions, but they can’t eliminate the virus from your body. According to Cleveland Clinic, about 90 percent of people with HPV infection clear the virus without treatment in a year or two. Standard HPV treatments include:

• Cryotherapy — Using liquid nitrogen to freeze warts or destroy abnormal cells
• Electrocautery — Burning warts off via an electrical current
• Cold knife cone biopsy — Removing a piece of cervical tissue
• Prescription cream — Applying a topical cream to destroy warts
• Laser therapy — Shining an intense light to destroy warts or abnormal cells

A healthy immune system provides your best defense against HPV, so if you have the virus, make sure the doctor treating you for psoriasis knows this. Rather than using a biologic or other systemic treatment to alleviate psoriasis symptoms by suppressing your immune system, your doctor might recommend starting with phototherapy (such as psoralen plus ultraviolet A light) or a topical (such as a corticosteroid) to avoid immunosuppression unless necessary.

Also, consider that skin injuries can trigger psoriasis. If your body interprets a cold knife cone biopsy or other HPV treatment as an injury, a psoriatic flare may follow. Ask your doctor about potential side effects before starting treatment.

Due to the prevalence of HPV and psoriasis, if you have both conditions, you are not alone. Although there may be an initial adjustment period, you can enjoy life with psoriasis and HPV. For questions about risk factors, symptoms, or treatments, schedule an appointment with your health care provider. To connect with others who understand what you are going through, join a support group or post on MyPsoriasisTeam.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and psoriatic arthritis and their loved ones. On MyPsoriasisTeam, more than 117,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis and psoriatic arthritis.

Are you living with both HPV and psoriasis? Do you have questions or suggestions regarding management of the skin symptoms? Share your experience in the comments below, or start a conversation by posting on your Activities page.