What Is Anal Psoriasis and How Is It Treated?

What Is Anal Psoriasis?

As the name suggests, anal psoriasis primarily affects the skin in the area around the anus. It is a type of inverse psoriasis that affects the skin around the anus. It’s a chronic autoimmune condition that causes red, inflamed, itchy, and sometimes painful patches of skin in that sensitive area. However, symptoms may also appear in other nearby areas, such as the vulva, scrotum and penis. As the condition progresses, it can extend to the buttocks, thighs, groin and surrounding regions. In some individuals, anal psoriasis may occur alone, but it is more commonly seen alongside psoriasis on other parts of the body, such as the scalp, elbows or knees.

Anal psoriasis, a form of genital psoriasis, usually develops in people who have already been diagnosed with psoriasis. In fact, more than 60% of individuals with psoriasis also develop genital psoriasis. If you have psoriasis and notice redness, itching, or irritation around the anus, it could indicate the spread of the disease to this region.

Key Characteristics

Anal psoriasis typically presents with the following symptoms in the anal region:

• Dry, sensitive skin

• Skin appears red and shiny around the anus

• Pain or discomfort

• Itching

• Burning sensation

Causes and Risk Factors

Psoriasis is an autoimmune condition. The exact reason why psoriasis affects specific areas, such as the anus or genitals, is still not fully understood. However, genes seem to play a role. Research indicates that approximately one in three individuals with psoriasis has a family member who also has the condition. External and environmental factors might also play a role. These include:

• Skin infections or injuries, especially in the genital areas

• Obesity

• Smoking and drinking

• Physical and mental stress

• Extreme cold conditions

• Certain medications like beta-blockers, lithium, ACE inhibitors and TNF inhibitors

How is Anal Psoriasis Treated?

The following treatment methodologies help reduce flare-ups and manage anal psoriasis conditions more effectively. These methodologies are broadly classified into four types: topical treatments, oral treatments, injectables and home-care tips.

A) Topical Treatments

Applying medicated creams or ointments, as prescribed by a doctor, can help relieve the discomfort, pain and inflammation caused by genital or anal psoriasis. Commonly recommended topical treatments include:

• Mild or potent corticosteroid creams, based on the severity

• Calcipotriene cream

• Pimecrolimus cream

• Tacrolimus ointment

• Coal tar (mild variety only, based on a doctor’s recommendation)

• Vitama

• Zoryve

B) Oral Treatments

Some of the OTC and prescription medicines to treat anal psoriasis are:

• Corticosteroids

• Immunosuppressants

• D-MARDs (disease-modifying antirheumatic drugs)

• PDE4 (phosphodiesterase 4) inhibitors

• Oral retinoids

• TYK2 (tyrosine kinase 2) medications

C) Injectables

Your dermatologist may inject corticosteroids directly into the affected area or administer an intramuscular injection if the rash is widespread. Psoriasis is often managed using biologic disease-modifying antirheumatic drugs (DMARDs), which target specific components of the immune system. The main types of biologics used include:

• Interleukin-17 Inhibitors

• Anti-tumour necrosis factor-alpha (TNF-alpha) inhibitors

• T-cell inhibitors

Home-Care Tips

Here are some simple at-home strategies that may help manage anal psoriasis more effectively:

• Wearing loose and comfortable clothes

• Maintaining proper toilet hygiene

• Eating a high-fibre diet

• Washing the genital areas properly

• Applying natural and therapeutic oils on the skin, like olive and coconut oil

• Keeping stress levels low