Inverse Psoriasis Treatment
Inverse psoriasis, also known as intertriginous psoriasis, develops in skin folds and is caused by an immune response. Much like other forms of psoriasis, inverse psoriasis is an autoimmune condition that causes the body to attack itself – in this case, the skin. In this article, we will discuss the symptoms in more detail, and we will outline inverse psoriasis treatment options too.
Inverse psoriasis typically develops in areas such as the groin, armpits and under the breast. It manifests as a red, shiny rash. It can also be purple, brown, or otherwise a darker color than the surrounding areas. These lesions also tend to be moist, as well as itchy and irritated.
Inverse psoriasis occurs in approximately 21% to 30% of people with psoriasis. Those with deep skin folds are more likely to develop inverse psoriasis.
Inverse Psoriasis vs. Psoriasis Symptoms
Both psoriasis and inverse psoriasis can cause symptoms that are irritating and painful. Though their symptoms are similar, there are some differences.
Symptoms of psoriasis include:
- Red patches of skin that are covered by silver scales.
- Dry, cracked skin that is itchy and tends to bleed.
- Itching, burning and soreness.
- Thickened nails with ridges.
- Swollen and stiff joints.
Symptoms of inverse psoriasis include:
- Smooth, red rash.
- Shiny appearance to the rash.
- Dark brown or purplish patches, especially in those with a dark skin tone.
- Located in skin folds, such as the armpit, under the breasts, or the groin.
- Itchiness or pain.
- Moisture that increases the risk of developing a yeast infection.
Top 5 Treatments for Inverse Psoriasis
There are various treatment options available for inverse psoriasis. Sometimes these treatments will be prescribed concurrently, which may hasten the improvement of symptoms.
1. Topical Treatments
Topical treatments are the first-line treatment for inverse psoriasis. These medications are applied to the skin and help reduce inflammation and irritation.
Undoubtedly, one of the most effective topical treatments available is steroid creams. These creams can be purchased over the counter (OTC) or they are prescribed by a healthcare provider. They must be used with caution, as they can cause thinning of the skin. However, they are highly effective at reducing inflammation. Your healthcare provider must monitor your response to steroid treatments.
Other topical prescriptions available can halt the body’s immune response. Some of these treatments include:
- Topical calcineurin inhibitors, such as tacrolimus and pimecrolimus.
- Topical vitamin D analogs, such as calcipotriene and calcitriol.
- Phosphodiesterase (crisaborale).
When an infection is suspected, a medication to treat bacterial or fungal infections is prescribed. Examples include chlorhexidine and chloroxylenol.
Phototherapy, also known as light therapy, is an option for those with moderate to severe inverse psoriasis. This method uses UVB light rays to slow the growth of skin cells.
Phototherapy uses a lightbox that provides artificial UVB rays. Your healthcare provider will let you know the duration of treatments.
It is important to note that phototherapy may worsen symptoms of inverse psoriasis before getting better.
3. Systemic Treatments
Systemic treatments are prescribed for moderate to severe psoriasis that is resistant to topical medications and phototherapy, or in conjunction with these therapies.
Systemic treatments can adversely affect other body systems because they suppress the immune system. Periodic blood tests are warranted when prescribed these medications.
Examples of systemic medications include:
- Mycophenolate mofetil.
Biologics are another form of systemic medication. These work differently than the aforementioned treatments, which moderate immune system functioning. Biologics are monoclonal antibodies that target a specific area of the immune system. Examples of biologics include etanercept and infliximab.
4. Herbal Supplements
Many people believe that herbal supplements may improve the symptoms of inverse psoriasis. Even though there is less research indicating that these treatments may be effective, there are a variety of options to consider.
According to Healthline, the American Journal of Clinical Dermatology found that “…Mahonia aquifolium may be an effective psoriasis treatment. M. aquifolium is a species of grape found in Oregon. A 10 percent concentration of the plant may help mild to moderate psoriasis. You should only use it topically unless you’re using it an alternative way under the direction of your doctor.”
Other herbal supplements that may be effective include:
- Aloe Vera.
- Sweet whey extracts.
- Apple cider vinegar.
- Tea tree oil.
5. Nutritional Supplements
There is some evidence that nutritional supplements may assist with the treatment of inverse psoriasis. It is important to discuss these treatments with your healthcare provider because the U.S. Food and Drug Administration does not regulate nutritional supplements.
Nutritional supplements that may be effective include:
- Fish oil.
- Vitamin D.
- Vitamin B12.
Fish oil should be taken cautiously because it can affect the body’s blood clotting abilities. It can also lower blood pressure.
Vitamin D can be taken as a supplement, but it is also found in food. Examples include eggs and vitamin D fortified drinks, such as milk and orange juice. In addition, being outside in direct sunlight for 10 minutes improves vitamin D levels.