It's important to consider several factors when selecting a psoriasis treatment for a specific part of the body. Each has its own set of charactertics that may make one treatment option more desirable than another.
Genital PsoriasisGenital psoriasis is relatively common; however undue patient reluctance to discuss this problem may delay diagnosis or result in the wrong treatment being used. It is vitally important that patients don't assume that a cream prescribed for hands or elbows is safe when used on another body part like genitals or face. In this regard, the skin of this region is already thin which can promote excessive absorption of medications as well as further thinning or atrophy if overly strong steroid creams are applied. An excellent choice for psoriasis of the genitals includes hydrocortisone/iodoquinol cream (previously known as the branded product Vytone).
Psoriasis of the Palms and Soles
Psoriasis of the palms and soles, palmoplantar psoriasis, requires extra potent medication due to the thickness of the skin being treated. Psoriasis in these areas is often rather scaly and extra thick compared to other body parts. Ingredients designed to dissolve flakes and enhance penetration of the medications can be compounded into topical creams and ointments to make them more effective for hands and feet. One effective combination, which can be made by prescription, includes a strong topical steroid (such as clobetasole) along with a salicylic acid and coal tar solution. Although messy and smelly, this combination is quite effective for thick, stubborn palmoplantar psoriasis.
Skin Fold PsoriasisAlso known as flexural or inverse psoriasis, psoriasis of skin folds is frequently mistaken for yeast or fungus infections due to the locations involved (armpits, under breast and between the thighs in the groin). Because psoriasis is inflammatory and not infectious, a straightforward antifungal cream usually has little effect on flexural psoriasis. However since yeast can trigger or aggravate the condition, it is not surprising that one of the most effective creams for inverse psoriasis includes a mild steroid mixed with ketoconazole, an antifungal ingredient. As with genital psoriasis, one worry with flexural psoriasis is atrophy and even stretch marks resulting from overly strong steroid creams being applied here.
Treatment of scalp psoriasis is difficult due to the inability to apply medications directly onto a hairy scalp, as well as the mess of using greasy ointments there. Two solutions are to use medicated shampoos (such as Pentrax or Sebulex) and non-greasy medications, such as Luxiq or Olux foams. When flaking is severe, it is sometimes necessary to apply a medicated oil (such as Dermasmoothe FS) at night and wash it out in the morning. The medications mentioned here require a prescription from your doctor, but the shampoos are available over the counter.