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Tacrolimus does not cause skin thinning and can therefore be used on areas where the skin is thinner, such as the genitals
Tacrolimus is a topical treatment for psoriasis that can be used on sensitive areas of the body, including the genitals, face, neck, and skin folds.
Tacrolimus is a calcineurin inhibitor that is FDA-approved to treat eczema but is often prescribed off-label to treat psoriasis because it does not cause skin thinning and can therefore be used on areas where the skin is thinner, and it has fewer side effects than other treatments.
What is genital psoriasis?
Psoriasis is an autoimmune inflammatory condition that can affect the skin all over the body. When only the genital area is involved, it is called genital psoriasis.
It is estimated that psoriasis affects about 2% of the world’s population, 63% of whom are affected by genital psoriasis at least once in their lifetime. Genital lesions significantly impair quality of life and mental well-being.
Genital psoriasis can affect various regions of the genital area including:
- Vulva, penis, or scrotum
- Crease between the thigh and genital area
- Crease between the buttocks (including the skin around the anus)
- Pubis
- Inner and upper thigh
How does tacrolimus work to treat genital psoriasis?
Tacrolimus is a prescription-only medication that effectively treats psoriasis, eczema, atopic dermatitis, and other inflammatory skin diseases.
It works as an immunosuppressant and is taken either as an injection or oral medication to prevent new organ rejection in recipients of organ transplants.
Tacrolimus works by acting on the immune system and reducing inflammation. Unlike topical steroids, however, it has fewer side effects which is one of the reasons why it is recommended for long-term use on more sensitive areas of the body such as the genitals.
What causes genital psoriasis?
The exact cause of genital psoriasis is unknown, but experts believe it is linked to an overreaction of the immune system, which causes inflammation and accelerated new skin cell growth.
Although the antibody that causes the condition has not yet been identified, it is commonly referred to as an autoimmune disease or an immune-mediated disease.
What are risk factors for genital psoriasis?
In addition to genetics and an exaggerated immune response, certain factors can increase the risk of getting genital psoriasis, including:
- Stress
- Skin irritation or any injury to the skin
- Infections
- Alcohol consumption
- Smoking
- Obesity
- Vitamin D deficiency
- Excessive perspiration
- Certain medications, such as lithium and beta-blockers
- Family history of psoriasis
QUESTION
Psoriasis causes the top layer of skin cells to become inflamed and grow too quickly and flake off.
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What are the symptoms of genital psoriasis?
There are two types of psoriasis that can affect the genital area:
Inverse psoriasis
- Typically occurs in body folds, such as underarms, under the breasts, and in the genital area
- Worsened by sweat and rubbing in the body fold areas
- Symptoms include:
Plaque psoriasis
- Typically occurs on the scalp, knees, elbows, and torso but can appear on the genitals.
- Symptoms include:
What are the side effects of tacrolimus?
Known side effects of oral tacrolimus include:
- Flushing of the face (occurs if tacrolimus is taken along with alcohol consumption)
- Increased risk of cancer
- Increased risk of infections
- Cough
- Fever
- Flu-like symptoms
- Headaches
- Muscle aches
Known side effects of topical tacrolimus include:
- Burning
- Warmth
- Itching
- Acne
- Infection of the hair follicles