Psoriasis in Women: Special Concerns

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On July 7, 2025

While the hallmark symptoms of psoriasis are skin plaques or a rash, the type of psoriasis, where it appears, and the severity of symptoms are different in women than men.

Location of Plaques

There are a few differences between women and men in where psoriasis is more likely to appear, says Dr. Taglia. “While nail psoriasis is more common in men, palmoplantar psoriasis, a variant that involves mostly palms and soles, is seen more commonly in women,” she says.

Because of where it appears on the body — the hands and feet — palmoplantar psoriasis is known for causing significant disability, and it’s also one of the more difficult types of psoriasis to treat.

While psoriasis in intertriginous areas (skin folds or areas of skin-to-skin contact) occurs in both sexes, it’s slightly more common in men.

The Itch Factor

“Women tend to report pruritus [itching] more frequently than men, as well as more intensity in overall itch,” says Taglia.

Research has shown that quality of life is more negatively impacted in women with chronic itch. Women with psoriasis have described their itch as “dreadful, hurting, oppressive, torturing, awful, and unbearable,” according to a study’s authors.

Not only does this impact daily functioning and interactions with others but it also interferes with sleep, which affects both mood and overall health.

“There are studies showing gender differences in the processing of itch,” says Alison Ehrlich, MD, a board-certified dermatologist at Ehrlich Dermatology in the Washington, DC, area.

In a study that used brain imaging, researchers found that women reported higher itch intensities than men, corresponding to more intense activation in parts of the brain involved in the processing of itch.

Genital Psoriasis

“In terms of genital involvement, men report higher rates of involvement, at 59 percent, than women, at 39 percent, particularly in anogenital locations,” says Taglia.

That’s the area where the anus and genital organs meet.

Genital psoriasis can also affect the crease between the thighs and genital area; the vulva; the penis and scrotum; the crease between the buttocks; the pubis, which is the skin above the genitals; and the inner and upper thighs.

Two forms of psoriasis can occur in the genital area: plaque psoriasis and inverse psoriasis. Plaque psoriasis in white skin can look red, with a scaly, silvery white buildup of dead skin cells. Among people of color, the plaques may be darker and can range in color from purple to gray to dark brown.

Inverse psoriasis usually occurs in body folds such as the underarms, under breasts, and in the genital area. Symptoms include skin that looks smooth, glossy, and tight. Both forms of psoriasis can hurt, itch, or crack.

Because of the location, genital psoriasis can have a significant impact on intimacy, both physically and emotionally.

While fewer women may have this type of psoriasis, in those who do, the intensity of symptoms is significantly higher for women than men. Sexual activity and intercourse may cause pain or worsen psoriasis symptoms in both men and women, but women are more likely to report impaired sexual dysfunction.