Your skin is constantly exposed to stimuli such as fabrics, detergents, and skin products, as well as environmental triggers such as sun, cold, dust, and pollen. All of these factors are enough to cause acute skin reactions such as rashes or bumps, but some skin conditions have more complicated origins and longer-lasting effects.

One of these complex skin conditions is psoriasis, an inflammatory, immune-mediated skin condition. There are 5 types of psoriasis, the most common type being plaque psoriasis. Of these 5 types, one is known as inverse psoriasis, and that’s what we’re here to discuss.

What is inverse psoriasis? In this article, we’ll dive into what this skin condition is, its symptoms and stages, and different management options to help you find relief and healing.

What Is Inverse Psoriasis?

Inverse psoriasis is a type of psoriasis that may develop for up to 30% of people living with psoriasis. This condition is also called intertriginous psoriasis or flexural psoriasis. The name “intertriginous” comes from Latin roots meaning “between” and “to rub,” helping to explain where this type of psoriasis occurs. Flexural psoriasis further illuminates the body parts that are vulnerable to irritation: Flexural refers to a bend or fold in a part of the body, such as under the breasts, armpits, behind the knees, near the groin and buttocks, and in neck folds. (Source, Source, Source, Source, Source)

How Do I Know if My Psoriasis Is Inverse?

The reason why the name inverse psoriasis is used for this condition is to differentiate it from the more common plaque psoriasis, which features thick, scaly patches of skin on the external sides of joints, like the elbows and knees. “Inverse” refers to the condition occurring on the opposing, internal side of these sensitive skin areas. (Source)

Symptoms of Inverse Psoriasis

Having the terminology to describe a condition is important, but most often, you experience a disease firsthand before you have a name or a diagnosis for it. Typically, inverse psoriasis presents itself in these ways on nearly any crease or fold on the skin’s surface:

• lesions of varying colors, depending on skin color. Areas may appear as purplish, brown, darker than surrounding skin, or bright red lesions in body folds.
• inflamed skin that’s shiny, moist, and smooth in texture
• severe itching and pain in the affected areas that can be worsened by sweating and rubbing

It’s common for people to be living with inverse psoriasis while simultaneously having another type of psoriasis. Having deep skin folds makes the skin more prone to friction, which can make inverse psoriasis more common. (Source, Source, Source)

Stages of Inverse Psoriasis

The stages of inverse psoriasis can be broken down into onset, diagnosis, and managing your condition through treatment. At any stage, you may experience times of remissions and flares, where your symptoms either abate for a while or worsen for certain periods. Knowing your triggers, receiving the correct diagnosis, and following an individualized care plan will set you on the right path to living a full life with your condition. (Source)

Onset: What Triggers Inverse Psoriasis?

When you start showing symptoms of inverse psoriasis, there’s likely something in your environment or lifestyle that triggered this bodily reaction. Common triggers for inverse psoriasis can include:

• certain medications, especially when starting or stopping them
• infections
• skin injuries
• stress
• use of substances such as tobacco or alcohol
• friction on skin folds, particularly if you have obesity

(Source, Source)

If you start developing these signs and symptoms in the sensitive areas of your skin, it’s time to seek out a medical professional to pin down a diagnosis as the next step on your path to healing.

Diagnosis

Your health care provider should perform a thorough physical examination, and may ask you if psoriasis runs in your family, since the disease has a genetic component. If you only have signs of inverse psoriasis but not other types of psoriasis, a skin biopsy, allergy test, or blood test may be used to rule out other similar-looking skin conditions. These might include intertrigo, which is caused solely by moisture and friction, and other rashes related to autoimmune diseases. (Source, Source, Source)

Letting your provider know all the areas of your body that are affected will help you get the correct diagnosis — and inverse psoriasis can occur in the most sensitive of places, including the genitals. Even though this may be a difficult topic to broach, it’s important that your care team knows what you’re dealing with so that you can find the relief and healing you deserve. (Source)

Being diagnosed with inverse psoriasis means you’re living with a chronic condition that currently has no cure, but there are many treatment options available, and lifestyle habits that you’re in control of, to help you live your healthiest life even with this disease. WellTheory and our caring coaches and Nutritional Therapy Practitioners can be great allies to add to your care team as you take healing into your own hands.

Conventional Ways of Managing Inverse Psoriasis

Although having psoriasis is a lifelong journey, there are various options available to care for your skin. Here are some of the most common treatment options that may be recommended by your provider. These options can reduce symptoms and provide temporary relief.

Topical Treatments

Topical medications, applied directly to the skin, are typically your first line of defense for treating inverse psoriasis. These treatments are able to reduce inflammation and excessive cell reproduction. Some options may be available over the counter, but others might require a prescription. (Source)

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Systemic Treatments

Systemics are prescription medications that work throughout the body, especially if topical treatments are not tolerated or working effectively. They can be taken by mouth or by injection and they work in a variety of ways, depending on the drug. Some dampen the immune response and others slow down skin cell growth by inhibiting certain enzymes. (Source, Source, Source)

Secondary Treatments

Yeast and fungal infections can easily take hold in skin folds. Along with your psoriasis treatment, your doctor may supplement your care plan by prescribing medications if you have an infection, or powders to keep lesions moisture-free. (Source)

Nutritional Ways of Managing Inverse Psoriasis

There are many natural, nutrition-based remedies that can help heal inflammation and bring you relief from inverse psoriasis from the inside out. To get a personalized nutrition and lifestyle care plan for your inverse psoriasis, connect with WellTheory’s Care Team and get individualized guidance and symptom relief.

Consume More Antioxidant-Rich and Anti-Inflammatory Foods

Antioxidant-rich and anti-inflammatory foods such as leafy greens, berries, honey, and fatty fish can reduce inflammation on a cellular level, while tart cherries, turmeric, and ginger all have compounds that can reduce pain and inflammation naturally. Research has shown that a plant forward diet (rich in vitamin C, beta carotene, and flavonoids) improves skin lesions, so incorporating more fresh fruit, vegetables, and polyphenol rich items such as tea, herbs, and spices is worthwhile if you are struggling with inverse psoriasis. (Source)

Supplement With Vitamin D

Vitamin D-rich foods and vitamin D supplementation for psoriasis have shown to regulate the immune response, meaning consuming more foods high in vitamin D — such as salmon, mackerel, and eggs — can support your immune system and reduce symptoms. (Source)

Avoid Inflammatory Foods and Gluten

Inflammatory foods and foods containing gluten can trigger inflammation in the body. Research has found that asymptomatic celiac disease (an autoimmune disease that results in an inflamed small intestine after consuming gluten) is more common in individuals with psoriasis than with the general population. In fact, if you have psoriasis you are about 3 times more likely than others to have celiac disease — for this reason, cutting out gluten from your diet may further support your symptom healing. (Source, Source)

The Bottom Line on Inverse Psoriasis

Inverse psoriasis affects areas of sensitive skin that are prone to friction and moisture. It is an immune-mediated, long-term, and chronic condition, but it can be managed and symptoms can be reduced. When smooth, inflamed skin appears in skin folds and causes pain and itching, this is a sign your body is reacting to an underlying problem.

By getting to the root of the problem and not simply addressing symptoms with medications and topical treatments, you can reduce flare-ups and experience symptom relief. When you’re accurately diagnosed, managing inverse psoriasis and getting back to living your life is possible. Be open and honest when sharing your symptoms to your health care provider, and get a comprehensive, whole-body care plan that works toward your healing.