What do a skin condition and a common virus have in common? More than you might think.

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, affecting around 13 million people each year. Research suggests a two-way link between HPV and psoriasis: HPV may trigger some types of psoriasis, and people living with the skin condition may be more likely to develop HPV. Understanding this connection can help you take steps to protect your skin and your overall health.

In this article, we’ll examine the relationship between psoriasis and HPV infection and look at risk factors, symptoms, and treatment options. If you have questions about psoriasis and HPV, schedule an appointment with your healthcare provider or a doctor specializing in dermatology or immunology.

What Is Psoriasis?

An autoimmune disease happens when the body’s immune system attacks healthy cells by mistake. Psoriasis is one example — it causes the immune system to make skin cells grow too quickly, leading to patches of thick scaly skin.

There are several types of psoriasis. The most common type is plaque psoriasis, which causes raised skin patches, or plaques, that tend to itch, burn, or sting and can be dry, flaky, or scaly. While psoriasis often shows up on the elbows, knees, and torso, it can also affect the fingernails, toenails, scalp, and genitals.

Psoriasis is a common skin disease, but it’s not contagious, meaning you can’t catch it from another person. Risk factors for psoriasis include having a family history of the disease and smoking tobacco, but anyone can develop the condition. While psoriasis has no cure, many people can manage it with medical care and lifestyle changes.

What Is HPV?

Human papillomavirus is a highly contagious virus that spreads through skin-to-skin contact. It can affect the hands, feet, face, genitals, and other areas. There are more than 100 types of HPV, including some that cause genital warts. Although all warts are HPV, not all strains of HPV cause warts.

Most HPV infections are harmless, but high-risk strains such as HPV16 and HPV18 can cause cancer. According to the National Cancer Institute, HPV is responsible for almost all cases of cervical cancer, but it’s also linked to anal, penile, vaginal, vulvar, and throat cancers. Most HPV cancers are considered squamous cell carcinomas, a type of cancer that begins in the flat cells lining many areas of the body.

There's no cure for HPV, but in many cases, a strong immune system can fight off the infection within one or two years. However, some types of HPV are harder to get rid of and need regular checkups.

You can lower your risk by getting the latest HPV vaccine (Gardasil 9), which helps protect against several high-risk strains of the virus that cause genital warts and cervical cancer. Your doctor can tell you if the HPV vaccine is a good option for you and how often you should schedule a follow-up for a Pap smear and HPV test.

Using protection during sex can also help reduce transmission.

The Relationship Between Psoriasis and HPV

Anything that causes a psoriatic flare-up is called a trigger. Although triggers vary from person to person, common ones include stress, cold weather, skin injuries, tobacco uses, and high levels of alcohol consumption. Research has suggested that viral infections, including HPV, can also set off psoriasis symptoms.

After HPV-related psoriatic lesions were first reported in 1982, researchers went to work to try to understand the connection. An observational study, in which researchers simply observe rather than treat participants, found that a human papillomavirus infection can trigger plaque psoriasis. How and why this happens is unknown, but some doctors suspect an HPV infection triggers inflammation, which activates cells linked to the inflammatory response that leads to psoriasis symptoms.

Increased Vulnerability

Studies have also shown that the skin of people with psoriasis has an increased risk of HPV infection compared to what some researchers call “normal” skin, or skin without psoriatic disease. A cohort study, in which researchers follow individuals with similar characteristics over many years, concluded that people with HPV may be twice as likely to develop psoriasis as the general public.

What does this mean for you? If you have psoriasis and are sexually active, it means discussing the risks of HPV with your doctor and asking for guidance on how to protect yourself from HPV or how to manage the condition if you already have it.

Symptoms of Psoriasis and HPV

Not all human papillomavirus types, or strains, cause symptoms. Those that do tend to produce visible warts on the hands, fingers, and genitals. If HPV warts develop in places you frequently experience psoriasis flare-ups, you may have difficulty seeing a significant difference between the two. Your healthcare provider is your best resource if you have questions about infectious diseases, HPV, and psoriasis, but here are a few ways to tell if you have HPV-related lesions.

Psoriasis Symptoms

Psoriasis lesions are often dry, cracked, flaky, or scaly and may:

• Appear pink or red on white skin and purple and gray on brown or black skin
• Be raised
• Itch, burn, or feel sore
• Bleed
• Flare for a few weeks and then go away

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HPV Symptoms

On the other hand, HPV warts may:

• Appear as small bumps that resemble cauliflower
• Be flat or raised
• Itch or ache
• Bleed

Not all genital warts cause discomfort. The number of warts you have may grow or stay the same, and they sometimes go away on their own. Even if you don’t have warts that you can see, it’s still possible to have a high-risk strain of HPV. That’s why screening tests are so important — some strains can lead to cervical cancer or other HPV-related cancers over time.

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Having any or all of these symptoms doesn’t mean you have psoriasis or HPV. Only a trained medical professional can make an accurate diagnosis. If your healthcare provider suspects an HPV infection after a physical exam, a Pap smear, or an HPV test, they may want to follow up with a cervical biopsy to confirm the diagnosis.

Managing Psoriasis and HPV

There’s no cure for psoriasis or HPV, but with the help of your doctor, both conditions can be managed.

Psoriasis Treatments

Most psoriasis treatments fall into a few main categories:

• Topicals — Lotions, creams, or ointments applied to the skin
• Systemics — Medications that work internally to hold back the immune system (called immunosuppression) and are given by mouth, injection, or intravenous infusion
• Phototherapy — Exposure of skin to ultraviolet light
• Complementary or integrative — Acupuncture, mindfulness, and other therapies not used in conventional or Western medicine

HPV Treatments

HPV treatments can get rid of warts, abnormal cells in the cervix, and other HPV-associated lesions, but they can’t eliminate the virus from your body. Standard HPV treatments include:

• Cryotherapy — Using liquid nitrogen to freeze warts or destroy abnormal cells
• Electrocautery — Burning warts off via an electrical current
• Cold knife cone biopsy — Removing a piece of cervical tissue
• Prescription cream — Applying a topical cream to destroy warts
• Laser therapy — Shining an intense light to destroy warts or abnormal cells
• Sinecatechins (green tea extract ointment) — Plant-based ointment approved to treat external genital and anal warts

A strong immune system is your best protection against HPV infection. If you have the virus, make sure to tell the doctor managing your psoriasis so they can keep that in mind when planning your treatment.

Also, keep in mind that skin injuries can trigger psoriasis. If your body sees a cold knife cone biopsy or other HPV treatment as an injury, it could cause a psoriatic flare-up. Ask your doctor about potential side effects before starting treatment.

Living With Both Conditions

Due to the prevalence of HPV and psoriasis, if you have both conditions, you’re not alone. It may take some time to adjust, but many people live full, healthy lives with psoriasis and HPV. If you have questions about risk factors, symptoms, or treatments, schedule an appointment with your healthcare provider. Everyone’s body is different, so your doctor can help you find the best plan for your needs.

Find Your Team

MyPsoriasisTeam is the social network for people with psoriasis and psoriatic arthritis and their loved ones. On MyPsoriasisTeam, more than 134,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis and psoriatic arthritis.

Are you living with both HPV and psoriasis? Do you have questions or suggestions regarding the management of skin symptoms? Share your experience in the comments below, or start a conversation by posting on your Activities page.