Oftentimes, women with psoriasis ask many questions regarding the effects of their skin condition on pregnancy or vice versa.
However, if you already have psoriasis, this shouldn’t stop you from getting pregnant since it carries no side effects.
As a matter of fact, studies found that the hormonal fluctuation that occurs during pregnancy may relieve symptoms of psoriasis, such as itchiness, scaly skin, and plaque formation.
With that being said, you may need to change the medications you usually take to treat psoriatic flareups since not all drugs are safe for the baby.
In this article, we will decipher the connection of being pregnant with psoriasis and see what precautions you may need to take.
What is the link between psoriasis and pregnancy?
Scientists conducted dozens of studies and clinical trials to see whether psoriasis puts the pregnant woman at risk of miscarriages or preterm labor.
The results always came back negative; psoriasis doesn’t affect the course of the pregnancy.
However, and according to one study published in the Journal of the American Academy of Dermatology, researchers found that women with severe forms of psoriasis are more likely to deliver a baby with low birth weight compared to the control group.
These findings were not present with mild and moderate cases of psoriasis.
Conversely, another study found that up to 60% of pregnant women with psoriasis report improvement of symptoms. Researchers attributed this phenomenon to the upregulation of progesterone (an important female reproductive hormone), which suppresses the action of the immune system.
Finally, 10–20% of pregnant women report worse symptoms of psoriasis that require specialized care by a dermatologist.
The primary concern of being pregnant with psoriasis is the drugs you take to treat your condition.
During pregnancy, the fetus undergoes a substantial number of changes to form new cells, tissues, and organs. These changes involve hormones, neurotransmitters, and other chemicals to ensure that your baby is forming new organs properly. This is commonly known as organogenesis.
The entire process is closely regulated to prevent any complication that endangers your baby.
Unfortunately, many pharmacological drugs interfere with this process when taken by the pregnant woman.
As the drug gets absorbed by the gastrointestinal tract, it travels through the blood, where a small concentration of the medication joins the fetal circulation via the placenta.
Most of these drugs are harmless to the baby. However, there are some well-documented medications that could be very dangerous for organogenesis (more on that later).
The treatment of psoriasis
Pregnant with psoriasis: safe drugs
As explained above, not all drugs are safe during pregnancy.
However, the route of administration also plays a role in determining the safety of a certain drug. By far, topical treatments are the safest since they exert their action at the site of the application. Therefore, the amount of drug that gets into the circulation is negligible.
Steroid creams are a classic example of topical drugs that cause no side effects to the baby. If you already delivered your baby, you should avoid rubbing the cream around your breast area when you’re about to breastfeed him/her.
Another therapeutic approach that often gets prescribed in pregnant women with psoriasis is ultraviolet light B (UV-B) phototherapy.
Before taking any drug, make sure to consult with your primary care physician, OB/GYN, or dermatologist first.
Pregnant with psoriasis: the drugs to avoid
Researchers identified numerous molecules that could potentially harm you, your child, or ruin the quality of your breast milk.
Here’s a list of medications to avoid during pregnant:
- Topical treatments (e.g., coal tar, tazarotene)
- Pharmacological drugs (e.g., adalimumab (Humira), etanercept (Enbrel), infliximab (Remicade))
- Methotrexate – this drug is especially detrimental for the baby since scientists identified it as a cause of miscarriage, cleft palates, and other birth defects. Methotrexate can also cause chromosomal alterations in both men and women, which is why couples who are trying to conceive must stop taking the drug at least 3 months before conception.
- Oral retinoids – taking this drug increases the risk of birth defects, especially during the first trimester. In fact, experts advise against getting pregnant until at least 2 years after stopping the drug.
Precautions for pregnant women with psoriasis
The best approach you can take to ensure the safety of your baby is to contact your OB-GYN or dermatologist before attempting to become pregnant.
Additionally, you may need to stop taking some of your pharmacological drugs before trying to conceive.
Another thing you can do is to avoid triggers and lifestyle habits that precipitate your psoriasis to flare up.
Once you become pregnant, make sure to inform your OB-GYN of your condition to come up with a plan that excludes all the harmful drugs.
Being pregnant with psoriasis may be scary in the beginning, especially if you don’t know the repercussions of this condition on your pregnancy.
Hopefully, this article managed to clear out the confusion surrounding this topic, but if you still have any questions or concerns, please don’t hesitate to ask in the comment section below.
Here you can read about treatments for your psoriasis: https://itsitchy.com/6-common-treatments-that-can-help-your-psoriasis/
Written by Zac Hyde M.D.