How Psoriasis and Psoriatic Arthritis May Affect Pregnancy

How Psoriasis and Psoriatic Arthritis May Affect Pregnancy

Learn why some psoriasis medications may not be safe during pregnancy.

Pregnancy is a time filled with a lot of emotion—excitement, happiness, nervousness, and sometimes worry. On top of the usual concerns, if you live with psoriasis or psoriatic arthritis, you may also have concerns about how these conditions will affect your pregnancy, if medications are safe for you and your baby, and how the changes to your body will impact disease activity.

To start off, research shows that up to 60 percent of women report improved psoriasis symptoms during pregnancy. Because of that improvement, many women are able to switch to less-powerful treatments during pregnancy. However, up to 20 percent of women report that symptoms worsen during pregnancy. The important thing to take away from this is that both pregnancy and psoriasis are a different experience for every person, and it is important to work with your healthcare providers.

It is unknown whether a mother's psoriasis has any affect on a baby during pregnancy. Some studies suggest increased risks, such as low birth weight, however, other research shows no difference. Again, the best thing you can do for the health of your baby and yourself is to work with your healthcare provider.

Psoriasis treatment and pregnancy
It is important to discuss your psoriasis treatments with your healthcare providers. Some psoriasis treatments may not be safe during pregnancy.

Topical treatments. For women with mild psoriasis, experts say topical treatments are the best option to try first. These include moisturizers and emollients, like petroleum jelly or mineral oil. Low- to moderate-dose topical steroids also appear to be safe during pregnancy. If you nurse your baby, however, be careful about applying steroid creams to your breasts, so that you don’t pass the medication on to the baby. And note that one topical medication, tazarotene, isn’t used in pregnancy, because it may cause birth defects.  

Phototherapy. Some types of light therapy–such asnarrow-band UVB phototherapy, broad-band UVB and even sunlight–have the green light. This involves exposing the skin to ultraviolet light regularly and under medical supervision–emphasis on medical supervision.  Just be sure to apply sunscreen to your face before therapy to prevent melasma, a condition in pregnant women that causes brown spots to appear. Another type of light therapy, called PUVA, is usually avoided.

Systemics. Doctors typically stay away from systemic medications–which can pass through your bloodstream to your fetus–in pregnancy unless topical treatments and light therapy aren’t giving enough relief. Cyclosporine has been linked to premature delivery and low birth weight, but it can be an option if needed. Oral retinoids and methotrexate are known to cause birth defects and should never be used.

Biologics. Scientists aren’t sure how biologics affect a developing fetus. Research so far suggests they’re safe, but experts still recommend them only when there’s a strong medical need. Since they could suppress the baby’s immune system, some doctors recommend stopping them later in pregnancy and delaying the newborn’s first vaccines.

It’s important that you speak with your healthcare professional before going on or off any medications. With the right precautionary measures and by following advice from your physician, your psoriasis and pregnancy worries can be put at ease. 

Medically reviewed in June 2019.

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