If you are pregnant or are planning to become pregnant, you may be wondering whether your pregnancy can affect your psoriasis and whether treatments can affect your developing baby.
Many women find that pregnancy makes their psoriasis better, but for others it gets worse. That’s the challenge of psoriasis—it’s unpredictable. Some research suggests that women with severe psoriasis have a higher chance than women without psoriasis or with mild psoriasis of having a baby with a low birth weight.
You’ll want to work closely with your obstetrician as well as your psoriasis physician or dermatologist. Although some treatments may be safe during pregnancy, many are not and need to be stopped before you conceive. Some of these guidelines affect both parents.
Pregnancy and Psoriasis Treatments
You and your doctors will work together on a psoriasis management plan. Here are some changes to treatments that are usually necessary before and during pregnancy and possibly while nursing.
Topical treatments. If you have mild psoriasis, you probably use topical treatments, which are applied to your skin to improve its condition. Don’t assume that using a cream can’t affect your developing baby. For instance, retinoids, the vitamin A derivatives used in some topical treatments, may cause birth defects and should be stopped before you even consider pregnancy.
Light therapy. The safety of light therapy during pregnancy depends on the type of light therapy. If you are pregnant or are planning to become pregnant, you’ll need to stop PUVA treatment—the combination of ultraviolet A light therapy and the drug psoralen. Psoralen is known to cause birth defects. Likewise, men who plan on fathering a child should not have this type of therapy around conception time. Treatment with ultraviolet B light is generally safe when you’re pregnant and when you’re nursing, but use sunscreen to prevent brown spots.
Systemic drugs. Some traditional medications need to be avoided before conception and throughout pregnancy and nursing. These include oral retinoids for women and methotrexate for both men (before conception) and women.
Biologic treatments. Biologic drugs, which are protein-based drugs derived from living cells, target specific parts of the immune system. They can be very effective, but their effects on a developing baby are not known. If you are taking one of these drugs, talk with your doctor before getting pregnant.
Psoriasis and Your Baby
Because psoriasis is may be a genetic disease, you may wonder if your child will develop it as well. Psoriasis does not follow a strict hereditary pattern. This means that no one knows for sure who will develop psoriasis, even if it runs in the family. If you have psoriasis, your child has about a 10 percent chance of developing it. If both you and your spouse have psoriasis, the chances increase to about 50 percent.
1. Conception, Pregnancy and Nursing, National Psoriasis Foundation.
2. Questions and Answers About Psoriasis, NationalInstitute of Arthritis and Musculoskeletal and Skin Diseases, NIH.
3. Treatment With Light Therapy, National Psoriasis Foundation.
4. Systemic Medications: Methotrexate, National Psoriasis Foundation.
5. Moderate to Severe Psoriasis: Biologic Drugs, National Psoriasis Foundation.