Impacts, symptom adjustments, and management strategies for psoriasis during pregnancy.
Pregnancy can pose challenges for women with psoriasis, a chronic inflammatory condition that affects the skin. The treatment options for psoriasis become significantly more complex during pregnancy due to concerns about the safety of medications for both the mother and the developing fetus.
Biologic therapies, often used for moderate to severe psoriasis, carry uncertain safety profiles during pregnancy. While some studies suggest that continuing biologics until the end of the first trimester rather than discontinuing them before conception may reduce psoriasis flares during pregnancy, the long-term safety of biologics on fetal outcomes remains under investigation.
Many systemic treatments for psoriasis are not recommended during pregnancy due to potential teratogenic effects or adverse fetal outcomes. Topical treatments, such as corticosteroids, are often preferred during pregnancy, with careful medical supervision.
Pregnant women with psoriasis may experience flares, especially if treatments are discontinued prematurely. Therefore, managing the balance between controlling maternal psoriasis and minimizing potential risks to the fetus is crucial. This balancing act often requires closer monitoring and potentially modifying therapy throughout pregnancy and postpartum.
Light therapy, specifically phototherapy, appears to be safe to use during pregnancy, though data are limited. However, pregnant women should cover their face or use a strong sunscreen to avoid a worsening of melasma during light therapy. PUVA, a type of light therapy, is not suitable for use during pregnancy.
Approximately 55% of women with psoriasis see an improvement in their psoriasis symptoms during pregnancy, while the other 45% experience either no change or a worsening of symptoms. A rare condition called Pustular Psoriasis of Pregnancy (PPP) may develop in women with a personal or family history of psoriasis during pregnancy. Women with PPP may experience fatigue, fever, diarrhea, delirium, and should seek medical treatment.
It's important to note that psoriasis is not contagious and cannot be passed from a pregnant woman to her baby. Hormonal changes during pregnancy can affect each individual differently, potentially causing psoriasis symptoms to improve, remain the same, or worsen.
Women with psoriasis who are pregnant or planning pregnancy should engage in close consultation with their dermatologists and obstetricians to optimize treatment choices. Some safe treatment options for psoriasis during pregnancy include reducing stress, getting enough sleep, regularly exercising, taking part in yoga or meditation, taking oatmeal or Dead Sea salt baths, using moisturizers, and speaking to a doctor about treatment options.
Smoking may be a trigger for psoriasis, and women with psoriasis during pregnancy may be more likely to smoke, have obesity, and not take folate or vitamin supplements. Delivery may trigger a psoriasis flare, and women should discuss treatment options with their doctor. Women may need to change their treatment plan while pregnant or breastfeeding.
In summary, pregnancy necessitates a careful, individualized approach to psoriasis treatment, prioritizing fetal safety while managing maternal disease activity. Biologics might be used cautiously, often discontinued around or after the first trimester rather than before conception, and topical or milder treatments are preferred when possible. Women with psoriasis who are pregnant or planning pregnancy should work closely with their healthcare providers to find the best treatment plan for their unique situation.
References: [1] British Journal of Dermatology [2] The Lancet [3] Journal of the American Academy of Dermatology [5] American Academy of Dermatology
- Treatmentseekers with psoriasis, a skin condition, might find their options becoming blocked during pregnancy due to concerns about the safety of medications, especially biologics.
- Despite some studies suggesting continued use of biologics until the end of the first trimester may reduce psoriasis flares during pregnancy, the long-term safety of these treatments on fetal outcomes remains under investigation by science.
- In contrast to biologics, many systemic treatments for psoriasis are not recommended during pregnancy due to potential risks to the developing fetus, and topical treatments, such as corticosteroids, are often preferred with medical-health supervision.
- Women with psoriasis should be aware that while pregnancy can pose challenges for managing their condition, they can take steps to improve their health-and-wellness, such as reducing stress, exercising, and using moisturizers, with consultation from their healthcare providers.
- It's crucial for womens-health that pregnant women with psoriasis work closely with both their dermatologists and obstetricians to optimize treatment for their unique medical-conditions, considering the safety of the fetus while managing their psoriasis symptoms effectively.
