Psoriasis and pregnancy is a concern whether a woman is planning a pregnancy, currently pregnant and even after a pregnancy when she is breastfeeding. The main concern relates to treatment methods used for psoriasis and how they will affect women in these three stages.
Psoriasis Treatment Methods and Pregnancy
As far as psoriasis and pregnancy is concerned, evaluating the medications being used is important if you are planning on getting pregnant in the near future, are pregnant or are breastfeeding. An evaluation of the treatment methods for psoriasis is important because some medications used for the treatment of lesions can negatively impact a baby.
If you are on medication for psoriasis, it is important to talk to your dermatologist or obstetrician to first make sure that none of your medications will interfere with conception if planning to get pregnant. Secondly, you want to make sure that none of the medications will interfere with the healthy growth of the fetus in the womb and also that if you breastfeed that the medications do not transfer to the baby through breast milk.
Systemic vs. Topical Medications
Topical treatments for psoriasis are applied directly to the skin and are usually the first step in psoriasis treatment and are usually recommended for mild cases of psoriasis. Topical medications usually have fewer side effects than systemic medications and generally do not pose any risk to those wanting to get pregnant, are pregnant or are breastfeeding.
They may only be a problem if they are applied to large areas of the body or are used very frequently. This can cause these topical medications to be absorbed into the skin where they will be transferred to the bloodstream where they can have adverse effects as far as psoriasis and pregnancy are concerned. This is especially true of topically applied steroids and vitamin A derivatives (tazarotene for example.)
Systemic treatments for psoriasis are either taken orally (tablets/pills) or injected into the skin or the muscle. Since these directly enter the body’s circulatory system, they can pose various risks for women planning a pregnancy, already pregnant or breastfeeding as discussed below.
Planning a Pregnancy?
Certain medications when taken orally with an injection can remain in your system for a number of months or years so these should be avoided for at least 3 years before you start planning to get pregnant as they can not only interfere with your ability to get pregnant but can also cause birth defects even after not using the medications for years.
While psoriasis and pregnancy is mainly a concern for women with psoriasis, some medications such as methotrexate can also affect men’s sperm and should be stopped at least 6 months before conception attempts begin.
Some medications leave the body after a single menstrual cycle such as acitretin but many remain in the body for months or years and include certain vitamin A derivations as well as steroids (tazarotene, methotrexate, isotretinoin, etc). An alternative is to simply avoid all systemic medication until after closing the door on future pregnancy.
Psoriasis and Pregnancy
One benefit of pregnancy for many women with psoriasis is that they may discover that their psoriasis symptoms lessen during pregnancy. This is because of the mild immune suppression which normally occurs in pregnancy in order to protect the baby which can also lead to decreased severity of psoriasis symptoms as well as other immune related conditions.
In addition, pregnant women may find that medications they use during the pregnancy may need to be altered as their response to treatment they usually used prior to the pregnancy may change during pregnancy.
If you are using any doctor approved medications to treat psoriasis during the pregnancy especially if you have severe psoriasis, it is important to be diligent about reducing the chance of birth defects by taking your multivitamins as well as folate supplements and being mindful of following proper nutrition practices and prenatal care. Any medications usually state on the packaging or the insert whether they are safe for pregnant women.
Compared to pregnancy dangers when medications can be transferred to the baby through the placenta, when breastfeeding, medications used can be transferred through breast milk so this is definitely something to consider with systemic psoriasis treatment.