National Psoriasis Foundation releases recommendations for treatment of psoriasis in pregnant and lactating women
Women with psoriasis who are pregnant or breastfeeding should use topical treatment as the first-line therapy for psoriasis, according to new recommendations released by the National Psoriasis Foundation Medical Board.
Specifically, the medical board suggests that moisturizers and emollients, such as petroleum jelly, be used initially as there are no adverse effects to these products. Further recommendations include:
- After use of moisturizers and emollients, low to moderate dose topical steroids may be used, followed by high potency topical steroids only as needed in the second and third trimester.
- Narrowband ultraviolet light B (UVB) phototherapy or light therapy should be the second-line treatment for pregnant women. If narrowband UVB is not available, then broadband UVB, which exposes the skin to more ultraviolet light, may be used.
- Lastly, TNF inhibitors, which suppress the immune system, may be used with caution, as well as the immunosuppressant drug cyclosporine in the second and third trimesters. Specific strategies may be used to minimize risk and exposure.
In addition, breastfeeding while taking medications should be avoided due to the lack of long-term and population-based studies.
"Treating psoriasis in women who are pregnant or breastfeeding presents special challenges due to the side effects of certain medications and the ethical concerns of placing this patient population in clinical trials," said Dr. Mark Lebwohl, chair of the National Psoriasis Foundation Medical Board.
Psoriasis and pregnancy
Studies suggest that pregnant women with psoriasis have increased risk of poor birth outcomes, including preterm births and preeclampsia. Women with severe psoriasis were also found to have a higher incidence of low birth weight babies compared to those without the disease.
November 22, 2011