National Psoriasis Foundation releases recommendations for psoriasis treatment in pregnant and breastfeeding women
PORTLAND, Ore. (Nov. 28, 2011)—The National Psoriasis Foundation Medical Board has released new recommendations for the treatment of psoriasis in pregnant and lactating women.
The recommendations call for topical treatment as the first-line therapy for psoriasis—a chronic, genetic disease of the immune system that appears on the skin, causing it to crack, itch and bleed. Specifically, the medical board recommends that moisturizers and emollients, such as petroleum jelly, be used initially as there are no known adverse effects to these products.
Additionally, the Psoriasis Foundation Medical Board suggests that:
- 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 trimesters.
- 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, a class of drugs that 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.
- 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 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. "It's important for women to work with their doctor to determine what treatment is appropriate for them during pregnancy and to consider the precautions for each."
Psoriasis can be unpredictable in pregnancy. Some women see an improvement in the severity of their psoriasis during pregnancy, while others report their psoriasis gets worse. Changes in severity of psoriasis vary by individual and from pregnancy to pregnancy.
Studies also suggest that pregnant women with psoriasis have increased risk of poor birth outcomes, such as 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.
About the National Psoriasis Foundation
Serving its community through more than 50 years of patient support, advocacy, research, education, and funding, the National Psoriasis Foundation (NPF) is the world’s leading nonprofit fighting for individuals with psoriasis and psoriatic arthritis. The NPF mission is to drive efforts to cure psoriatic disease and dramatically improve the lives of more than 8 million individuals in the United States affected by this chronic immune-mediated disease. As part of that effort, NPF created its Patient Navigation Center to offer personalized assistance to everyone with psoriasis or psoriatic arthritis. To date, NPF has funded more than $21 million in research grants and fellowships that help drive discoveries that may lead to more and better treatments and ultimately a cure. Learn more at www.psoriasis.org.