Pregnancy and Nursing
In general, psoriasis does not affect the male or female reproductive systems. However, many psoriasis treatments require special precautions before and during pregnancy. It is important to consult with your doctor to verify your psoriasis treatments are safe for pregnancy and nursing.
How psoriasis changes during 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.
Psoriatic arthritis and pregnancy
Although medications should be limited during pregnancy and nursing, this may be impossible for those who have psoriatic arthritis. Some pain medications can be used safely during pregnancy. Talk with your doctor about all over-the-counter and prescription medications you take before conception, during pregnancy and while nursing.
Psoriasis and birth
Be sure to let your obstetrician know that you have psoriasis and or psoriatic arthritis. Many women report a psoriasis flare shortly after delivery. It's also important to discuss with your obstetrician if you have genital psoriasis and are planning a vaginal delivery. One recent study published in the Journal of the American Academy of Dermatology found that women with severe psoriasis are at a higher risk of having a low birth weight baby than women without psoriasis. In contrast, women with mild psoriasis do not face this higher risk.
Treating psoriasis while pregnant or nursing
There is little research on the impact of psoriasis and psoriatic arthritis treatments on pregnant and nursing women. The National Psoriasis Foundation released guidelines in 2012 for treating psoriasis in pregnant or breastfeeding women. Topical treatments are the first choice of treatment, particularly moisturizers and emollients, such as petroleum jelly. Limited use of low- to moderate-dose topical steroids appears safe, but women should use caution when applying topical steroids to the breasts to avoid passing the medication to the baby while nursing. Read more about using topical treatments during pregnancy or nursing.
Narrow-band ultraviolet light B (UVB) phototherapy should be the second-line treatment. If narrow-band UVB is not available, then broad-band UVB may be used. Nursing women should avoid psoralen and ultraviolet light A because psoralen enters breast milk and could cause light sensitivity to infants.
Generally speaking, systemic and biologic drugs should be avoided while pregnant or breastfeeding unless there is a clear medical need. Childbearing women should avoid oral retinoids, methotrexate and cyclosporine due to a link to birth defects with each of those treatments.
You may also be interested in:
- More information about exposures during pregnancy and lactation from Organization of Teratology Information Specialists (OTIS) »
- A list of FDA-approved psoriasis treatments for pregnant and nursing women.
- Listen to Dr. Alan Menter, dermatologist and researcher, discuss the impact of pregnancy and childbirth on psoriasis.