5 Truths About Pregnancy and Psoriasis Every Woman Should Know
Last updated: September 2018
Are you a woman living with psoriasis who desires to have children? There are a lot of questions around psoriasis and pregnancy. Check out this interview I had with Physician Assistant Lisa Hill of Atlanta Medical Dermatology on the do's and don'ts of psoriasis while pregnant.
Alisha: What treatment options does a pregnant woman have if she has psoriasis?
Lisa Hill, PA:"Light therapy and topical steroids are the treatments of choice in pregnancy. Although most topical steroids are not category B, they are generally considered okay to use during pregnancy in limited amounts and time."
Alisha: If a woman is considering pregnancy, how long does she need to be off her current treatment before conceiving?
Lisa Hill, PA: "It is generally accepted that a medication should be eliminated from the body in approximately 5-times the half-life of the drug. Because of the variability in half-lives of medications, this will vary from drug to drug. If a woman is planning a pregnancy, then she should talk to her dermatologist before she tries to conceive to check specifically about her treatment regimen and when it is safe to start trying."
Alisha: The hot topic in the psoriasis community is that for some women, their condition improves during pregnancy. Can you explain why some women psoriasis improves while pregnant?
Lisa Hill, PA: "When your body is pregnant, it is preoccupied with growing a human being and the immune system is “distracted," for lack of a better word, during this time. The immune system “forgets” it’s supposed to be making psoriasis for the time being. It’s main focus has shifted to growing and protecting a growing fetus. Once the body is done growing a human and the mom delivers her baby, it usually is only a matter of time for her body to start making psoriasis again. Every woman is different, and some women see their psoriasis comes back less after pregnancy and some see it comes back more than before being pregnant."
Alisha: What happens if a woman accidentally conceives while on a treatment? Are there treatments that would raise more concerns than others? Once she finds out she is pregnant what should her next step be?
Lisa Hill, PA: "If a woman conceives while on treatment she should stop treatment until she can contact her dermatologist to ask if her specific treatment is ok to continue while pregnant. There are systemic medications that are completely contraindicated in pregnancy, like Methotrexate, that actually cause miscarriages to happen. If a woman accidentally conceives while on a Biologic treatment, she should contact her dermatologist prior to her next dose of medication to see if she should continue or not. Most physicians feel that her psoriasis likely will be better during pregnancy and she will not need to be on a biologic. However, in some severe circumstances, the benefits outweigh the risks and the biologic can be continued. Many biologic companies have a pregnancy registry of all pregnancy outcomes from their drug. A pregnancy on a biologic can be reported to the drug company for them to follow the outcome of the pregnancy, which helps provide more information to the public about the exposure of fetuses to biologics and their effects."
Alisha: Ultimately, what 3 tips can you give to women who are considering pregnancy or are pregnant and have psoriasis?
Lisa Hill, PA: "If a woman is considering pregnancy and has psoriasis, I would highly recommend that she schedule an appointment with her dermatologist PRIOR to getting pregnant. That way, she can discuss to go ahead and start on a pregnancy safe regimen that she will be able to continue easily once she becomes pregnant. If she accidentally becomes pregnant, then DON’T PANIC, and just contact your doctor as soon as you find out and discuss with them what needs to be done about your treatment regimen. My second tip would be to try to relax and enjoy your pregnancy. Since most people’s psoriasis is better when pregnant, keeping a low-stress level is also important for your skin. Thirdly, don’t be a hero! If you have an outbreak of psoriasis during pregnancy, then seek medical help. There is no reason to suffer through a flare up when you can try topical steroids or light therapy for relief!"
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