How to Treat Psoriasis While Pregnant

Psoriasis is a chronic skin condition characterized by red, scaly lesions and periodic outbreaks. Psoriasis causes skin cells to grow and mature in three to four days, rather than the normal 30-day cycle. The excess skin cells builds up on the skin surface, causing lesions most often on the scalp, elbows, knees and trunk. The cause of psoriasis is unknown but it is hereditary. Effective topical and systemic (oral or injected) treatments are available, but caution must be used when pregnant and nursing to avoid harm to the developing fetus.

Instructions

Topical Therapies

1

Steroids: Safety during pregnancy has not been proven, so topical steroids should be used only when the benefit outweighs the potential risk. Because steroids may be absorbed through the skin if used on large areas, do not use steroids under wrappings (occlusive dressings) unless you consult a doctor.

2

Anthralin and calcipotriene: No studies have been done on the use of these medications by pregnant or nursing women.

3

Tazarotene: Avoid using tazarotene, a topical retinoid, while you are trying to conceive and through pregnancy and breastfeeding. Stop using tazarotene immediately if you become pregnant while using it.

Systemic Therapies

4

Biologics (etanercept (Enbrel), infliximab (Remicade) and adalimumab (Humira): Avoid all biologics while trying to conceive through pregnancy and breastfeeding. There is only limited information about the effect of these medications on the fetus, so they should be used only if there is clearly a medical need.

5

Cyclosporin A: No associated birth defects have been observed, but cyclosporin is associated with low birthweight and premature birth. Use only if there is clearly a medical need.

6

Methotrexate: Methotrexate may cause miscarriage and birth defects. Both men and women should not take methotrexate for at least 12 weeks before trying to conceive through pregnancy and breastfeeding. There is no risk after methotrexate has been discontinued.

7

Oral retinoids: Associated with a high risk of birth defects. Do not take oral retinoids while trying to conceive through pregnancy and breastfeeding.

Phototherapy

8

Psoralen plus ultraviolet A light (PUVA): Both psoralen and UVA cause genetic defects in the developing fetus and should be avoided by men and women while trying to conceive through pregnancy and breastfeeding.

9

Ultraviolet B light (UVB): Safe during conception, pregnancy, and breastfeeding.

10

UVB plus tar or anthralin (Goeckerman regimen): Safe during conception, pregnancy and breastfeeding.