Can pregnancy affect the course of psoriasis?
Just as the course of pregnancy differs in every woman, women may be different, every future mother with psoriasis is unique. Almost 60% of patients observe that the symptoms of the disease are significantly reduced or even completely disappear throughout the nine months of pregnancy. This happens because of an increase in progesterone (hormone) reduces the overactive response of the immune system that brings on the symptoms of psoriasis. Consequently, many women can switch to less effective therapies. For 10-20% of expectant mothers, pregnancy worsens the symptoms of the disease. If you are on this list, you need to consult your doctor and make a plan for treating psoriasis that will be safe for your child.
Nevertheless, there is no need to panic as there are all the necessary recommendations and methods of therapy during pregnancy that you can use.
Similarly, women with psoriatic arthritis may experience either less or more severe symptoms. In the treatment of psoriatic arthritis, removal of pain occupies an important place. Since pregnancy reduces the number of acceptable painkillers and other medications, treatment options should be considered before pregnancy or in its early stages.
How does psoriasis affect pregnancy?
Psoriasis does not affect the ability of a woman to have a child. Those who suffer from psoriasis can get pregnant with minimal problems, suggesting that there are no other conditions that can affect fertility. This disease is not associated with congenital defects or miscarriages. In one study, it was found that women with severe psoriasis have a higher probability of delivering a baby with a lower weight than those who do not have this autoimmune disorder. But such a pattern is not inherent women who suffer from mild and moderate psoriasis have not found such a pattern. The biggest problem in pregnancy is the drugs that are used to treat psoriasis. Despite some of them being are harmless and do not bringing any danger, others can lead to congenital defects or miscarriage, so their use should be avoided.
What are the treatment options for psoriasis during pregnancy?
The problem with the pregnancy of women suffering from psoriasis is that there are few affordable drugs that are not toxic for the baby. Most antipsoriatic drugs cause congenital defects in the baby. However, there are methods with which you can manage the symptoms of the disease.
It is very important that the skin does not dry out during a pregnancy. Since during pregnancy a woman stops taking medications, dermatologists prescribe topical remedies (creams, ointments, sprays) that need to be applied directly to psoriatic lesions. There is much less chance for any problems with the fetus, when using drugs for external use. But it is important to remember that as they are absorbed in the skin, there may sometimes be side effects. Therefore, topical treatment should only be carried out on damaged areas.
Mitigating agents are local products in which there are no medicines. They soothe the skin and have moisturizing properties. Such funds do not pose any risk to the health of the mother or child. These include moisturizing creams, lotions, petroleum jelly.
Phototherapy with UVB rays can be used by pregnant and lactating women, the symptoms of which are not well controlled by local drugs.
Drugs that should be avoided during pregnancy:
Retinoids — the risk is that your child will be born with congenital defects, grows if you take these medicines orally. Doctors usually do not recommend them as a treatment for women in their childbearing age.
It is strictly forbidden to take acitretin before or during pregnancy. Doctors recommend waiting 3 years after you stop treatment with this drug before trying to get pregnant.
Isotretinoin is another drug for the treatment of psoriasis which can cause birth defects. It is excreted faster than acitretin, you need to wait about a month after it is discontinued before trying to get pregnant.
If you“re planning to get pregnant, you should avoid tazarotin (available as an ointment or gel) as this can cause serious congenital defects. It is necessary that a minimum of 2 weeks have elapsed to purify your body of this medication before you attempt to become pregnant.
Methotrexate — a treatment with this medication may result in improper growth of your child's body parts. This medication can also provoke miscarriage and a low number of active spermatozoa in men. You and your partner should abstain from taking this drug for at least 3 months before becoming pregnant.
PUVA - therapy (psoralen plus UVA) - doctors are not completely sure how this combined treatment affects babies in the womb. But some studies have shown that it can cause serious defects in the fetus.
Ciclosporin: this drug has no adverse effects on the fetus, but has side effects in general. It is prescribed for a short course for patients with severe psoriasis.
How do different kinds of psoriasis affect pregnancy?
To date, we do not have much information or evidence that different types of psoriasis can have a different effect on pregnancy. Most types of this disease have similar triggers, so it is unlikely that they will have different reactions to pregnancy.
There may be an improvement or exacerbation of the symptoms that must be controlled during this period.
There are severe cases of rare psoriatic erythroderma that can cause life-threatening complications for both the mother and the fetus.
Erythrodermic type of the disease causes large-scale lesions and reddening of the skin which can be extremely painful. People with this serious condition should be immediately hospitalized.
Tips for pregnant women with psoriasis
During pregnancy, some women may refuse to take any medication. Others may worry about stopping the usual treatment plan. In any case, pregnant women suffering from psoriasis should consult their doctor and choose the best and most harmless options for managing the disease.
There are a number of safe and useful recommendations that future mothers can keep their disease under control with.
Avoid stress: nervous tension can cause an outbreak of psoriasis. Avoiding stress during pregnancy will help you prevent a possible exacerbation of the disease.
Use sunlight properties: ultraviolet rays can help reduce inflammation and other symptoms of the disease. It is best to try light therapy under the supervision of a doctor. If this procedure is not available to you, 10 to 15 minutes of exposure to the sun can help reduce the risk of psoriasis exacerbation.
Apply amoisturizing cream: as a rule, hypoallergenic moisturizers are safe for pregnant women. They can be used as an additional therapy to reduce symptoms during a psoriasis outbreak.
Can the symptoms change during pregnancy?
Unfortunately, the doctor has no opportunity to know or predict how psoriasis will manifest throughout the entire period of prenatal development of a child.
Many future mothers suffering from psoriasis are observed to reduce symptoms from beginning to end of pregnancy. Others experience changes in symptoms throughout this period.
Doctors and researchers believe that these differences can be caused by changes in the hormonal background of each woman.
What is the risk of a baby inheriting psoriasis and what is the probability?
All pregnant women are worried about their unborn baby, wondering if the child has five fingers and whether his legs and arms are properly formed. As a patient with psoriasis, your biggest fear will be whether your child will inherited psoriasis or not.
While the causes of psoriasis are not well understood, there is evidence that this is a hereditary illness. Thus, people who are suffering from psoriasis are more likely to have this disease. According to the studies, about one third of patients report a family history of the disease.
However, the presence of psoriasis should not be a constraining factor in your decision to have children since psoriasis is a controllable disease. Thanks to the preliminary planning and support of friends and family, men and women with psoriasis can create a family.
Before you decide to get pregnant, consult a doctor to check if the medicines you take at the moment will have a negative effect on your baby's development. Despite the fact that it is recommended to stop all oral medications before pregnancy, there are drugs that are relatively safe.
For patients with psoriatic arthritis, it is almost impossible to stop taking medications, but there are medicines that are not harmful to the baby.
Future mothers who turn to local therapeutic drugs instead of continuing systemic therapy should continue to be careful, since such agents, absorbed into the skin, also enter the body. It should be noted that patients of both sexes should avoid treatment with PUVA therapy when trying to become pregnant. The plan of your treatment from the conception to the birth of the child should be made by the attending physician.
The ultimate problem for pregnant women with psoriasis is delivery. No matter how the baby is born, whether in a natural way or with the help of Caesarean section, baby delivery can aggravate psoriasis symptoms.
Surgery and surgical procedures to people suffering from psoriasis, as these actions can cause an exacerbation of the disease. In addition, sudden hormonal changes that occur after delivery are negatively affected.
In any case, a woman with psoriasis should discuss the risk of a psoriasis outbreak with her doctor. Besides, future mothers are advised to get all the necessary information regarding the preventive measures that must be taken to avoid exacerbation of the disease and first aid in case of deterioration of its symptoms.
When the time for breastfeeding comes, a woman must take preventive measures, especially mothers who have pysortic lesions on the nipples. It is necessary to look after them with the help of moisturizing or softening agents. Although psoriasis on the nipples doesn’t not affect the baby, it can bring discomfort and painful sensations to the mother. In addition, avoid aggressive local medications in the breast area and especially nipples as they can get in maternal milk.