Psoriasis in Pregnancy

definition

The German synonym for psoriasis is psoriasis. It is an inflammatory, non-infectious, chronic skin disease. Psoriasis is one of the most common autoimmune diseases. Well-defined red plaques with silver scales are characteristic of this disease.

Psoriasis doesn't necessarily affect pregnancy. Affected women often ask themselves whether the unborn child will develop normally, whether they can breastfeed, whether the psoriasis will worsen during pregnancy and whether the drugs are harmful to the unborn child. There is no general answer to these questions. But certain experiences, results and findings from scientific studies can point the way.

Change in psoriasis during pregnancy

Some studies attempted to establish a relationship between hormonal fluctuations and psoriasis. In many cases, women report that their psoriasis improved during pregnancy. After delivery, however, the disease was often found to worsen. Some authors suggest that the changes in psoriasis can only be partially explained by hormonal fluctuations during pregnancy.

Psoriasis flare-up due to pregnancy

The skin of affected pregnant women is usually better.

But in some cases a psoriasis flare-up can also occur. According to studies, this occurs in less than one in four women. The causes of the worsening symptoms are unknown. One suspects a combination of several components. Changes in the hormonal balance and stress factors could play a role. Some women get their first psoriasis attack during pregnancy. Consultation from a doctor is required if psoriasis attacks during pregnancy.

In a US study of 248 psoriasis patients, it was found that 87% of women who had multiple pregnancies saw the same response over and over. This means that if a psoriasis flare-up occurs, there is a high risk that a new pregnancy will also have a flare-up.

Read more on the topic:

• Skin changes during pregnancy
• Dry skin during pregnancy
• Skin diseases during pregnancy

Treatment options

Treatment for psoriasis is limited during pregnancy. Most of the drugs used are harmful to the unborn child. In particular, systemic / internal therapies can often lead to serious deformities in the unborn child.

Therefore, oral medication for psoriasis is usually not used. For example, acitretin and methotrexate should be avoided. Ciclospoprin A appears to be harmless to the embryo. But it has a high risk of side effects and interaction with other drugs and also with the substance naringin in grapefruits. The drug is prescribed only in exceptional cases for psoriasis during pregnancy.

Even with locally applied drugs, not all substances should be used during pregnancy. For example, vitamin A derivatives should be avoided. The use of vitamin D derivatives in small amounts is possible.

As part of psoriasis treatment, well-tolerated, moisturizing and calming creams can usually be used without hesitation. According to need and indication, corticosteroids, e.g. Cortisone ointments are used for the affected areas of the skin. If possible, these ointments should not be used on the breasts, abdomen and hips as they can increase the appearance of stretch marks. In addition, ointments with ingredients such as urea and salicylic acid can be used locally in small quantities.

Read more on the topic: Cortisone in pregnancy - how dangerous is it?

light therapy

Light therapy is a part of psoriasis treatment. It is also called Phototherapy designated. There are different types.

With PUVA, photosensitization occurs through psoralen and UVA radiation. PUVA therapy can be damaging to the embryo. This is due to the contained psoralen. Therefore, this type of light therapy is not recommended during pregnancy.

Narrow-spectrum UVB therapy is apparently harmless to the unborn child. It can therefore be used in psoriasis treatment - if psoriasis occurs over a large area. The UVB radiation has a good effect, but not a satisfactory duration of action. However, an adequate balance between benefits and harm is required so that UVB therapy can temporarily be the means of choice.

Read more on the topic: Light therapy for psoriasis

Genital psoriasis during pregnancy - dangerous?

Since psoriasis is not contagious in the genital area either, it usually poses no danger, even during pregnancy. If you are unsure, the gynecologist should be contacted.

Read more on the topic:

• Vaginal fungus in pregnancy
• Genital herpes

Psoriatic arthritis in pregnancy

15% of patients with psoriasis have psoriatic arthritis. Weight gain during pregnancy can make psoriatic arthritis worse in some women. This means that in addition to the skin symptoms, joint pain can occur.

The therapy must be discussed with the gynecologist in terms of a benefit-harm ratio. The treatment of psoriatic arthritis is based on a graduated scheme. This means that the therapy depends on the severity of the disease. It is divided into mild, moderate and heavy.