All About Psoriasis During Pregnancy

How psoriasis behaves during pregnancy is a topic of concern to both pregnant women and those planning to have a baby in the near future. The most important thing is to stop worrying and worrying about it, since stress is harmful, including in preparation for pregnancy. The second step is to visit a gynecologist and dermatologist. They will be able to tell exactly what to do in the case of psoriasis during pregnancy, what medications to use and what to refuse.

Features of psoriasis during pregnancy

Based on the feedback from the patients, we can say that psoriasis in pregnant women does not cause serious problems. No changes occur, and for many women the disease subsides altogether.

The pustular form of the disease behaves a little differently. Most cases of exacerbation of psoriasis during pregnancy are associated with this particular form. The condition either does not change or worsens.

Scientists conducted research on the effect of the disease on pregnant women, having studied the condition of 91 patients, and received the following results:

  • 56% – symptoms have decreased or disappeared;
  • 26% – there was an exacerbation;
  • 17% – the state has not changed in any way.

Many women who reported improvement in their first pregnancy reported improved symptoms during their second pregnancy as well. In 87% of cases, the disease proceeds in the same way as in the previous pregnancy. In women, itching decreases with improvement, rashes and discomfort disappear. This is due to increased levels of the hormone cortisol, which has anti-inflammatory and anti-allergic effects.

More often there are cases of relapse after childbirth, which is typical for moderate and severe forms of the disease. The postpartum period is generally difficult for women, and when combined with worsening psoriasis, recovery can be even more difficult.

Is psoriasis dangerous during pregnancy?

It should be said right away that psoriasis does not in any way affect the ability to conceive and is not included in the list of contraindications for pregnancy. The disease does not reduce fertility, does not provoke the development of defects in the fetus. The only exception is one rare form – herpetiform psoriatic impetigo. It is more difficult to prescribe the correct treatment for psoriasis. This is due to the many restrictions on the use of certain drugs. 

In the question of how psoriasis affects pregnancy, the severity of the disease is important. Women with a mild form should not worry that the disease will have an adverse effect on the fetus. Difficulties can arise in the presence of diseases associated with a severe form of psoriasis. For example, infection of the vesicles in the pustular form of the disease.

As mentioned above, the greatest danger is posed by herpetiformis psoriatic impetigo – an exacerbation of common psoriasis, which manifests itself precisely in pregnant women. It is for this form that pustular rashes, similar to herpetic ones, are characteristic. But the disease is very rare. Usually it is provoked by neuroendocrine disorders:

  • disorders of the parathyroid glands;
  • hypoparathyroidism;
  • hypocalcemia (lack of calcium);
  • traumatic or infectious damage to the thyroid gland.

The disease begins with a sharp rise in temperature, headache and joint pain. Against this background, pustules appear, which are localized in the area of ​​large folds and on the inner surface of the thighs. In severe cases, the illness may be accompanied by chills, vomiting, seizures, and delirium.

Without treatment, the process progresses and leads to the loss of the child. In medicine, there have also been deaths, but these are isolated cases. More often, this form of psoriasis is chronic and recurs for more than 10 years. At the same time, after childbirth, the woman’s condition stabilizes. The disease is not a contraindication for pregnancy. You just need to properly prepare by consulting a dermatologist.

Thus, the harmful effects of psoriasis are as follows:

  • The impact of complications of the disease on the body of a pregnant woman and a child.
  • Side effects of drugs for internal and external use. Medicines may be safe for ordinary women, but are dangerous for pregnant women.
  • The possible development of psoriasis in a child. If one parent is sick – the probability is 8-15%, if both – 40-60%. But today there is already an effective treatment for psoriasis in children, so you should not worry about heredity. 

Otherwise, the disease has no effect on the woman and the child. You can breastfeed him, have tactile contact.

How is psoriasis treated during pregnancy?

A pregnant woman needs to be very careful about any treatment for psoriasis. Having learned about your situation, you should immediately visit a dermatologist to adjust the therapy regimen.

Only a doctor can determine how to smear psoriasis during pregnancy and what systemic drugs to take. Some medications have a negative effect on the fetus. This applies to:  

  • retinoids;
  • antimetabolites – folic acid antagonists;
  • hormonal ointments;
  • cytostatics;
  • celandine;
  • tar;
  • Fluorolen, used in phototherapy.

The list of approved drugs is very limited, and for each woman it is determined individually by an experienced dermatologist. Among the most commonly used are:

  • Skin-Up;
  • Zinocap;
  • salicylic ointment;
  • zinc ointment.

It is important to constantly moisturize the skin and not let it dry out. Many manufacturers produce lines specifically for pregnant women. Unheated sea salt baths can also help. Equally important is the diet, which should contain omega-3 fatty acids: walnuts, vegetable oils, fatty fish and cheese.

In general, it is important to remember that the key to a successful pregnancy against the background of psoriasis is constant monitoring by a gynecologist and dermatologist. Therefore, you should not postpone visits to specialists and visit them as soon as you find out about your situation, as well as when you start planning a pregnancy.

event_note December 29, 2021

account_box Dr. Peter B Milburn

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