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The truth about psoriasis and pregnancy

If you’re living with psoriasis and thinking about getting pregnant, you’ve likely heard the rumors – both the good and the bad. Are women with psoriasis at higher risk for pregnancy complications? Will your psoriasis go away when you’re pregnant? What happens after you deliver – are the post-pregnancy flare-up rumors true?

It’s a lot to consider. So to help clear things up (no pun intended), we’ve broken down what the science has to say about it.

Psoriasis does not impact your chances of getting pregnant

Well, here’s the good news: research shows that having psoriasis does not affect your chances of having a baby.1 Now don’t go running out and jumping into bed just yet (or at least not until you finish reading this article)! There are still a lot of things to consider when living with psoriasis and deciding to get pregnant. The elephant in the room is of course your treatment, and whether or not your treatment regimen will need to change when you’re pregnant. Have an open conversation with your doctor about this – they are used to helping patients tackle these issues.

But there are also some things you may not want to think about that could become major dilemmas you’ll need to address. Anyone want to talk about nipple irritation? We didn’t think so. But get this – while some experts recommend the use of mild topical steroids to ease flare-ups after pregnancy2, they caution against using them on your breasts during breastfeeding.3 So that could mean more irritation in places you’d rather not talk about than most.

Your psoriasis might get better during pregnancy             

Don’t ignore the word “might”! This one is a mixed bag. Lots of people hear talk of psoriasis getting better during pregnancy and get really excited, and we don’t blame them. But research shows this doesn’t happen for everyone – about 40-60% of women find their skin condition improves during pregnancy.4 If you’re one of them, it can be quite an enjoyable 9 months.

Your psoriasis might get worse after pregnancy

Apologies for getting you all excited and then raining on the parade. But the research unfortunately shows that psoriasis may in fact worsen after the pregnancy bliss. In the same study, 65% of women reported a worsening of psoriasis symptoms postpartum.5 Again, this is just one study and psoriasis and pregnancy interact differently in everyone. You and your doctor know your body best, and can determine the best course of action.

You may be at greater risk for pregnancy complications

This one is important – studies show that women with psoriasis have a higher risk of premature birth, low birth weight or placental complications.6 If you’re concerned about the risks, speak to your doctor.

Your baby may or may not have psoriasis

If you have psoriasis then there’s about a 1 in 4 chance that your child will inherit the condition. If both you and your partner have psoriasis, the chance is around 65%.9,10 It’s worth remembering, though, that just because your baby inherits genes linked with psoriasis, it does not mean he or she will actually develop the condition. In fact, around one in ten people carry genes associated with psoriasis, and yet just 2% of the population is affected.11 In other words, psoriasis is a complex skin disease that involves many factors, not just genes. 

So there you have it, the science has spoken. Now it’s time for you to speak to your doctor and decide what’s best for you. Have you grappled with this decision before? Share your experience with our Facebook community here.

 

References

  1. Pregnancy and pregnancy outcome among women with inflammatory diseases. Seeger JD, Lanza LL, West WA, Fernandex C, Rivero E. 2007 ; 214(1) :32-9. http://www.ncbi.nlm.nih.gov/pubmed/17191045
  2. Evidence-based (S3) guideline on topical corticosteroids in pregnancy. Chi CC, Kirtschig G, Aberer W, Gabbud JP, Lipozenčić J, Kárpáti S, Haustein UF, Zuberbier T, Wojnarowska F. Br J Dermatol. 2011 Nov;165(5):943-52. doi: 10.1111/j.1365-2133.2011.10513.x. http://www.ncbi.nlm.nih.gov/pubmed/?term=21729030
  3. Website “National Psoriasis Foundation/USA” – Pregnancy and Nursing, Treatment with topicals during pregnancy, Treatment with light therapy. Last accessed: 14.09.15. 
    https://www.psoriasis.org/pregnancy 
    https://www.psoriasis.org/pregnancy/treatments/topicals 
    https://www.psoriasis.org/pregnancy/treatments/light-therapy
  4. Psoriasis in Pregnancy. Sorin D, Pavlovsky L, David M. Curr Derm Rep (2012) 1:209–213. http://link.springer.com/article/10.1007/s13671-012-0024-8
  5. Hormonal effect on psoriasis in pregnancy and post partum. Murase JE1, Chan KK, Garite TJ, Cooper DM, Weinstein GD. Arch Dermatol. 2005 May;141(5):601-6. http://www.ncbi.nlm.nih.gov/pubmed/15897382
  6. International Federation of Pharmaceutical Manufacturers & Associations. Bringing Psoriasis into the Light. Available at: http://www.ifpma.org/fileadmin/content/Publication/2014/Psoriasis_Publication-Web.pdf Accessed: Sept 2015.
  7. Psoriasis and pregnancy outcomes: a nationwide population-based study. Yang YW, Chen CS, Chen YH, Lin HC. J Am Acad Dermatol. 2011 Jan;64(1):71-7. doi: 10.1016/j.jaad.2010.02.005. http://www.ncbi.nlm.nih.gov/pubmed/?term=20970879
  8. Pregnancy outcome in women with psoriasis. Ben-David G, Sheiner E, Hallak M, Levy A. J Reprod Med. 2008 Mar;53(3):183-7. http://www.ncbi.nlm.nih.gov/pubmed/?term=18441722
  9. Genetic counselling in psoriasis: empirical data on psoriasis among first-degree relatives of 3095 psoriatic probands. Swanbeck G, Inerot A, Martinsson T, Enerbäck C, Enlund F, Samuelsson L, Yhr M, Wahlström J. Br J Dermatol. 1997 Dec;137(6):939-42. http://www.ncbi.nlm.nih.gov/pubmed/?term=9470911
  10. Website “British Skin Foundation” – Is psoriasis hereditary? Last accessed: 14.09.15. http://www.britishskinfoundation.org.uk/SkinInformation/AtoZofSkindisease/Psoriasis.aspx
  11. Website “National Psoriasis Foundation/USA” – Genes and Psoriasis. Last accessed: 14.09.15. https://www.psoriasis.org/research/genes-and-psoriatic-disease
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