Treating Psoriasis During Pregnancy and While Breastfeeding

The first line of therapy for treating psoriasis in pregnant and breastfeeding women should be topical treatment with moisturizers and emollients, such as petroleum jelly, because these products cause no known adverse effects.¹ These new recommendations are from the National Psoriasis Foundation Medical Board, based in Portland, Oregon.

If moisturizers and emollients provide inadequate relief, low to moderate doses of topical corticosteroids may be tried, followed by high-potency topical corticosteroids used only as needed in the second and third trimesters of pregnancy.

Second-line treatment should be narrowband ultraviolet B (UVB) light therapy for pregnant women. Broadband UVB may be used if narrowband UVB is not available.

Other medications that may be considered are tumor necrosis factor (TNF) inhibitors and the immunosuppressant drug cyclosporine, but these medications should be used cautiously and only in the second and third trimesters of pregnancy. Certain strategies can be used to minimize risk and exposure. For example, women should not breastfeed while taking these medications because potential adverse effects are unknown.

Psoriasis affects more than 7 million Americans, and study findings suggest that pregnant women with this chronic skin condition are at increased risk for poor birth outcomes, such as preterm birth and preeclampsia. Compared with women without the disease, women with severe psoriasis have a higher incidence of low birth weight infants.

Reference
1. National Psoriasis Foundation. National Psoriasis Foundation releases recommendations for treatment of psoriasis in pregnant and lactating women. Available at: http://www.psoriasis.org/page.aspx?pid=2286. Accessed December 7, 2011.