Heard a lot about psoriasis and pregnancy? Find out what’s true and what’s not

If you’re living with psoriasis and thinking about getting pregnant, you may have some questions. 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 rumours 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 pregnancy, they caution against using them on your breasts during breastfeeding.2 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.3

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.3  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 low birth weight or placental complications4,5. 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.6 If both you and your partner have psoriasis, the chance is around 65%.6 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.7 In other words, psoriasis is a complex skin disease that involves many factors, not just genes.

References

1Pregnancy 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

2Evidence-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

3Psoriasis 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

4Psoriasis 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

5Pregnancy 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

6Genetic 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

7Website “National Psoriasis Foundation/USA” – Genes and Psoriasis. Last accessed: 18 July 2019. https://www.psoriasis.org/research/genes-and-psoriatic-disease

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