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.
Characteristic for this disease are easily distinguishable red plaques with silver scales. Psoriasis does not 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 medication is harmful to the unborn child. These questions cannot be answered in general. But certain experiences, results and findings from scientific studies can point the way forward.
Changes in psoriasis during pregnancy
Some studies have tried to establish a relationship between hormonal fluctuations and psoriasis. In many cases, women report that their psoriasis has improved during pregnancy. After delivery, however, a worsening of the condition was often observed.
Some authors suspect that the changes in psoriasis can only be explained to a limited extent by hormonal fluctuations during pregnancy. The skin condition of affected pregnant women usually often improves. But in some cases, a psoriasis relapse can also occur.
According to studies, this occurs in less than every 4th woman. The causes for the worsening of the symptoms are unknown. A combination of several components is suspected.
Changes in hormone levels and stress factors could play a role. Some women get their first psoriasis attack during pregnancy. If psoriasis attacks occur during pregnancy, a doctor’s consultation is required. In a study in the USA with 248 psoriasis patients, it was found that 87% of the women who had experienced several pregnancies always observed the same reaction. This means that if a psoriasis relapse occurs, there is a high risk that a relapse may also occur during a new pregnancy.
Treatment options
The treatment of psoriasis is limited during pregnancy. Most of the drugs used are harmful to the unborn child. Especially the systemic internal therapies can often lead to serious deformities of the unborn child.
For this reason, oral medications for psoriasis are generally not used. For example, acitretin and methotrexate should be avoided. Ciclospoprine A seems to be harmless for 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 for psoriasis in pregnancy only in exceptional cases. Even with the 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 soothing creams can usually be used without hesitation.
Corticosteroids, such as cortisone ointments, can be used for the affected skin areas as required and indicated. If possible, these ointments should not be applied to the breasts, abdomen or hips, as they can increase the development of stretch marks. In addition, ointments with ingredients such as urea and salicylic acid can be used locally in small quantities.
Light therapy is a component of psoriasis treatment. It is also called phototherapy. There are different types.
PUVA involves photosensitization by psoralen and UVA radiation. PUVA therapy can have a damaging effect on the embryo. The reason for this is the psoralen contained in it.
Therefore, this type of light therapy is not recommended during pregnancy. A narrow spectrum UVB therapy is apparently harmless for the unborn child. Therefore, it can be used in psoriasis treatment – if psoriasis occurs over a large area. UVB radiation has a good effect but no satisfactory duration of action. However it requires an adequate weighing between use and damage, so that a UVB therapy can be temporarily means of the choice.
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