What You Should Know About Psoriasis and Pregnancy

A Pregnancy Surprise with an Unexpected Psoriasis Twist

Sarah had always managed her psoriasis well; moisturizers, gentle shampoos, and the occasional dermatologist visit kept her skin flares in check. But when she saw those two pink lines on a pregnancy test, she wasn’t just filled with excitement. A new worry crept in: What will happen to my psoriasis during pregnancy? Will it get worse? Will the treatments harm my baby? Will my child inherit this condition?

Sarah is not alone. Many expectant mothers with psoriasis share the same concerns. This guide will walk you through everything you need to know about psoriasis and pregnancy, so you can step into this beautiful journey with confidence and clarity.

How Does Pregnancy Affect Psoriasis?

Pregnancy is a time of dramatic hormonal changes, and for many women, psoriasis symptoms actually improve. Research suggests that about 40-60% of pregnant women with psoriasis experience relief as their immune system shifts to support the growing baby. However, 10-20% may see worsening symptoms, and for others, psoriasis remains unchanged.

Why Does Psoriasis Improve for Some Women?

• Pregnancy triggers an increase in anti-inflammatory cytokines, which may calm the overactive immune response that drives psoriasis.

• Higher levels of estrogen and progesterone may have protective effects on the skin.

• Increased cortisol levels act as natural anti-inflammatories.

Why Does It Worsen for Others?

• Some women experience increased skin sensitivity due to hormonal shifts.

• Stress and lack of sleep—common in pregnancy—can trigger flare-ups.

• Discontinuing certain psoriasis treatments (especially biologics) for safety reasons can lead to a rebound effect.

Postpartum Flare-Ups: Be Prepared

While some women enjoy clearer skin during pregnancy, the postpartum period is often a different story. After delivery, hormone levels drop sharply, and psoriasis can come back with a vengeance. If you experienced relief during pregnancy, prepare for potential flares in the months after birth.

Safe Psoriasis Treatments During Pregnancy

One of the biggest concerns for expectant mothers with psoriasis is treatment safety. Not all psoriasis medications are safe during pregnancy, and some may pose risks to the developing baby.

Treatments Generally Considered Safe:

✅ Moisturizers & Emollients – Keeping skin hydrated is essential. ✅ Topical Corticosteroids (Low-Potency) – Mild creams can help control flares. ✅ Coal Tar (Limited Use) – Small amounts in shampoos may be safe but always consult your doctor. ✅ Phototherapy (Narrowband UVB) – A well-researched, non-drug treatment safe during pregnancy.

Treatments That Require Caution:

⚠️ Salicylic Acid – Found in some psoriasis treatments; best to limit use over large areas. ⚠️ Vitamin D Analogues – Use should be carefully monitored by a doctor.

Avoid These During Pregnancy:

🚫 Methotrexate & Acitretin – Known to cause birth defects; absolutely unsafe. 🚫 Biologics & Systemic Medications – Some may be safe, but many lack enough research; always discuss with your healthcare provider.

What About Nopsor Treatment?

Nopsor Shampoo (coal tar and salicylic acid) and Nopsor Pomade contain herbal ingredients designed for psoriasis management. While coal tar is sometimes used in small amounts, it’s best to consult with your doctor about the safety of any topical treatment during pregnancy.

Will My Baby Inherit Psoriasis?

This is a question every expecting parent with psoriasis asks. Psoriasis has a genetic component, but it’s not guaranteed your child will develop it.

• If one parent has psoriasis, the child has a 10-20% chance of developing it.

• If both parents have psoriasis, the risk jumps to 50% or higher.

• Environmental triggers like stress, infections, or diet may also play a role in whether the condition manifests.

While there’s no way to prevent psoriasis entirely, focusing on a healthy lifestyle, a balanced diet, and early skincare routines may help reduce the likelihood of flare-ups later in life.

Breastfeeding with Psoriasis: What You Need to Know

Many mothers worry about whether psoriasis affects breastfeeding or if medications will pass through breast milk.

Breastfeeding and Psoriasis Flares

Some women experience flares on their breasts, making breastfeeding painful. Applying a gentle moisturizer or coconut oil can help soothe irritated skin. If psoriasis affects the nipples severely, a lactation consultant can provide alternative feeding methods.

Are Psoriasis Medications Safe for Breastfeeding?

• Topical corticosteroids: Generally safe if wiped off before nursing.

• Moisturizers and emollients: Safe and beneficial for both mother and baby.

• Phototherapy (UVB): Does not affect breast milk.

• Systemic medications: Many are not safe; check with your doctor before using.

There is growing interest in whether breast milk can help psoriasis, as it contains anti-inflammatory compounds. However, scientific evidence is limited, and more research is needed.

Final Thoughts: Embracing Pregnancy with Psoriasis

Pregnancy is a unique and transformative time, and having psoriasis adds another layer of complexity. But with the right information, medical guidance, and self-care, you can navigate pregnancy and postpartum successfully.

Sarah, the expectant mother we met at the beginning of this article, found that while her psoriasis flared unpredictably, staying informed and working closely with her doctor gave her confidence. Today, she’s not just managing her skin—she’s embracing motherhood with joy.

If you’re expecting and have psoriasis, remember you’re not alone, and there are safe ways to manage your condition. Talk to your doctor, prepare for postpartum changes, and most importantly, enjoy the journey to meeting your little one.

References:

National Psoriasis Foundation (NPF): Provides comprehensive guides and articles on managing psoriasis, including during pregnancy.

American Academy of Dermatology (AAD): Offers detailed information on the treatment options available for psoriasis patients during pregnancy.