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The average age for a woman to be diagnosed with psoriasis is 28. If you are a woman with psoriasis, this is around the peak age for getting pregnant. If you want to start a family, it is natural to have questions about how psoriasis will affect you and your child. You will want to know how psoriasis may affect your pregnancy and how your pregnancy may affect your psoriasis. You will also want to know the risk of passing psoriasis to your child and how psoriasis treatment changes during pregnancy and breast-feeding.
Psoriasis and Pregnancy
Psoriasis should not affect your ability to get pregnant. Most women who want to get pregnant have successful pregnancies. In fact, most women find that psoriasis improves during pregnancy. But for about 10 to 20 percent of women, psoriasis may flare. Some studies suggest that women with severe psoriasis may have a higher risk of giving birth to a baby with a lower than normal birth weight. The good news is that there is no reason not to get pregnant because you have psoriasis. Pregnancy with psoriasis is not a high-risk pregnancy.
Psoriasis is also safe for breast-feeding. Even if you have psoriasis on your breasts or nipples, this is not a danger to your baby. It may make breast-feeding more uncomfortable and for some women that may lead to a switch to bottle-feeding.
Will Your Baby Have Psoriasis?
Psoriasis does tend to run in families. Several psoriasis genes have been discovered that can be passed down to a child. But passing on the gene does not mean your baby will always get psoriasis. Identical twins have the exact same genes, but studies show that if one identical twin has psoriasis, there is a 30 percent chance that the other twin will not.
Something else in a person’s environment must occur to trigger the psoriasis gene. Researchers are still trying to figure out what the triggers are. Being born with the gene only increases the risk. If you and your partner both have psoriasis, your child has a 75 percent chance of developing the condition. If only one of you has psoriasis, the risk is only 15 percent.
Psoriasis Treatment and Pregnancy
Having psoriasis is not dangerous for your baby, but some psoriasis treatments are. It is really important to talk to your doctor if you plan to get pregnant or if you get pregnant unexpectedly. Planning ahead is best. This gives your doctor time to get you off any medications that may be dangerous. This is called a washout period. If you have an unplanned pregnancy, let your doctor know right away. You may need to change treatments.
Here are the basics on psoriasis treatments, pregnancy, and breast-feeding:
- As with all drugs during pregnancy and breast-feeding; no drugs are the safest.
- Topical moisturizers and emollients are the safest drugs to use.
- Phototherapy using UVB is considered safe. Phototherapy with UVA and psoralen (PUVA) is not safe.
- A short course of topical steroids is probably safe, but you should not use these on your nipples if breast-feeding.
- Any oral psoriasis drugs should be avoided if possible. Drugs like retinoids, methotrexate, and cyclosporine should be avoided at all costs. These are known to cause birth defects. Biologic drugs are not known to cause birth defects, but there is not enough data on them to say they are safe.
Every year 65,000 to 107,000 women with psoriasis have babies. Many of these women have moderate to severe psoriasis. The vast majority of these women have successful pregnancies and healthy babies. If you have psoriasis and you want to start a family, talk to your doctor. You may need to change your treatment for a while but there is no reason to avoid pregnancy.