A few years ago, I hosted a roundtable discussion attended by women living with psoriasis on a variety of topics surrounding the disease. I asked the ladies: “If you had to sacrifice 10 years of your life for a quality treatment, such as a biologic to rid you of your psoriasis or psoriatic disease, would you?”
This question was inspired by an earlier discussion about the possibility of harmful side effects, such as cancer, from biologics. One woman had tears in her eyes when she said she wasn’t sure if she would sacrifice 10 years, but she was afraid of stopping her medicine, prompting her psoriasis to flare.
Another woman, who had a son, said she would not trade years of her life for a cure because she wanted to be here as long as possible for her child. The other four women stated that they would sacrifice those years, with one woman saying, “It’s not about the quantity of life, but the quality.” What all four of those women had in common was that they did not have kids. Some of them said they were not willing to stop their psoriasis treatment to carry a child through pregnancy.
There are many questions and concerns about having psoriasis while pregnant. In addition to these women, I had a chance to discuss the subject with both a dermatology PA-C out of Atlanta about carrying a child while dealing with the disease. Here’s what she had to say.
Check out these Facts about psoriasis and pregnancy
True or False: There are no treatment options available for pregnant women.
False: Lisa Hill, PA-C of Atlanta Medical Dermatology advises that there are, in fact, a few treatment options for women: “Light therapy and topical steroids are the treatments of choice in pregnancy. Although most topical steroids are not category B, they are generally considered OK to use during pregnancy in limited amounts and time.”
In 1979 the Food and Drug Administration created a list that contained five different categories (A,B,C,D, and X) which signified the risk factors of each medicine for pregnant women. The list was revised in 2015, but has yet to be universally accepted and translated among medical professionals. “Category B” stands for drugs that have been tested on animals and showed no risk, but had not actually been tested on pregnant women. An updated explanation of medication and pregnancy can be found here.
“If a woman is planning a pregnancy, then she should talk to her dermatologist before she tries to conceive to check specifically about her treatment regimen and when it is safe to start trying,” Lisa says.
True or False: A woman’s psoriasis improves during pregnancy.
Depends: I’ve heard this topic discussed in lengthy detail among women in the psoriasis community, but for most expectant mothers, it’s still unclear whether pregnancy affects the disease. I had the chance to also speak with psoriasis advocate, fashion blogger, and mother-to-be Sabrina Skiles, who is now pregnant with her second child. She researched the issue and found various opinions: “I read a lot of horror stories about women’s psoriasis coming back full force [during pregnancy], and sometimes it came back in areas they had never had it before. But then, on the other hand, there are women who say their psoriasis stayed the same or it went away…”
Lisa dove further into why improvement of psoriasis is seen in some women: “When your body is pregnant, it is preoccupied with growing a human being and the immune system is ‘distracted’ (for lack of a better word) during this time. The immune system ‘forgets’ it’s supposed to be making psoriasis for the time being. Its main focus has shifted to growing and protecting a growing fetus. Once the body is done growing a human and the mom delivers her baby, it usually is only a matter of time for her body to start making psoriasis again.”
It’s important to remember that every woman is different and there is no “one size fits all” answer to this question.
True or False: A woman should stop her psoriasis treatment if she unexpectedly becomes
True: If a woman is on drugs, such as biologics, she should most definitely take precautions to prevent pregnancy due to the dangerous side effects medicines can cause to a fetus. Lisa says: “If a woman conceives while on treatment she should stop treatment until she can contact her dermatologist to ask if her specific treatment is ok to continue while pregnant. There are systemic medications that are completely contraindicated in pregnancy, like methotrexate, that actually cause miscarriages to happen.” If you are on a psoriasis drug it’s best to plan your pregnancy and speak with your doctor about how long it will take the medicine to leave your system. Some drugs only take days, while others may take weeks to completely leave the body.