Can atopic dermatitis worsen during pregnancy?

Question

Hello doctor,

I am 33 and have had severe atopic dermatitis since childhood, but over the past few months, my flare-ups have become unbearable, especially around my neck, breasts, and inner thighs. I am planning for pregnancy soon and was wondering whether my skin condition or medications like Dupilumab could affect conception or the baby’s health. I have stopped using steroid creams out of fear, but now my skin is constantly dry and inflamed.

Are there safer options during pregnancy or breastfeeding?
Also, my periods have become painful and more irregular. Can stress and hormonal imbalance worsen eczema?
Can hormonal contraceptives or IUDs aggravate the condition?
I also feel very self-conscious during intimacy because of the itching and skin thickening. Could this be due to low estrogen levels?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

I can really understand how exhausting these flare-ups must feel, especially when you are planning for pregnancy. You have managed this for years, so it is completely natural to be extra cautious now.

Atopic dermatitis can definitely worsen due to hormonal and emotional stress, and changes before pregnancy sometimes make the skin extra sensitive. Stopping steroid creams suddenly might have caused rebound inflammation, which is why the skin feels constantly dry and irritated now.

Dupilumab (Dupixent) is relatively safe based on current studies, but data in pregnancy is still limited. If your symptoms are severe, your dermatologist might continue it under close supervision it is considered safer than long-term oral steroids.

For now, switch to regular use of bland emollients (like petroleum jelly or ceramide-based creams) several times a day, especially after bathing. For inflammation, mild topical steroids (like hydrocortisone) can be used safely even during pregnancy in short courses under your doctor’s guidance. Tacrolimus ointment is another safer option for sensitive areas if needed.

Avoid triggers like-

Synthetic fabrics.
Hot showers.
Harsh soaps.
Stress. .

Try gentle cleansers and keep the skin well hydrated.

Your irregular and painful periods could be due to stress or hormonal imbalance, which can indirectly worsen eczema. Low estrogen can cause dryness, but this is reversible and does not necessarily mean a permanent hormone issue.

Hormonal contraceptives may not directly cause eczema, but can sometimes make it fluctuate. Non-hormonal IUDs or barrier methods are safer if your skin flares with hormonal shifts.

Do not lose confidence; these skin changes are treatable, and with the right care plan from your dermatologist and OB-GYN, you can have a comfortable pregnancy and better skin balance.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.