What are the safe ways to treat psoriasis in pregnancy?

Question

Hello doctor,

I am 35 years old and currently six weeks pregnant. I have moderate psoriasis and had been taking Secukinumab (immunosuppressant) until I discovered that I was pregnant. I discontinued the medication abruptly, but now my psoriasis is flaring significantly. I would appreciate your guidance regarding the best and safest management options for psoriasis during pregnancy.

Is there any safe treatment for psoriasis during pregnancy?
Could these flares cause systemic inflammation that may harm the baby?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

It is understandable to feel concerned, especially with a flare-up of moderate psoriasis after stopping your biologic therapy. Pregnancy can affect psoriasis unpredictably; for some women, it improves, while for others, symptoms may worsen, particularly during the first trimester. While secukinumab (interleukin-17A inhibitor) and other biologics are generally avoided during pregnancy due to limited safety data, certain cases may justify their continued use under specialist supervision, especially if the disease is severe and significantly impacts the quality of life.

Mild to moderate flares can often be managed with topical treatments that are considered safe during pregnancy. These include low- to medium-potency corticosteroids (topical corticosteroids), moisturizers, and coal tar–free emollients. Phototherapy using narrowband ultraviolet B (NB-UVB) light is another safe, non-pharmacological option that can be very effective during pregnancy.

Regarding the impact of flares, while psoriasis itself is not directly harmful to the baby, uncontrolled inflammation and increased physical stress could potentially affect overall pregnancy health. This is why it is important to strike a balance between effectively managing symptoms and minimizing potential risks.

You should consult both your dermatologist and obstetrician-gynecologist (OB-GYN) to develop a personalized treatment plan that is safe for both you and your baby. With careful and collaborative management, many women with psoriasis go on to have healthy pregnancies.

I hope this information helps you.

Thank you.