How to manage psoriasis during pregnancy?

Question

Hello doctor,

I am a 36-year-old woman. I have had red, scaly patches on my elbows, scalp, and lower back for the past few months. The itching becomes worse in winter. A doctor told me it is psoriasis. I am worried because it is visible, and people stare at it. Sometimes the skin cracks and bleeds.

I read that psoriasis is an autoimmune disease.

Does this mean it will keep coming back?
Will it affect pregnancy or menstrual periods?
What are the safest treatment options for women like me?
I do not want strong medicines if they cause side effects. Can diet or stress make it worse?

I also want to know if this condition can affect my joints or cause arthritis later. Please explain everything in simple terms.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com

I read your query and can understand your concern.

Psoriasis occurs when the immune system (the body’s defense system) becomes overactive and causes skin cells to grow too quickly. As a result, thick, red, scaly patches develop on the skin. This condition usually follows a relapsing pattern, meaning it tends to come and go in phases. At times, it may improve, while at other times it may worsen. However, with proper treatment and care, psoriasis can be very well controlled.

Psoriasis will not affect your fertility, conception, or menstruation. On the contrary, some patients observe an improvement in their condition when they become pregnant due to changes in hormones. The only issue with this disease is the usage of some potent drugs prescribed for treating severe cases of psoriasis, which are harmful when taken during pregnancy.

Treatment plan:

Treatment begins with a focus on gentle methods. Moisturizers and emollients help hydrate the skin, preventing dryness, scaling, and cracking. Topical medications include steroid creams, Calcipotriol or other vitamin D analogues that retard the proliferation of cells in the skin, as well as coal tar shampoo/lotions, which could be used especially in case of involvement of the scalp.

Treatment may include sunbathing or phototherapy (a treatment involving light that retards the proliferation of skin cells). Lifestyle treatment should include the avoidance of harsh soaps, moisturization of the skin, and prompt treatment of infection. Oral medication and biologics (immune-targeted medications) should be used only in the case of severe symptoms.

Regarding follow-up:

Regular follow-up is advised to monitor improvement and adjust treatment if needed. Please schedule a follow-up visit soon.

Preventive measures:

Stress is the triggering factor for psoriasis flare-ups, so stress management is very important. Maintaining a balanced diet, getting regular sleep, practicing yoga, and engaging in routine exercise can help keep psoriasis under better control. In addition, some patients find it beneficial to reduce alcohol intake, avoid smoking, and limit highly processed foods.

Kindly revert if there are any queries.

Thank you.