Can psoriasis worsen to psoriatic arthritis after pregnancy?

Question

Hello doctor,

I am 34 years old and have psoriasis on my scalp and knees. However, after having my second baby eight months ago, I began experiencing stiffness and joint pain in my hands and feet. On some days, I can barely grip objects, and I am struggling to care for my children. Could this be psoriatic arthritis triggered by childbirth or hormonal changes? Are there treatments that are safe to use while breastfeeding, and could this condition affect my ability to have more children in the future?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I am sorry for this, that sounds incredibly tough – juggling a new baby while dealing with this pain and stiffness. I truly admire your strength. What you are describing – new joint symptoms on top of psoriasis, especially after childbirth – raises concern for psoriatic arthritis (PsA). Postpartum hormonal shifts can sometimes act as a trigger for autoimmune flares like this.

The good news?

There are safe and effective treatments while breastfeeding.

We can start with:

1. Topical NSAIDs: (Diclofenac gel) for targeted knee or hand pain.

2. Oral NSAIDs: (Ibuprofen or Naproxen) in low-to-moderate doses are generally considered compatible.

3. Sulfasalazine: A very common first-line DMARD (disease-modifying anti-rheumatic drug), often safe for breastfeeding (we will monitor closely).

4. Vertolizumab pegol (Cimzia): A biologic specifically approved as safe during pregnancy and breastfeeding.

This does not mean that you cannot have more children. Well-controlled psoriatic arthritis (PsA) should not prevent future pregnancies.

I hope this helps.

Please follow up if you have any further concerns.

Thank you.