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The selection of medicines for the treatment of psoriasis during pregnancy is small, since the majority of psoriasis medications are toxic to the fetus, and can lead to disorders during the intrauterine development of the child.
Your doctor will advice you weather or not to use your previous medications for psoriasis, or will prescribe you other - safe for pregnancy - treatments, if it is necessary.
Topical Psoriasis Treatment during Pregnancy
Dermatologists prescribe the topical means for psoriasis treatment during pregnancy only in rare severe cases.
Topical medicines are not safe, since they get absorbed through the skin into our bodies. Some of them are contraindicated to pregnant woman, since they are teratogenic (can lead to disorders during the intrauterine development of the child).
Topical Medicines during Pregnancy:
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Moistening creams are permitted topical medicines which can be used without any risk.
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Uric acid and Salicylic acid can be used only on the limited sections of the skin.
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Topical steroids can be used in severe cases in small quantities and on very limited sections of the skin. These medicines should not be applied on the breast, stomach or arms.
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Vitamin D derivatives can be used in severe cases in very small quantities and on very limited sections of the skin.
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Vitamin A derivatives are contraindicated during pregnancy, since they are teratogenic (can lead to disorders during the intrauterine development of the child).
Systemic Psoriasis Treatment during Pregnancy
Systemic treatment uses substances that travel through the bloodstream in the body. Systemic treatment is typically used only in severe cases of psoriasis: i.e. psoriasis that hasn't responded to topical treatments or phototherapy, severe types of psoriasis (Psoriatic Erythroderma etc) or psoriasis that covers more than 20% of the body. Many of the systemic drugs can cause serious side effects.
The majority of Systemic means possess teratogenic action, which can lead to severe anomalies in the development of the fetus; their teratogenic action is especially high during pregnancy.
Therefore, the majority of psoriatic medicines for the internal administration are stopped during pregnancy.
Systemic medications: Acitretin (trade name Soriatane) and other Retinoids as well as Methotrexate - can cause severe defects in a child and even lead to spontaneous abortion.
Planning pregnancy is possible only after enough time has passed after stopping these medicines in order for their complete removal from the body; therefore a couple must use contraceptives during the treatment with and for the course of at least three months after stopping the treatment with Acitretin, Methotrexate and such.
Narrow-band phototherapy (UVB) is considered safe enough during pregnancy.
Psoriatic Arthritis and Pregnancy
Women, who suffer from Psoriatic Arthritis, during their pregnancy, can feel a strengthening of the pains in the joints, caused by weight gain.
In many cases Psoriatic Arthritis improves during pregnancy, just like psoriasis itself. In some cases it will get worse again after giving birth, similar to psoriasis.
Psoriatic Arthritis also does not affect your chances of having children or a successful pregnancy.
Generalized Pustular Psoriasis in Pregnancy
In some women during the pregnancy there may appear one of the most severe and rare versions of psoriasis - Generalized Pustular Psoriasis, which may develop either during the pregnancy or soon after giving birth.
Hormonal fluctuations may lead to the appearance of the Generalized Pustular Psoriasis in pregnancy or after giving birth.
Psoriatic lesions, in this case, usually at first affect the skin folds. Throughout the stomach area and in the inguinal region there start to appear extended red plaques, accompanied by itching. The pustules appear around the psoriatic plaques, sometimes the pustules are filled with mucosa. This process is accompanied by the worsening in general overall health. Other symptoms may include nausea, fever and chills.
Topical steroids in this case are usually ineffective due to the constant hormonal changes; therefore antibiotics are frequently prescribed during such aggravations.
Generalized Pustular Psoriasis in pregnancy frequently has severe consequences for the fetus, and may even lead to a spontaneous abortion.
Generalized Pustular Psoriasis, which arose during the pregnancy, usually passes after giving birth.
If it appeared during the first pregnancy, the risk of its appearance remains in the subsequent pregnancies.
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