Fitness and healthy lifestyle 

Psoriasis during pregnancy: features, treatment. Drugs and methods prohibited during pregnancy with mother's psoriasis. Topical remedies to avoid during pregnancy


Psoriasis is a chronic, non-infectious disease that predominantly affects the skin. The disease occurs mainly in young women, including during pregnancy. The course of psoriasis in expectant mothers largely depends on the initial severity of the condition, as well as on the individual characteristics of the response of the immune system.

Causes

Psoriasis is equally common in men and women. Mostly people aged 15-30 are sick. The first episode of the disease usually occurs during adolescence. It is not always possible to find out the exact cause and provoking factors for the development of psoriasis in a particular patient.

Psoriasis belongs to a group of autoimmune diseases. This means that the body's own immune system reacts against the body's cells, destroying them and interfering with the normal functioning of organs and tissues. There is a pathological production of aggressive antibodies that lead to the formation of autoimmune inflammation and the development of all the main symptoms of the disease.

In psoriasis, mainly the skin is affected. Involvement of internal organs and joints in the pathological process is possible. Up to 10% of all psoriasis patients suffer from psoriatic arthritis.

Risk factors for developing psoriasis:

  • genetic predisposition;
  • stress;
  • infectious diseases;
  • mechanical damage to the skin;
  • bad habits (addiction to nicotine and alcohol);
  • taking certain medications (anti-inflammatory, antihypertensive, etc.).

The exact reasons for the development of psoriasis have not yet been clarified. An important role is played by the genetic mechanisms of transmission of the disease. It is assumed that the genes responsible for the development of psoriasis affect the functioning of the immune system and, above all, T-lymphocytes. In 50% of patients, the PSORS1 gene is isolated, which is considered the main culprit in the development of psoriasis.

The viral theory of the appearance of psoriasis has not been confirmed. At the same time, it is known that the disease often manifests itself after the transferred flu, tonsillitis or other infectious diseases. We are not talking about the direct destructive action of microorganisms, but about the individual reaction of the immune system in response to the ingress of viruses and bacteria into the blood. The likelihood of developing psoriasis increases after severe infections.

It is noticed that the disease often occurs against the background of staphylococcal and streptococcal skin lesions and mycoses (fungal infection). Some experts consider this a provoking factor, while others argue that mycoses and other skin diseases arise as one of the complications of psoriasis. The likelihood of developing the disease increases in HIV-infected women.

Psoriasis is more common in people with thin, dry skin prone to allergic reactions. In areas of oily skin, the disease is extremely rare. The first lesions are usually found in areas of friction or injury. The risk of developing psoriasis increases in women who work in hazardous industries and have constant contact with substances that are aggressive to the skin.

Skin symptoms of psoriasis

Psoriasis most often occurs during adolescence, long before the first pregnancy. In anticipation of the baby, an exacerbation of the disease is possible against the background of hormonal changes and changes in the body's immune response. In rare cases, the first episode of psoriasis occurs during pregnancy.

Signs of psoriasis:

  • the appearance of typical psoriatic plaques;
  • thickening of the skin;
  • itchy skin;
  • peeling.

A psoriatic plaque is a pale gray area of ​​thickening of the skin. In appearance, the plaque resembles hardened wax. The mass can be located anywhere on the skin, including the scalp. The favorite localization of psoriatic plaques is the extensor surfaces of the arms and legs in the area of ​​the joints.

The psoriatic triad is a characteristic symptom that distinguishes this pathology from other autoimmune skin lesions. The triad consists of three phenomena, successively replacing each other with friction or other impact on psoriatic plaque:

  • the phenomenon of a stearin spot (when the plaque is rubbed, scales similar to stearin slide off from it);
  • the phenomenon of the terminal film (after removing the scales, a shiny surface resembling a film is exposed);
  • the phenomenon of pinpoint bleeding (after removal of the terminal film, minor bleeding occurs).

Koebner's symptom is another characteristic manifestation of psoriasis. When the skin is damaged, free from rashes, new plaques appear on it quickly enough. Considering that most women with psoriasis suffer from itchy skin, the spread of the disease occurs quite quickly.

A distinctive feature of psoriasis is the presence of a "sentinel plaque". After complete cleansing of the skin during treatment, one plaque is necessarily left on one of the skin areas (more often on the extensor surfaces of the arms and legs). In the future, the exacerbation of the disease will go in the area where the "sentinel plaque" remains.

Psoriasis is a chronic disease. Modern medicine can only slow down the progression of the disease and eliminate a cosmetic defect, but does not guarantee a complete cure. In rare cases, recovery from psoriasis occurs spontaneously and is practically unrelated to the intensity of treatment. Self-healing occurs more often in adolescents after puberty. In adulthood, complete recovery is rare.

Extracutaneous manifestations of psoriasis

Up to 10% of all women suffer from the development of psoriatic arthritis. This condition affects the elbow and knee joints, as well as the small joints of the hands and feet. Inflammation of one organ is extremely rare. Most often, several joints from one or both sides are involved in the pathological process.

Psoriatic arthritis occurs many years after the first skin signs of the disease appear. Pregnancy itself can cause the progression of the disease and the transition of inflammation to the joints. Fluctuations in hormonal levels and altered immune system reactivity cause aggressive antibodies to work against cartilage cells. Skin symptoms of the disease usually appear with joint damage.

Symptoms of psoriatic arthritis:

  • pain in the affected joint;
  • limitation of joint mobility;
  • redness and swelling of the skin around the joint.

In most women, in addition to skin lesions, changes in the nail plates develop. Possible damage to internal organs - heart, liver, kidneys. Systemic changes in psoriasis are rare and usually occur after many years of active disease.

The course of psoriasis during pregnancy

It is rather difficult to predict in advance how the disease will behave during pregnancy. In some expectant mothers, the skin and articular manifestations of pathology subside and do not make themselves felt until the very birth. This is probably to blame for a temporary increase in cortisol - a hormone of the adrenal glands. Cortisol reduces the activity of the inflammatory process and slows the progression of the disease. This course of psoriasis is the most favorable and significantly increases the chances of carrying and giving birth to a healthy child.

Hormonal changes during pregnancy can lead to the progression of the disease. Exacerbations of psoriasis are possible at any stage of pregnancy and in the postpartum period. A small percentage of expectant mothers develop a severe form of pathology - generalized pustular psoriasis. Typical plaques appear all over the body. Severe itching occurs, scratching appears. A secondary bacterial infection often joins. Against the background of a deterioration in the general condition, it is possible to terminate pregnancy at any time.

Psoriatic arthritis almost always gets worse during pregnancy. This is due to the rapid increase in body weight, especially after 20 weeks. There are pains in the joints, their mobility is impaired. After the baby is born, the manifestations of psoriatic arthritis decrease markedly.

After childbirth, most women experience an exacerbation of psoriasis. New plaques appear all over the body, including the scalp. The duration and severity of the exacerbation will depend on the overall activity of the inflammatory process.

Complications of pregnancy

Exacerbation of psoriasis during pregnancy can cause the development of such conditions:

  • early miscarriage;
  • premature birth;
  • placental insufficiency;
  • chronic fetal hypoxia and delayed development.

All complications of pregnancy are not specific and are associated with a change in the general reactivity of the body and the activation of the inflammatory process in the skin, joints and internal organs.

Consequences for the fetus

It is reliably known that a woman suffering from psoriasis has a 10% probability of having a child with a similar pathology. If both parents have the disease, the risk of developing the disease increases to 50%. It is not the disease itself that is inherited, but only a predisposition to it. This means that the child will most likely be born healthy, but will be at risk of developing psoriasis throughout his life. In this case, the disease may never manifest itself, even in the mildest form.

It is important to remember that psoriasis is not contagious. The disease is not transmitted to the fetus through the placenta and does not directly affect its development. The likelihood of having a baby with congenital psoriasis is extremely low. Most often, the disease manifests itself in adolescents with a certain genetic predisposition and when exposed to other provoking factors.

Planning a pregnancy with psoriasis

Psoriasis is not a contraindication for carrying and giving birth to a child. For conception, you should choose a time outside the exacerbation of the disease. After the disappearance of the last rashes, at least 1 month should pass. After that, it is allowed to plan the child. If the disease proceeds without long periods of remission, you need to choose a time with the least amount of rashes and other manifestations of psoriasis.

Before conceiving a child, you should visit a doctor and undergo a full examination by a specialist. It will not be superfluous to get rid of foci of chronic infection: to cure teeth, undergo a course of therapy in the presence of diseases of ENT organs. Any infection during pregnancy can exacerbate psoriasis and cause complications.

Treatment methods

Psoriasis during pregnancy should be treated by a rheumatologist. The therapy is carried out under the obligatory supervision of a gynecologist, who assesses the woman's condition, the course of pregnancy and the development of the fetus. The therapy regimen is selected individually, taking into account the severity of the patient's condition and the gestational age.

If the expectant mother is taking any medications for psoriasis on an ongoing basis, when she becomes pregnant, she should definitely inform her doctor about it. Many medicines are prohibited for use while the baby is waiting. Some drugs cross the placenta and can lead to the formation of various fetal malformations, miscarriage and other serious complications of pregnancy.

For the treatment of psoriasis, the following drugs are used:

  • glucocorticosteroids;
  • immunosuppressants;
  • agents that improve microcirculation in the skin.

During pregnancy, mainly topical hormonal preparations are used. These can be various creams and ointments with weak corticosteroid activity, which are recognized as relatively safe for the fetus. Local remedies are applied to the affected skin in a thin layer. The duration of therapy is determined by the doctor supervising the pregnant woman.

Systemic corticosteroids and immunosuppressants are rarely used during pregnancy. Their use is justified only in severe cases of the disease. In each case, the therapy regimen is selected individually and taking into account all possible risks to the growing fetus.

Skin care is of great importance in psoriasis therapy:

  1. During an exacerbation of the disease, take a warm shower (the water temperature is not higher than 36 degrees). Avoid bathing in the bathroom.
  2. Do not use loofah or skin care products.
  3. After showering, don't forget about emollient creams and lotions designed specifically for dry skin. Check with your dermatologist about the best remedies for psoriasis.
  4. Do not rub with a towel after water treatment. Gently blot the skin with a soft cloth, being careful not to touch any plaque or flaking of the skin.

Outside of an exacerbation of the disease, the expectant mother is recommended to be under the sun as often as possible. A good effect is seen from bathing in salty sea water. The Dead Sea resorts are considered an excellent place for the prevention of psoriasis. During exacerbations, sun exposure should be avoided.

Psoriasis is a chronic, slowly progressive disease that can disrupt normal pregnancy and childbirth. When the first symptoms of psoriasis or an exacerbation of the disease appear while waiting for the baby, it is imperative to consult a doctor.

However, many women already note that pregnancy makes their illness easier, and menopause makes them worse. According to experts, changes in the nature of the course of psoriasis at different stages of the reproductive period in women are due to hormonal fluctuations, but the action of other, so far unknown, factors cannot be ruled out.

What is psoriasis?

Psoriasis is a chronic skin disease caused by genetic, immunological and external factors. External factors that can trigger the disease include stress, the use of certain drugs, and infectious diseases. Hormonal fluctuations in women can also affect the course of the disease, leading to the appearance of new rashes or, conversely, improving the condition of the skin.

How does psoriasis progress during pregnancy?

Most women note that during pregnancy, the disease proceeds more easily, and after childbirth, its course becomes more severe. During menopause, the disease often becomes more severe. In addition, psoriasis often begins during menopause.

Although the relationship between hormonal changes and the course of psoriasis has been studied in several studies, it is still unknown what hormonal mechanisms trigger psoriasis and affect its course.

Non-hormonal causes of psoriasis

It is believed that the development of the disease and its exacerbations may be due to other, non-hormonal factors. According to some experts, the frequent onset of psoriasis during adolescence does not necessarily mean that hormonal changes are the only cause of the disease. Perhaps this is the result of a special genetic program.

Although some women report that the course of their psoriasis depends on the stage of the menstrual cycle, there is no evidence from research that hormonal fluctuations during the menstrual cycle can influence the course of the disease. There is also no clear evidence that oral contraceptives have a positive or negative effect on psoriasis.

Is psoriasis dangerous during pregnancy?

Psoriasis is not an obstacle to pregnancy and does not impair fertility in women.

Many psoriasis sufferers fear that their disease might spread to their children. Since psoriasis is not contagious, you can safely breastfeed and cuddle your baby without fear of transmission. However, psoriasis can have a genetic predisposition. According to studies, if one of the parents is sick, the risk of transmitting psoriasis to offspring is 8-15%, if both - from 50% to 60%.

Women with psoriasis are often afraid of getting pregnant. They ask questions - will the disease disrupt the development of the child, will they be able to feed him, will the pregnancy aggravate the course of psoriasis, will the treatment they use harm the child?

How is psoriasis in pregnant women treated?

Treatment of psoriasis in pregnant women is difficult, especially if it is severe. During pregnancy, women should stop treatment with most drugs for systemic use, as they can lead to intrauterine growth abnormalities.

If a woman is planning a pregnancy, she should notify the dermatologist in advance. The dermatologist can then decide whether to continue with the previous psoriasis treatment during pregnancy and prescribe another treatment if necessary.

Women with psoriatic arthritis may experience increased joint pain during pregnancy due to weight gain.

How exactly does pregnancy affect the course of psoriasis?

Most studies involving pregnant women show that pregnancy affects the course of psoriasis.

A US study * of 248 women with psoriasis identified hormonal changes during pregnancy and menopause that may affect the course of psoriasis.

The study showed that in 30-40% of women examined during pregnancy, psoriasis took on a milder course, which was usually observed in the first trimester of pregnancy. About 20% of women reported that pregnancy worsened their illness, the rest did not notice any changes. The study also found that the age of pregnant women and the severity of psoriasis did not affect its course. According to another study, pregnancy improves the condition of patients with psoriasis in 63% of cases. In some women, significant improvement occurred during pregnancy, manifested by hypopigmentation in the affected areas.

Changes in the course of psoriasis (for better or worse) during the first pregnancy allow predicting how it will proceed during subsequent pregnancies. The above study showed that in 87% of mothers with several children, each pregnancy was accompanied by similar changes in the course of psoriasis.

Why does psoriasis get better during pregnancy?

Although the reasons for the improvement in the condition of patients with psoriasis during pregnancy are unknown, there are several explanations for this. Some researchers believe this improvement is due to increased levels of estrogen and progesterone. It is possible that the transient immunosuppressive action of these hormones suppresses autoimmune responses in psoriasis.

Other researchers highlight the positive role of cortisone. The fact is that cortisone has an anti-inflammatory effect, and during pregnancy its level in the body rises, so the inflammation caused by psoriasis becomes less pronounced (as when using a cream with cortisone).

It is obvious that the positive effects of pregnancy on the course of psoriasis are due to many factors. Perhaps the main one is an increase in the level of cortisol in pregnant women, secreted by the adrenal glands of both the mother and the fetus. However, it is no less likely that this may be associated with other, as yet unidentified, substances.

In some cases (less than a quarter), pregnancy has a negative effect on the course of psoriasis.

The reasons for this, as already mentioned, are unknown, but it is possible that this may be a stress-related disruption of hormone metabolism.

What is impetigo herpetiformis?

Some women develop psoriasis during pregnancy.

Herpetiform impetigo is one of the clinical variants of generalized pustular psoriasis, which usually occurs during pregnancy.

This is an extremely difficult but, fortunately, very rare form of psoriasis. It usually develops in the third trimester of pregnancy or immediately after childbirth.

About a third of women with this form of the disease have psoriasis early or have a family history of psoriasis.

It is believed that hormonal fluctuations and impaired metabolism of vitamin D lead to exacerbations of pustular psoriasis in pregnant women.

Symptoms of herpetiform impetigo

Lesions often begin with folds of the skin. Red plaques, sometimes accompanied by itching, begin to spread throughout the abdomen and groin. Pustules appear around the plaques. Sometimes mucous membranes are involved in the pathological process.

Herpetiform impetigo is accompanied by a deterioration in general health. Along with other symptoms, patients may have nausea, fever, and mental disturbances.

Glucocorticoids are usually ineffective, so antibiotics are often given during flare-ups.

This form of psoriasis often has dire consequences for the fetus, leading to miscarriage in half of the cases.

Pustular psoriasis

Pustular psoriasis that occurs during pregnancy usually resolves after childbirth. Although in 82% of cases it develops during the first pregnancy, the risk of exacerbation persists in subsequent pregnancies.

In the first three months after childbirth, most women with psoriasis reappear on the skin, including in areas where there was previously an improvement. At the same time, the data from different studies are ambiguous.

Some studies show that in about 88% of women, psoriasis worsens in the first four months after giving birth.

According to a study conducted in the United States, 41% of women experience an exacerbation immediately after childbirth, but 55% of women do not notice any changes in the nature of the disease during this period.

Treatment of psoriasis during pregnancy

The choice of drugs for the treatment of psoriasis during pregnancy is small, since most of them are toxic to the fetus.

During pregnancy, psoriasis may get easier, which may allow you to reduce your dose or stop some medications.

Pregnant women need to carefully monitor the skin to prevent it from drying out.

Local treatment of psoriasis

Since most drugs for systemic use during pregnancy have to be canceled, the dermatologist has to prescribe local therapy.

However, these drugs are not without side effects as they can be absorbed through the skin. Some of them are contraindicated for pregnant women, since they have a teratogenic effect. Except for emollients, which pose no danger to either the mother or the fetus, the rest of the topical treatments can only be applied to limited areas of the skin.

Local remedies that should be avoided during pregnancy:

Vitamin A derivatives are contraindicated in pregnancy, as they have a teratogenic effect.

Vitamin D derivatives - can be used in very small amounts and in very limited areas of the body.

Local products approved for use:

Emollients - Soothing and moisturizing creams can be used without any risk.

Glucocorticoids (cortisone) - can sometimes be used in small amounts on very limited areas of the skin. These drugs can increase the risk of stretch marks and should not be applied to certain areas of the body, including the breasts, abdomen, and shoulders.

Exfoliators, including urea and salicylic acid, can be used on localized areas of the skin.

Systemic treatment of psoriasis

Most drugs for the systemic treatment of psoriasis have a teratogenic effect, that is, they can lead to severe fetal anomalies. The risk of teratogenic effects is especially high in the first trimester of pregnancy. Therefore, most oral medications are discontinued during pregnancy.

Systemic drugs that should be avoided during pregnancy:

Acitretin (and other retinoids) and methotrexate - Can cause severe birth defects and lead to miscarriage. Women must use contraception during treatment with these drugs. It is possible to plan a pregnancy only a few months after the abolition of these drugs (after the abolition of acitretin, two months should pass, after the abolition of methotrexate - four months) in order to wait for their complete elimination from the body.

It should be noted that methotrexate affects spermatogenesis. Therefore, if the husband uses methotrexate, then during treatment and for three months after its cancellation, the married couple must use contraception.

PUVA therapy - can pose a threat to the fetus, since the patient uses psoralens (photosensitizers) before the UV irradiation session.

Systemic agents permissible for psoriasis with extensive lesions during pregnancy:

Cyclosporine is safe for the fetus, but has side effects on the mother's body. Allowed during pregnancy only in severe psoriasis.

UV-B phototherapy, a narrow-band phototherapy used to treat large lesions in psoriasis, is safe during pregnancy.

Breastfeeding for psoriasis

Women with psoriasis, including those who get sick during pregnancy and after childbirth, may breastfeed their baby.

Breastfeeding should be avoided only by those women who use systemic drugs or local agents on large areas of the skin, since these drugs can be absorbed into milk and enter the baby's body with it.

Pregnancy is one of the most critical periods in a woman's life. At this time, her body becomes more susceptible to various kinds of influences that provoke the development of various diseases. Psoriasis during pregnancy can cause a lot of anxiety for the expectant mother, since it has quite pronounced symptoms.

Psoriasis is a non-infectious disease characterized by the formation of pustular eruptions. They can have a variety of shapes, appearances and structures. The disease develops gradually, progressing every day more and more and leading to an increase in external manifestations.

First, small plaques appear on the skin, consisting of epithelial layers. They can occur over the entire surface of the body, regardless of the sex of the person or any external factors. Over time, the rash grows in size, unites in islets and is able to occupy a large area on the body.

The appearance of the rash differs significantly from the normal state of the skin. In places of deformation, there is a significant deformation of tissues and their significant coarsening. In addition, the rash is characterized by a change in the color of the damaged skin, the shade of which varies from white to bright red. In some places, papules can rise up to 1 cm above the skin.

The formation of a disease can provoke a huge number of factors, ranging from changes in hormonal levels and ending with a decline in the protective properties of the immune system. However, the dominant role in the formation of the disease is played by a genetic predisposition, since a specific gene must be present in the human body for its formation and development. If it is present, there is a high likelihood of psoriasis, and all other provoking factors only contribute to its formation.

The disease belongs to the category of autoimmune and is absolutely not contagious to others. It is almost impossible to cure it 100%, since the genetic factor does not lend itself to drug influence. Based on this, the only way to combat it is symptom control.

Why is the development of the disease during pregnancy dangerous?

Many women who suffer from psoriasis or are prone to its development during pregnancy are faced with the peculiarities of the course of the disease. Moreover, its presence is not a contraindication to conception, since it does not in any way affect a woman's reproductive functions or fetal development.

During pregnancy, the female body undergoes restructuring, which will inevitably affect its functionality. Hormonal disruptions, metabolic disorders and changes in the course of the main processes cannot go unnoticed and in some cases even provoke the development of psoriasis. However, this situation is rare and occurs only in the most extreme cases.

Most often, the development of events proceeds according to a completely opposite scenario, and pregnant women notice a significant decrease in the intensity of the manifestations of the disease. The rashes become paler, shrink, soften and may disappear altogether. In this case, new plaques are not formed, and old ones become less pronounced. A similar picture is observed during the entire pregnancy right up to the birth itself, and after their completion, the disease gains intensity and manifests itself again.

By itself, a moderate course of psoriasis does not have any negative effect on the body of the mother and her child. The danger is the complications of the disease, which are expressed in the formation of psoriatic arthritis, which causes specific lesions of the joints. As a rule, its formation and development occurs starting from the second half of the second trimester of pregnancy.

The main symptoms of the disease are the appearance of pain in the elbow, hip or knee joints, which can cause severe discomfort and affect the motor activity of a woman. At the same time, complications of this kind do not affect the development of the child and only affect the functionality of his mother's body.

Is there an effect on the fetus

The transition of psoriasis to advanced stages disrupts the functionality of the vessels, which can affect the performance of the circulatory system. A similar situation leads to a malnutrition of tissues, among which is the placenta, which feeds the fetus. As a result, there is a decrease in its performance, which can affect the performance of the main feeding functions. In order to avoid such a development of events, one should not let the development of the disease take its course and treat it in a timely manner.

The disease does not pose any danger to the fetus, unless it goes into a neglected form.
However, the presence in the mother increases the risk of a problem in the child, since the gene that provokes it is inherited. However, this does not mean at all that it is 100% likely that he will develop psoriasis from the moment of birth. In general, the risk of developing the disease is approximately 15%. Based on this, with 85% of the probability it may not appear at all during the child's life.

A similar situation is observed when it comes to the manifestation of psoriasis in the mother or father. The development of symptoms in both parents increases the risk of developing the disease in children exponentially and is no longer 15%, but as much as 60%.

In general, the formation of a problem in the mother does not pose a danger to the fetus. The main danger for the child is the wrong treatment or the use of drugs that are prohibited for use during pregnancy.

How to treat psoriasis in pregnant women: features and medications

It is impossible to completely get rid of psoriasis, there is only an opportunity to influence its symptoms. Treatment of illness during pregnancy is especially delicate and should be carried out under the supervision of a physician supervising the woman's condition. At the same time, self-medication is strictly prohibited, due to the possibility of harming the child.

In addition, any medication in such a delicate period must be used with extreme caution. Moreover, we are talking about all drugs, even those prescribed by the attending physician. Due to the possible risks for the child, most medications will have to be abandoned and the therapeutic effect on
fundamentally different means.

Difficulties in the treatment of psoriasis arise when diagnosing a severe form that can develop during pregnancy. Therefore, even if there are primary symptoms of the disease, you must inform your doctor about this. In this case, it is best to plan for conception during the period of remission, when they are minimal or absent altogether. Based on the clinical picture of the course of the disease, the doctor will determine the appropriateness of using certain drugs and draw up a general plan of therapy.

Most of the standard drugs used to treat psoriasis are toxic to the body. Based on this, the use of such funds during pregnancy is prohibited, since it poses a threat to the development of the child. In particular, they cannot be used in the first trimester of pregnancy, since during this period the least toxic load can provoke the formation of mutations and other fetal pathologies. If, before the onset of pregnancy, treatment was carried out on the basis of similar funds, then their use should be discontinued in the future.

Such drugs include:


The use of such products without the knowledge of a doctor is strictly prohibited. However, during pregnancy, symptoms often increase and the skin condition worsens. Such a picture of the course of the disease requires the use of the most effective means, and the decision on their use is made exclusively on an individual basis.

When the situation worsens, it is necessary to more carefully monitor the condition of the skin and constantly moisturize them. The main difficulty in the treatment of psoriasis during pregnancy is the selection of the optimal drug that will have a minimal negative effect on
the child's body and have the maximum therapeutic effect.

Based on these difficulties, in the presence of moderate manifestations of the disease and the absence of dynamics of its growth, in most cases, doctors prescribe a course of local therapy. It is based on the use of various moisturizers and disinfecting lotions that are not absorbed into the blood or dry out the skin, such as salicylic ointment, various synthetic and vegetable oils.

Folk remedies as an alternative to traditional treatment

Due to the impossibility of using most medications, getting rid of the signs of psoriasis is carried out using the means of the general spectrum of action. Based on this, many women prefer not to expose themselves and their child to unnecessary risks, using traditional medicine to eliminate the symptoms of the disease.

The most popular among such remedies are various lotions and ointments,
handmade. As a rule, they are based exclusively on natural plant components that have a minimal negative effect on the body of a pregnant woman. To create broths, a string, chamomile, motherwort, burdock, yarrow and other medicinal herbs are used. The creams are based on propolis, garlic, honey, milk, aloe juice and many other components, which have an anti-inflammatory and moisturizing effect on tissues.

Decoctions are created on a water basis, for which the liquid is first brought to a boil, and then dried herbs are added to it. The broth is boiled for some time, and then it is drained from the fire and settled. The cooled liquid is decanted and used to create lotions.

For the manufacture of ointments, a fatty base is used, like butter,
petroleum jelly or ghee. Such funds are melted over a fire, in this form, useful substances are added to them, which are thoroughly mixed. The resulting mixture is transferred to the refrigerator, and after it has solidified it can be used for its intended purpose.

Conclusion

Psoriasis during pregnancy can cause significant discomfort to a woman. However, the presence of the disease does not in any way affect the development of the child until the disease progresses to advanced stages. Moreover, his treatment is carried out exclusively by local methods and only according to the prescriptions of the attending physician.

Pregnancy, the most important and unforgettable period in the life of every woman. But some of them are covered by anxiety about the state of health of their own and the future baby, the reason for which is the presence of a serious pathology - psoriasis. Women are worried about whether they will endanger the crumbs, whether the disease will be inherited, and also how pathology will behave in such an important period of life. These and not only questions will be disclosed in today's topic.

Planning a pregnancy with psoriasis

Worldwide studies have proven that psoriasis does not affect fertility, this function of a woman remains intact. But in order to prevent possible complications for expectant mothers, it is important to visit a dermatologist before planning such an important event. The specialist will revise the course of treatment, since during pregnancy, almost all drugs are prohibited, both for oral administration and local use. It is recommended that all systemic medications be discontinued at least one month before conception.

Is there a danger to the fetus?

Pregnancy and psoriasis are compatible things, only women suffering from this pathology should be a little more scrupulous about their health and control the process together with a gynecologist and a dermatologist. According to scientists at Harvard University, who monitored 358 women in an interesting position with common psoriatic eruptions, the following data were obtained. The number of miscarriages in this group of patients was four times higher than in healthy women.

It was also found that an ectopic pregnancy due to an incorrectly attached ovum was observed 4.5 times more often, and premature birth occurred 3.5 times, respectively. But the doctors were surprised by the fact that psoriasis during pregnancy did not affect the development of any pathologies in the fetus and the number of cesarean sections in these women was observed less than in healthy women. These studies were conducted in women with extensive skin lesions.

The mild form of psoriasis in pregnant women did not cause pathological changes and did not increase the possibility of spontaneous abortion.


The question remains important for the expectant mother, will the pathology be inherited by the baby? Scientists have been trying for decades to establish the exact reasons that cause the development of psoriasis, but unfortunately, the exact answer has not been found. After numerous studies, the factors that are related to the onset of pathology were nevertheless established. One of these factors is heredity, or genetic predisposition. The possibility of developing a disease in a baby increases by about 10% if a pathology is detected in the mother, and if both parents are sick, this figure can reach 50%.

Attention! The data are approximate and do not indicate the exact manifestation of the disease in the unborn baby, studies only confirm the factor of genetic predisposition.

Features of the course of pathology

While expecting a child, a woman's body undergoes many changes, and if she has chronic diseases, how they will lead to predict is very difficult, also applies to psoriasis. According to observations, it was noted that about 40-60% (the figure varies in different sources) of pregnant women felt improvements and decreases in the manifestations of pathology, about a quarter noted a worsening of their condition, and the rest did not notice any changes. Almost 90% of women who carried a child for the first time confirmed that the changes in the course of the disease were identical with previous pregnancies.

The changes towards remission of the disease have a logical explanation. During pregnancy, the level of various hormones changes, so progesterone and estrogen increase significantly, which leads to a weakening of the body's autoimmune reactions. It also increases the level of cortisone, which has a pronounced anti-inflammatory effect. A change in the course of psoriasis for the worse can be observed in the event of a violation of the metabolic processes of hormones. Also, experts believe that changes in one direction or another may not be related to the hormonal background.

Postpartum period

As a rule, during the first six weeks after childbirth, psoriasis in pregnant women goes into a regression stage, this condition was noted by more than half of young mothers. Usually, the rash returns to the same level as before pregnancy, the affected area of ​​the skin does not become larger.

Breastfeeding is not contraindicated as the disease is not infectious and does not affect milk quality. The only nuance that should be taken into account is taking medications and the possibility of lactation. Since if the course of treatment after childbirth is restored, some medications can pass into milk through the blood, the list of drugs should be agreed with the doctor.

Primary manifestations of psoriasis during pregnancy

Diagnosed with the primary signs of psoriasis while waiting for the baby is extremely rare, but not excluded. Herpetiform impetigo, called one of the forms of psoriasis, the disease has not been thoroughly studied and it has not been unequivocally established whether the pathology is an independent disease or a type of psoriatic rash. Most dermatologists consider it a type of generalized pustular form. Presumably formed against the background of autointoxication, mainly in the last trimester of pregnancy or immediately after it.

The main symptom is considered the formation of pustular spots in:

  • inguinal folds;
  • lower abdomen;
  • around the navel;
  • in the axillary sinuses;
  • under the breast.

The pustules have a yellowish, purulent secretion, bursting their contents spreads along the folds, provoking the development of a bacterial infection.

The disease is accompanied by:

  • high fever (due to bacterial infection);
  • chills;
  • pain in muscles and joints;
  • the formation of brown, purulent crusts;
  • rapid spread of plaques;
  • the presence of hypocalcemia and increased ESR in the blood;
  • itching is usually absent.

Herpetiform impetigo is difficult, the condition can cause many complications, including miscarriage, stillbirth and even death for the patient herself. If the disease develops at a later date and proceeds in an acute form, an urgent cesarean section is indicated.

Treatment

Therapy is difficult, since many drugs can cause fetal development disorders. For the most part, it remains possible to apply only external agents and those in a limited amount, agreed between a gynecologist and a dermatologist.

Contraindicated:

  • any retinoids;
  • products based on vitamins of groups D and A.
  • PUVA therapy.

Application is possible after agreement with the attending physician:

  • various moisturizers and emollients;
  • applying corticosteroid ointments to small areas of the skin;
  • exfoliating agents based on salicylic acid or urea;
  • phototherapy;
  • ingestion of drugs of the cyclosporin group (in extreme cases).

In addition, various folk recipes for local effects based on herbs will be useful during this period. Herbal medicine is considered practically harmless, with the exception of the use of poisonous plants. It is possible to prepare various lotions or lotions for wiping the affected skin areas, based on a decoction of medicinal herbs, for example:

  • sage;
  • St. John's wort;
  • chamomile;
  • pine trees;
  • turns;
  • plantain.

In the event of herpetiform impetigo, complex therapy is required with all types of procedures and drugs:

  • sulfonamides;
  • corticosteroids;
  • PUVA therapy;
  • antibiotics;
  • antiseptic ointments;
  • blood transfusion.

In the case of herpetiform impetigo, the priority for the medical staff is the woman's life and the refusal to use drugs can be fatal for the patient.

It must be remembered that pregnancy is a fleeting, fabulous period of your life, which should be remembered with positive impressions and even the existence of psoriasis should not darken it. For this, in order not to provoke exacerbation of pathology, it is important not to succumb to various negative emotions, to be in a calm and peaceful state and, of course, to adhere to all the advice and instructions of your doctor. Health to you and your future baby!


Psoriasis - How to Get Rid of a Deadly Autoimmune Disease?

Judging by the fact that you are now reading these lines, the victory in the fight against psoriasis is not yet on your side ...

And have you already thought about the cardinal methods of treatment? This is understandable, because psoriasis can progress, as a result of which 70-80% of the body surface is covered with a rash. Which leads to a chronic form.

Red blisters on the skin, itching, cracked heels, flaking skin ... All of these symptoms are familiar to you firsthand. But perhaps it is more correct to treat not the effect, but the cause? We found an interesting interview with a dermatologist at the Russian Center for Dermatology.

Psoriasis is a very unpleasant disease that causes a lot of inconvenience. During pregnancy, it occurs quite often, since during this period, serious hormonal changes occur in the woman's body. Psoriasis is a non-infectious pathology, so it is impossible to get infected with it. According to many studies, the disease does not pose a danger to the fetus, however, every expectant mother should carefully monitor her health and be monitored by a doctor, as well as use prescribed medications to alleviate the condition.

Causes of pathology in pregnant women

The causes of this disease in pregnant women, as well as in all other people, are unknown to science.

But experts believe that the following risk factors can contribute to the development of psoriasis during pregnancy:

  • Global restructuring of the hormonal system.
  • Weakening of the body's immune defenses (which is natural during pregnancy).
  • Vitamin D deficiency.
  • Pathology and intestines.
  • Hereditary factor.
  • Cold climatic living conditions.
  • Streptococcal infection.
  • Obesity.
  • Viral and bacterial infections in the body.
  • Disorders of metabolic processes.

    • Is it possible to get pregnant with psoriasis

    The opinion that psoriasis is a contraindication for planning pregnancy is erroneous, since this disease does not affect reproductive function and the process of carrying a fetus. It is advisable to plan a pregnancy during stable remission. But you need to be prepared for the exacerbation stage after conception. The only difficulty here is the limited choice of remedies.

    The exception is cases in which women are diagnosed with a severe form of a disease called herpetiformis psoriatic impetigo. Such conditions pose a threat to both the unborn child and the pregnant woman herself.

    You also need to remember that any infection can serve as a reason for the development of psoriasis. Therefore, before planning pregnancy, you should undergo a comprehensive examination and eliminate all possible foci of infection in the body, undergo appropriate treatment (visit a dentist, ENT doctor, gastroenterologist, etc.).

    The clinical picture of the disease

    The main symptom of psoriasis during pregnancy is a characteristic rash in the form of plaques all over the body. Scaly inflammatory elements can be either localized in a specific area or spread throughout the body, including on the scalp. In some cases, mucous membranes are affected.

    Features of psoriatic eruptions:

    • Excessive dryness and thickening of the skin in the affected area.
    • Injury and bleeding of plaques.
    • Silvery scales on pink spots.
    • Severe itching and burning.
    • Psoriatic triad (phenomena of stearin spot, terminal film and pinpoint bleeding).

    In addition, a woman has a decrease in performance, weakness, irritability, depression.

    What complications can there be?

    Pregnancy can serve as an impetus for the progression of pathology and the spread of the inflammatory process to the joints. In this case, the joints of the limbs are usually most affected, symptoms such as pain, redness and swelling in the affected area occur, as well as a significant limitation of the mobility of the arm or leg. Leg pain tends to get worse as pregnancy progresses, which is associated with an increase in the woman's body weight and with an increased load on the legs.

    Another danger of psoriasis when carrying a child lies in the fact that not only joints, but also blood vessels can be involved in the pathological process. This is fraught with impaired blood flow in the placenta, which can lead to intrauterine growth retardation.

    Other possible complications:

    • Hormonal disorders.
    • Premature labor.
    • Spontaneous early termination of pregnancy.
    • Disruptions in metabolic processes.
    • Weakening of the immune defense of the mother's body.
    • Fetal hypoxia.
    • Lack of vitamin D.

    The pustular form of psoriasis in pregnant women is unfavorable, in which there is a significant deterioration in the general condition of the woman. In the most severe cases, in addition to the spread of the rash throughout the body and the occurrence of severe itching, the patient begins to worry about nausea, chills, emotional disturbances, burning of the affected areas of the skin. There is a risk of secondary infection.

    Despite the fact that psoriasis is not contagious, and infection of the child from the mother is completely excluded, both during labor and after it, there is a risk that the disease will be transmitted to the baby at the genetic level. Moreover, it is not the disease itself that is inherited, but the gene responsible for its development. But this does not mean at all that the child will necessarily suffer from psoriasis, it is possible that the disease will never bother him. But throughout his life he will belong to the risk group.

    Treatment methods

    Treatment of psoriasis during pregnancy usually presents some difficulties, since during this period the use of a large number of medications is prohibited, in particular, hormone-based drugs. Many oral medications can have a detrimental effect on the developing fetus. Therefore, in the chronic form of the disease, it is advisable to consult with a dermatologist in advance about the possible complication of psoriatic disease. This should be done already at the planning stage of pregnancy, or in the early stages.

    An approximate regimen for the treatment of psoriasis in pregnant women:

    • The use of effective ointments and creams with the most harmless composition.
    • The use of funds to improve blood microcirculation in the epidermis.
    • The use of certain drugs based on glucocorticosteroids.
    • Use of immunosuppressants.
    • Taking sedatives based on herbal ingredients.
    • Compliance.

    Psoriatic disease in pregnant women is usually treated by a rheumatologist under the supervision of a gynecologist. When carrying a fetus, funds are usually prescribed only for external use, since systemic drugs are dangerous for the unborn child. In any case, it is permissible to use only those medicines that have been prescribed by the doctor; self-medication is strictly prohibited. The features and duration of therapy depend on the initial state and well-being of the woman, on the severity of clinical manifestations and the stage of the disease.

    Ointments for psoriasis

    Name

    Compound

    Action

    Salicylic acid.

    Softens, exfoliates and disinfects, but use is desirable only in the second and third trimesters.

    See

    Retinol, vitamins, glycerin, emulsion wax.

    Moisturizes and disinfects, protects the skin. Recommended for use from the second trimester of pregnancy.

    Zinc pyrithione.

    Destroys pathogenic flora and fungal infections, softens and regenerates the skin.

    Crystal

    Solid oil, extracts of chamomile, aloe, calendula, rose hips, cedar oil.

    Heals and protects the areas affected by psoriasis, reduces flaking, eliminates discomfort.

    Losterin

    Almond oil, D-panthenol, naphthalan.

    Promotes rapid cleansing of the epidermis from psoriatic eruptions, eliminates itching and burning.

    If necessary, if other remedies do not bring the desired effect, hormonal ointments, for example, Hydrocortisone, may be prescribed. They should be used with great care in limited areas of the body and in accordance with medical recommendations and instructions for use. After all, hormone-based ointments have many undesirable effects, such as addiction or withdrawal symptoms.

    Sedatives

    It is known that stress contributes to the progression of psoriatic disease and the rapid deterioration of the condition. Therefore, pregnant women are advised to take natural sedatives. It can be pharmacy drugs, for example, Novopassit, Persen, Nervogran or Sanason. But it is more preferable to take infusions from medicinal plants, which not only calm the nervous system, but also increase immunity, improve digestive and metabolic processes, reduce the feeling of nausea, and have a general positive effect on the body.

    These are herbs such as:

    • Chamomile.
    • Mint.
    • Valerian.
    • Linden.
    • Motherwort, etc.

    Despite the naturalness and safety, before using infusions from these plants, you should consult your doctor.

    Diet

    Correcting the diet will help reduce acute symptoms of the disease and improve the well-being of the pregnant woman. With the help of a diet, you can establish metabolic processes, improve the activity of the digestive tract.

    List of foods that should be included in the diet of a woman expecting a baby:

    1. Fermented milk products.
    2. Seafood.
    3. Vegetables and fruits.
    4. Freshly squeezed juices.
    5. Bran.
    6. Porridge.
    7. Mineral water, compotes, etc.

    List of prohibited foods:

    1. Bold.
    2. Sharp.
    3. Salty.
    4. Smoked.
    5. Fast food.
    6. Spices.
    7. Baking.
    8. Sweets.
    9. Carbonated drinks.

    A pregnant woman suffering from psoriasis should make every effort to prevent the development of complications and give birth to a healthy baby.

    To do this, it is important to adhere to the following recommendations:

    • More often to be in the fresh air, to take walks.
    • Perform special exercises for pregnant women.
    • Follow the principles of healthy eating.
    • Avoid stressful situations, try to adequately respond to them.
    • Observe good personal hygiene.
    • Timely inform the doctor about changes in your condition.
    • Do not self-medicate.

    Careful control over the course of the disease will help to avoid exacerbation and severe health consequences.