Psoriasis in pregnancy

Overview

Psoriasis is a long-lasting skin condition that causes red, scaly patches on the skin. During pregnancy, changes in your immune system can make psoriasis better, worse, or stay the same. It is important to manage the condition safely for both you and your baby.

Psoriasis is a common skin condition, and it is not unusual for women to have it while pregnant.

It affects women of childbearing age who already have psoriasis. Some women may develop psoriasis for the first time during pregnancy, though this is less common.

Symptoms

Common symptoms

• Red, raised patches of skin covered with silvery-white scales
• Itching or burning sensation
• Dry, cracked skin that may bleed
• Joint pain and swelling (this is a related condition called psoriatic arthritis)

Symptoms in children

• This topic focuses on pregnancy. However, psoriasis can also occur in children and teens, but symptoms are generally the same as in adults.

Symptoms in older adults

• This topic focuses on pregnancy, but older adults may experience similar symptoms. Psoriasis can persist or first appear later in life.

Causes

Main causes

• Psoriasis is caused by a problem with the immune system, where it mistakenly attacks healthy skin cells, making them grow too quickly.
• Genes play a role – if close family members have psoriasis, you are more likely to have it.

Risk factors

• Family history of psoriasis
• Stress (which can trigger or worsen flares)
• Infections, especially strep throat
• Certain medications (always tell your doctor about any medicines you take)
• Hormonal changes during pregnancy (affecting each woman differently)

When to see a doctor

See a doctor urgently if:

• If you have a sudden, severe flare with widespread redness, pustules, and fever – call your local emergency number immediately.
• If you develop severe joint pain or swelling that makes it hard to move.

Book a routine appointment if:

• If you notice changes in your psoriasis during pregnancy, even if they are mild.
• Before pregnancy, it is helpful to talk to your doctor about how to manage psoriasis while trying to conceive.
• If you are already pregnant and did not discuss your psoriasis with your maternity care team, do so at your earliest visit.

Diagnosis

Doctors usually diagnose psoriasis by looking at your skin and asking about your symptoms and family history. During pregnancy, they will also check your overall health and monitor your baby's growth.

Tests that may be done

• No specific test is needed for psoriasis itself. The diagnosis is made based on the appearance of the skin patches.
• If the diagnosis is uncertain, your doctor may do a small skin biopsy (taking a tiny sample of skin to look at under a microscope).
• Blood tests are not used for psoriasis, but your doctor may order routine pregnancy blood tests.

What to expect at your appointment

Your doctor will examine your skin, ask about your symptoms, and discuss your medical history. They will work with your maternity team to create a plan that is safe for you and your baby. You may be referred to a dermatologist (skin specialist) if needed.

Treatment

The goal of treatment during pregnancy is to control symptoms while keeping both you and your baby safe. Many treatments that are usually used for psoriasis need to be adjusted or avoided during pregnancy. Always talk to your doctor before using any cream, ointment, or medicine. Treatment options include topical therapies (creams and ointments applied to the skin), phototherapy (light therapy), and in severe cases, systemic medications under specialist care.

Self-care at home

• Keep your skin moisturized with fragrance-free emollients (moisturizing creams or ointments).
• Avoid harsh soaps and hot water; use lukewarm water and gentle cleansers.
• Manage stress with relaxation techniques such as deep breathing, meditation, or gentle yoga (with medical approval).
• Try to avoid scratching – keep nails short and consider cool compresses for itching.

Medical treatments

Topical treatments such as certain creams and ointments may be safe during pregnancy, but some are not recommended. Phototherapy (exposure to specific types of ultraviolet light under medical supervision) is often considered safe and effective. For severe cases that do not respond to these treatments, your doctor may consider systemic medications that are used only when absolutely necessary and after careful risk-benefit analysis. Do not use any over-the-counter psoriasis products without checking with your doctor first.

When is surgery considered?

Surgery is not a treatment for psoriasis itself. However, if you have psoriatic arthritis that causes joint damage, surgery might be considered after pregnancy and only if other treatments have not helped.

Living with this condition

Living with psoriasis during pregnancy involves balancing skin care, stress management, and regular check-ups. You can still enjoy most of your usual activities. It may help to keep a diary of your symptoms to notice any triggers. Talk openly with your partner, family, and healthcare team about how you are feeling.

Lifestyle tips

• Get enough rest – pregnancy can be tiring, and fatigue may worsen psoriasis.
• Avoid activities that cause skin injury (like harsh scrubbing or contact sports) as this can trigger new patches (Koebner phenomenon).
• Wear loose, soft clothing to reduce irritation.

Diet and exercise

Eat a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Some women find that avoiding processed foods and alcohol helps. Gentle exercise like walking or swimming (with your doctor's approval) is safe and can reduce stress. Always stay hydrated. Do not start any new diet or exercise program without consulting your doctor.

Mental health and emotional wellbeing

Psoriasis can cause anxiety, embarrassment, or low mood, especially during pregnancy when emotions are already heightened. It is normal to feel concerned about your skin and your baby. Talk to your healthcare provider if you feel very stressed or depressed – help is available. Remember that with proper care, most women with psoriasis have healthy pregnancies.

Prevention

Psoriasis cannot be prevented because it is largely genetic. However, you can reduce the chances of flares during pregnancy by managing stress, avoiding known triggers, and following a good skincare routine. Continue to see your doctor regularly.

Vaccines

Some live vaccines are not recommended during pregnancy, but others are safe. Discuss with your doctor which vaccines you need before or during pregnancy. This is not directly related to psoriasis, but keeping up to date with vaccinations helps prevent infections that could trigger a flare.

Screening programmes

There is no routine screening test for psoriasis. If you have a family history, you can discuss it with your doctor. Regular skin checks are a good idea, but not specifically for pregnancy.

Complications

If left untreated

• Severe, untreated psoriasis during pregnancy may lead to complications such as low birth weight or preterm birth in very rare cases.
• Possible worsening of psoriatic arthritis (joint pain and swelling).
• Uncontrolled itching and skin damage can lead to skin infections.
• Emotional distress may affect your quality of life and pregnancy experience.

Long-term outlook

The outlook for most women with psoriasis in pregnancy is very positive. With good communication with your healthcare team and appropriate management, you can keep your symptoms under control and have a healthy pregnancy and baby. After delivery, your psoriasis may change, but you and your doctor can work together to adjust your treatment plan. You are not alone – help and support are available every step of the way.

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