Table of ContentsView AllTable of ContentsUnderstanding Genetic RiskPlanning for PregnancyDuring PregnancyAfter Delivery
Table of ContentsView All
View All
Table of Contents
Understanding Genetic Risk
Planning for Pregnancy
During Pregnancy
After Delivery
David Pereiras / EyeEm/Getty Images
Researchers believepsoriasisis a genetic condition, but they don’t completely understand what causes the disease to be passed down from one generation to another. An inheritance pattern for psoriasis may involve multiple genes or a combination of genes.
A 2012 report inNature Geneticsexpands on several genome (genetic) association studies comparing DNA from people with psoriasis to people without it to determine genetic variations associated with the disease.
Researchers looked at collected DNA and other information and determined the number of genes involved in psoriasis are 36. Not all of these genes account for psoriasis risk and development, but they do give an idea of the risk of passing psoriasis-associated genes.
Most people who have psoriasis report they have a relative who has psoriasis. And having a parent with psoriasis increases a person’s risk for developing the condition. A parent with the disease has a 10% chance of passing the disease on to their child and if two parents have the condition, there is a 50% chance of passing the disease on to a child.
The strongest evidence on genes involved in psoriasis comes from twin studies. One 2013 review of studies of twins and psoriasis reported in theJournal of Investigative Dermatologyshows an up to 75% gene agreement in risk for identical twins, compared to an about up to 30% for non-identical twins.
Genetic risk is not enough for a person to develop psoriasis. Other environmental factors—such as infection, use of certain medications, or the presence of other health conditions, smoking, and stress—need to trigger the condition. This means that passing certain genes to your child does not mean your child will develop psoriasis.
How Does Psoriasis Affect Pregnancy?
If you tell your psoriasis-treating healthcare provider that you are considering getting pregnant, he or she may recommend you avoidpsoriasis treatmentsor only use the safest ones.
A planned pregnancy can help you and your practitioner plan for minimal treatment before getting pregnant and during pregnancy. You and your healthcare provider can work out a treatment plan in advance of your becoming pregnant.
Men should also limit their psoriasis treatments as well. In general, any type of systemic (whole body) treatment could be stopped, such as methotrexate, which is known for increasing risk for miscarriage and birth defects. In fact, methotrexate should be discontinued before trying to conceive.
Hormonal and immune changes may induce or reducepsoriasis symptoms. Most of the research suggests for the majority of women pregnancy tends to improve psoriasis symptoms or doesn’t change them at all. Of course, this varies from person to person.
Pustular Psoriasis of Pregnancy
During pregnancy, women with a personal or family history of psoriasis have a higher risk for pustular psoriasis of pregnancy (PPP). While rare, a woman with no family or personal history can also develop this condition. Women who develop PPP do so during their third trimester of pregnancy.
Pustules are pimple-looking bumps full of a yellowish fluid called pus. Affected skin areas are usually anywhere where skin folds, such under the breasts or armpits or the groin. Pustules usually do not affect the face, hands or soles of feet. Pustules can also join together and form large plaques.
Types of Pustular Psoriasis of Pregnancy
Other Concerns
Psoriasis is known for occurring alongside otherautoimmuneand inflammatory diseases anddepressionwhich may or may not affect a women’s pregnancy. Diabetes, high blood pressure, and othermetabolic conditionsmay be present and pose the potential for adverse events during pregnancy. Overall, there is no conclusive evidence that suggests psoriasis on its own increases the risk for any adverse outcome.
Treatment Safety
Some of your regular treatments for psoriasis may not be suitable for you to take during pregnancy. Your treatment options are dependent on the type of psoriasis you have, how severe it is, your personal preferences, and your practitioner’s recommendations. Work with your healthcare provider to determine a suitable treatment plan for managing psoriasis during pregnancy.
Because there are few studies with similar findings, the researchers merely suggest biologics might be a safe option. Ultimately, the decision whether to continue or pause biologic treatment is one you and your partner should discuss with your healthcare provider before trying to become pregnant.
Some types of light therapy, also calledphototherapy, are safe for use during pregnancy. Light therapy consists of exposure to daylight or specific wavelengths of light.
Any type of light therapy that uses ultraviolet light is not suitable for use during pregnancy.
For women with psoriasis, a healthy delivery is possible. Labor may increase the chance for a psoriasis flare. A cesarean delivery is a skin trauma and may induce a serious flare, as may hormonal changes. One 2015 report inPsoriasis: Targets and Therapyreported on an older study about postpartum flares finding that post-delivery psoriasis flares were observed in 87.7% of patients within four months of delivery.
Breastfeeding with psoriasis is very possible, asthe condition is not contagious. However, you should check with your healthcare provider about what medications are safe while breastfeeding, as some may get into breast milk.
An Overview of Phototherapy
A Word From Verywell
Of course, nothing is certain and the information on genetics is based on risk statistics. If someone with risk factors goes on to develop psoriasis, it comes down to environmental triggers in addition to genetics. Plenty of women with autoimmune diseases, like psoriasis, have healthy babies who grow up and don’t ever develop psoriasis or another autoimmune disease.
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Tsoi LC, Spain SL, Knight J, et al.Identification of 15 new psoriasis susceptibility loci highlights the role of innate immunity. Nat Genet. 2012 Dec;44(12):1341-8. doi:10.1038/ng.2467National Psoriasis Foundation.About psoriasis and psoriatic arthritis in children.Enamandram M, Kimball AB.Psoriasis epidemiology: the interplay of genes and the environment. J Invest Dermatol. 2013 Feb;133(2):287-9. doi:10.1038/jid.2012.434Yang YW, Chen CS, Chen YH, et al.Psoriasis and pregnancy outcomes: a nationwide population-based study.J Am Acad Dermatol. 2011 Jan;64(1):71-7. doi:10.1016/j.jaad.2010.02.005Weber-Schoendorfer C, Chambers C, Wacker E, et al.Pregnancy outcome after methotrexate treatment for rheumatic disease prior to or during early pregnancy: a prospective multicenter cohort study. Arthritis Rheumatol. 2014 May;66(5):1101-10. doi:10.1002/art.38368Trivedi MK, Vaughn AR, Murase JE.Pustular psoriasis of pregnancy: Current perspectives.Int J Womens Health. 2018; 10: 109–115. doi:10.2147/IJWH.S125784Bobotsis R, Gulliver WP, Monaghan K, et. al.Psoriasis and adverse pregnancy outcomes: A systematic review of observational studies. Br J Dermatol. 2016 Sep;175(3):464-72. doi:10.1111/bjd.14547Chi C, Wang S, Kirtschig G, et al.Safety of topical corticosteroids in pregnancy.JAMA Dermatol. 2016;152(8):934–935. doi:10.1001/jamadermatol.2016.1009Chi CC, Wang SH, Wojnarowska F, et al.Safety of topical corticosteroids in pregnancy. Cochrane Database Syst Rev. 2015 Oct 26;(10):CD007346. doi:10.1002/14651858.CD007346.pub3National Psoriasis Foundation. Treatment with topicals during pregnancy.https://www.psoriasis.org/pregnancy/treatments/topicalsTsao NW, Sayre EC, Hanley G, et al.Risk of preterm delivery and small-for-gestational-age births in women with autoimmune disease using biologics before or during pregnancy: A population-based cohort study.Ann Rheum Dis. 2018 Jun;77(6):869-874. doi:10.1136/annrheumdis-2018-213023Vena GO, Cassano N, Bellia G, et al.Psoriasis in pregnancy: challenges and solutions. Psoriasis (Auckl). 2015; 5: 83–95. doi:10.2147/PTT.S82975American Academy of Dermatology.Can a women treat psoriasis while pregnant or breastfeeding?
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Tsoi LC, Spain SL, Knight J, et al.Identification of 15 new psoriasis susceptibility loci highlights the role of innate immunity. Nat Genet. 2012 Dec;44(12):1341-8. doi:10.1038/ng.2467National Psoriasis Foundation.About psoriasis and psoriatic arthritis in children.Enamandram M, Kimball AB.Psoriasis epidemiology: the interplay of genes and the environment. J Invest Dermatol. 2013 Feb;133(2):287-9. doi:10.1038/jid.2012.434Yang YW, Chen CS, Chen YH, et al.Psoriasis and pregnancy outcomes: a nationwide population-based study.J Am Acad Dermatol. 2011 Jan;64(1):71-7. doi:10.1016/j.jaad.2010.02.005Weber-Schoendorfer C, Chambers C, Wacker E, et al.Pregnancy outcome after methotrexate treatment for rheumatic disease prior to or during early pregnancy: a prospective multicenter cohort study. Arthritis Rheumatol. 2014 May;66(5):1101-10. doi:10.1002/art.38368Trivedi MK, Vaughn AR, Murase JE.Pustular psoriasis of pregnancy: Current perspectives.Int J Womens Health. 2018; 10: 109–115. doi:10.2147/IJWH.S125784Bobotsis R, Gulliver WP, Monaghan K, et. al.Psoriasis and adverse pregnancy outcomes: A systematic review of observational studies. Br J Dermatol. 2016 Sep;175(3):464-72. doi:10.1111/bjd.14547Chi C, Wang S, Kirtschig G, et al.Safety of topical corticosteroids in pregnancy.JAMA Dermatol. 2016;152(8):934–935. doi:10.1001/jamadermatol.2016.1009Chi CC, Wang SH, Wojnarowska F, et al.Safety of topical corticosteroids in pregnancy. Cochrane Database Syst Rev. 2015 Oct 26;(10):CD007346. doi:10.1002/14651858.CD007346.pub3National Psoriasis Foundation. Treatment with topicals during pregnancy.https://www.psoriasis.org/pregnancy/treatments/topicalsTsao NW, Sayre EC, Hanley G, et al.Risk of preterm delivery and small-for-gestational-age births in women with autoimmune disease using biologics before or during pregnancy: A population-based cohort study.Ann Rheum Dis. 2018 Jun;77(6):869-874. doi:10.1136/annrheumdis-2018-213023Vena GO, Cassano N, Bellia G, et al.Psoriasis in pregnancy: challenges and solutions. Psoriasis (Auckl). 2015; 5: 83–95. doi:10.2147/PTT.S82975American Academy of Dermatology.Can a women treat psoriasis while pregnant or breastfeeding?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Tsoi LC, Spain SL, Knight J, et al.Identification of 15 new psoriasis susceptibility loci highlights the role of innate immunity. Nat Genet. 2012 Dec;44(12):1341-8. doi:10.1038/ng.2467National Psoriasis Foundation.About psoriasis and psoriatic arthritis in children.Enamandram M, Kimball AB.Psoriasis epidemiology: the interplay of genes and the environment. J Invest Dermatol. 2013 Feb;133(2):287-9. doi:10.1038/jid.2012.434Yang YW, Chen CS, Chen YH, et al.Psoriasis and pregnancy outcomes: a nationwide population-based study.J Am Acad Dermatol. 2011 Jan;64(1):71-7. doi:10.1016/j.jaad.2010.02.005Weber-Schoendorfer C, Chambers C, Wacker E, et al.Pregnancy outcome after methotrexate treatment for rheumatic disease prior to or during early pregnancy: a prospective multicenter cohort study. Arthritis Rheumatol. 2014 May;66(5):1101-10. doi:10.1002/art.38368Trivedi MK, Vaughn AR, Murase JE.Pustular psoriasis of pregnancy: Current perspectives.Int J Womens Health. 2018; 10: 109–115. doi:10.2147/IJWH.S125784Bobotsis R, Gulliver WP, Monaghan K, et. al.Psoriasis and adverse pregnancy outcomes: A systematic review of observational studies. Br J Dermatol. 2016 Sep;175(3):464-72. doi:10.1111/bjd.14547Chi C, Wang S, Kirtschig G, et al.Safety of topical corticosteroids in pregnancy.JAMA Dermatol. 2016;152(8):934–935. doi:10.1001/jamadermatol.2016.1009Chi CC, Wang SH, Wojnarowska F, et al.Safety of topical corticosteroids in pregnancy. Cochrane Database Syst Rev. 2015 Oct 26;(10):CD007346. doi:10.1002/14651858.CD007346.pub3National Psoriasis Foundation. Treatment with topicals during pregnancy.https://www.psoriasis.org/pregnancy/treatments/topicalsTsao NW, Sayre EC, Hanley G, et al.Risk of preterm delivery and small-for-gestational-age births in women with autoimmune disease using biologics before or during pregnancy: A population-based cohort study.Ann Rheum Dis. 2018 Jun;77(6):869-874. doi:10.1136/annrheumdis-2018-213023Vena GO, Cassano N, Bellia G, et al.Psoriasis in pregnancy: challenges and solutions. Psoriasis (Auckl). 2015; 5: 83–95. doi:10.2147/PTT.S82975American Academy of Dermatology.Can a women treat psoriasis while pregnant or breastfeeding?
Tsoi LC, Spain SL, Knight J, et al.Identification of 15 new psoriasis susceptibility loci highlights the role of innate immunity. Nat Genet. 2012 Dec;44(12):1341-8. doi:10.1038/ng.2467
National Psoriasis Foundation.About psoriasis and psoriatic arthritis in children.
Enamandram M, Kimball AB.Psoriasis epidemiology: the interplay of genes and the environment. J Invest Dermatol. 2013 Feb;133(2):287-9. doi:10.1038/jid.2012.434
Yang YW, Chen CS, Chen YH, et al.Psoriasis and pregnancy outcomes: a nationwide population-based study.J Am Acad Dermatol. 2011 Jan;64(1):71-7. doi:10.1016/j.jaad.2010.02.005
Weber-Schoendorfer C, Chambers C, Wacker E, et al.Pregnancy outcome after methotrexate treatment for rheumatic disease prior to or during early pregnancy: a prospective multicenter cohort study. Arthritis Rheumatol. 2014 May;66(5):1101-10. doi:10.1002/art.38368
Trivedi MK, Vaughn AR, Murase JE.Pustular psoriasis of pregnancy: Current perspectives.Int J Womens Health. 2018; 10: 109–115. doi:10.2147/IJWH.S125784
Bobotsis R, Gulliver WP, Monaghan K, et. al.Psoriasis and adverse pregnancy outcomes: A systematic review of observational studies. Br J Dermatol. 2016 Sep;175(3):464-72. doi:10.1111/bjd.14547
Chi C, Wang S, Kirtschig G, et al.Safety of topical corticosteroids in pregnancy.JAMA Dermatol. 2016;152(8):934–935. doi:10.1001/jamadermatol.2016.1009
Chi CC, Wang SH, Wojnarowska F, et al.Safety of topical corticosteroids in pregnancy. Cochrane Database Syst Rev. 2015 Oct 26;(10):CD007346. doi:10.1002/14651858.CD007346.pub3
National Psoriasis Foundation. Treatment with topicals during pregnancy.https://www.psoriasis.org/pregnancy/treatments/topicals
Tsao NW, Sayre EC, Hanley G, et al.Risk of preterm delivery and small-for-gestational-age births in women with autoimmune disease using biologics before or during pregnancy: A population-based cohort study.Ann Rheum Dis. 2018 Jun;77(6):869-874. doi:10.1136/annrheumdis-2018-213023
Vena GO, Cassano N, Bellia G, et al.Psoriasis in pregnancy: challenges and solutions. Psoriasis (Auckl). 2015; 5: 83–95. doi:10.2147/PTT.S82975
American Academy of Dermatology.Can a women treat psoriasis while pregnant or breastfeeding?
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