2013 promises to be a big year for one of Hollywood’s most talked about couples, Kim Kardashian and Kanye West. And while womb watchers continue to speculate over whether Kim and Kanye need to pad their nest with blue or pink feathers, health experts and more concerned about the new bundle’s skin.
Kardashian has psoriasis, a chronic immune disease that causes redness and irritation. Dry, flaky skin and itching are also possible.
A recent study published in British Journal of Dermatology reports that women with severe forms of this disease are one-and-a-half times more likely to deliver a baby with low birth weight. “There have been many studies of psoriasis and pregnancy and psoriasis seems to complicate pregnancy,” says Debra Jaliman, M.D., a NYC dermatologist and author of Skin Rules: Trade Secrets From a Top New York Dermatologist. “No one knows why these complications occur.”
"Women with severe psoriasis who participated in the study that received aggressive [psoriasis] treatment during pregnancy did not have low birth weight babies, leading the scientists to conclude the immune factors at work may have detrimental effects on the placenta and impair the growth of the baby in utero," says Roseline Dauphin-Baptiste M.D., an OB/GYN in Burbank, CA.
Some other possible complications include an increased risk of spontaneous miscarriage, preterm birth, preeclampsia and low birth weight, according to Jaliman.
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Is pregnancy a cure for psoriasis?
Kardashian might be spared from psoriasis symptoms while she’s pregnant. A 2005 study published in the Archives of Dermatology says 55 percent of pregnant women improve during pregnancy, 21 percent reported no change, and 23 percent worsen during pregnancy. This is thought to be due to an increase in estrogen levels.
Doctors aren’t sure why moms-to-be might see a reduction on symptoms during pregnancy.
“Even though we do not know for sure at this point, one hypothesis is that some of the immune factors responsible for psoriasis are suppressed during pregnancy. That could be the mechanism behind the improvement that most women experience during their pregnancy,” says Dauphin-Baptiste.
“Unfortunately, most will experience an increase in symptoms after delivery,” says Dauphin-Baptiste.
Like mother, like baby?
In addition to wondering if their baby will inherit Kardashian’s trademark exotic looks or West’s musical talent, the couple should consider that their baby has an increased risk of psoriasis, too.
“Psoriasis is thought to be genetic, but nobody knows the pattern of inheritance,” says Jaliman.
One out of three people with psoriasis report that a relative has or had it, too, adds Dauphin-Baptiste. Kardashian’s mom, Kris Jenner, has psoriasis. “If one parent has psoriasis, a child has a 10 percent chance of having the disease. If two parents have it, a child has a 50 percent chance of getting the disease,” she says. “It is not possible to predict who will or will not get psoriasis. Studies of identical twins have found that sometimes only one twin is affected whereas the other one is not.”
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Treating psoriasis during pregnancy
Dauphin-Baptiste says mild psoriasis can be safely treated during pregnancy using creams, ointments or lotions to moisturize the skin. “For the most part, shampoos, oils, and sprays to treat psoriasis of the scalp and over-the-counter topical creams/medications are not harmful. They are generally spread on the affected skin areas or used in a shampoo for scalp lesions. Some exposure to sunlight also helps.”
Pregnant women should talk to their doctor to develop a treatment plan that’s best for them.
Treatment for moderate to severe psoriasis involves using prescription creams or drugs that suppress the immune system or modify the body's response. “Those are generally not used during pregnancy,” says Jaliman. “Topical retinoids such as Tazorac cannot be used as they have not been tested for safety during pregnancy.”
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Triggers to avoid
Even though psoriasis cannot be prevented, Jaliman says a pregnant women like Kardashian (or anyone with psoriasis) should avoid these triggers, as they seem to make the condition worse:
- Stress and anxiety
- Cold, dry weather
- Skin injury
- Infection (especially Strep infections)
- Use of alcohol
- Smoking and certain medicines all seem to make the condition worse
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