Atopic dermatitis, commonly known as eczema, is a condition that makes the skin itchy and inflamed and can cause red or darker colored patches during a flare-up. Symptoms can be mild, moderate, or severe and can come and go. If you are one of the many people who are pregnant and dealing with this itchy, inflamed skin issue, you are not alone. Atopic dermatitis is common in pregnancy. Over half of people with eczema develop symptoms for the first time during their pregnancy. Hormonal changes in pregnancy can make symptoms worse.
There are many ways your healthcare providers may treat your atopic dermatitis during pregnancy. Treatment may be topical (used on the skin) such as moisturizers and creams or systemic (medication taken by mouth or by injection). Information on specific medications can be found in our fact sheets at https://mothertobaby.org/fact-sheets/ or by contacting a MotherToBaby specialist at 866.626.6847.
Generally, the first line of treatment in pregnancy is topical because of the route of exposure. The developing baby is exposed to things in a pregnant person’s blood. When you take a medication by mouth or swallow something, we know that is very likely to enter the bloodstream, where it can then potentially cross the placenta and reach the baby. With most topical products, the skin serves as a good barrier, so it is not expected that a significant amount of the product would be able to enter the pregnant person’s blood where it can then reach the baby. This is especially true when the topical product is used on small areas of the body, used infrequently, or used on healthy (non-broken) skin.
If topical treatment is not working for you, fear not, there may be a glimmer of hope – light therapy.
Understanding Light Therapy:
Light therapy, also known as phototherapy, is a treatment option for atopic dermatitis that involves exposing the skin to ultraviolet (UV) light under controlled conditions. There are various types of light therapy including: narrowband (NBUVB), broadband (BBUVB), UVA, UVA1, full-spectrum light, saltwater bath plus UVB (balneophototherapy), psoralen plus UVA (PUVA), and other forms of phototherapy. UV light is the same light that comes from the sun, and it is not radiation. This therapy aims to reduce inflammation and itchiness, ultimately improving the overall condition of the skin.
Light Therapy During Pregnancy:
While there’s limited research on light therapy during pregnancy, it is not expected to increase the chance of pregnancy complications. Most of the types of light are not expected to be absorbed through the skin and reach the developing baby. However, while NBUVB and BBUVB phototherapy can be used during pregnancy, they may reduce folic acid levels. Folic acid is very important for baby’s development especially in the first trimester of pregnancy. Make sure you talk with your healthcare provider about folic acid supplementation and monitoring folic acid levels if you do need to get phototherapy in the first trimester. You may find our factsheet on folic acid helpful here: https://mothertobaby.org/fact-sheets/folic-acid/. Additionally, psoralen plus ultraviolet A (PUVA) light therapy should be avoided during pregnancy due to increased chance of low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth).
In order to learn more about how atopic dermatitis and light therapy may affect pregnancy, MotherToBaby is currently enrolling people who are pregnant in the Eczema & Pregnancy Study. You can make an impact on the health of future families today by joining the study. Learn more about the study here: https://mothertobaby.org/ongoing-study/eczema-moderate-to-severe-atopic-dermatitis/
Protecting the Skin:
Your healthcare provider may recommend using sunscreen for additional skin protection after light therapy. Sunscreen ingredients such as avobenzone, homosalate, octisalate, and octocrylene may be absorbed through the skin in small amounts with regular use, especially if they are used on large areas of the body. However, there is no proven increased risk to a pregnancy from using these ingredients. Mineral sunscreens contain zinc or titanium which are physical blocking agents and stay on top of the skin. That means they are not absorbed through the skin and are not expected to reach the developing baby. More information is available on our blog: https://mothertobaby.org/baby-blog/screening-your-sunscreen-during-pregnancy/
As with any medical treatment during pregnancy, it’s essential to weigh the potential risks and benefits with your healthcare provider.
Things to Consider:
Before diving into light therapy, here are a few things to consider:
1. Consult Your Healthcare Provider: Always consult with your healthcare provider before starting any new treatment, especially during pregnancy. Your healthcare provider can help you assess potential risks and determine if light therapy, and what type of light therapy, is right for you.
2. Alternative Treatments: If light therapy isn’t suitable for you during pregnancy, don’t worry! There may be other treatment options available that can help manage your symptoms. Information on specific medications can be found in our fact sheets at https://mothertobaby.org/fact-sheets/ or by contacting a MotherToBaby specialist at 866.626.6847.
3. Consider Joining the MotherToBaby Eczema & Pregnancy Study: Are you interested in joining our community of expecting parents who are sharing their pregnancy journey with our study team? If you would like more information, visit https://mothertobaby.org/ongoing-study/eczema-moderate-to-severe-atopic-dermatitis/ or call 877-311-8972.
In Conclusion:
Atopic dermatitis can be challenging to manage, especially during pregnancy. However, light therapy offers a ray of hope for many people who are pregnant and struggling with this skin condition. Remember to always consult with your healthcare provider to determine the best course of action for you and your baby. You’ve got this!
