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!

The post Shedding Light on Atopic Dermatitis and Pregnancy: Understanding Light Therapy appeared first on MotherToBaby.

Your Skin

First, lets talk about your skin and how topical products (things you put on your skin) get into your system. Your skin is a large, dynamic living tissue that is made up of different layers. We need to understand the absorption process in order to evaluate the safety of cosmetic, medicinal, and chemical products that come into contact with our skin. When a substance is put on your skin, it first has to go through the outer layer of the skin called the stratum corneum, which is made up of dead cells. Then come the living layers of our skin, the epidermis (waterproof barrier), dermis (connective tissue, hair follicles and sweat glands), hypodermis (fat and connective tissue) and the vascular network.

How Much is Absorbed?

Different factors affect skin absorption, including how much is applied, the physical state of the product (is it a liquid, powder, gel, etc.), where on the body it is applied, how large of an area the product is applied to, the person’s age, and whether the skin is wet or dry at the time the product is applied. Often, only 1 or 2% of an applied dose is absorbed into your system. But sometimes, more is absorbed, especially if your skin has open wounds, cracks etc. or if you have a skin condition such as eczema. In fact, how “complete” your skin is can be the most important factor in determining how effective a barrier it can be to topical products.

It can be hard to get good safety information on every type of topical product. The FDA (Food and Drug Administration) does require cosmetic products to be “safe,” which is based on their specific labeling and use. Yet cosmetic products do not need FDA approval to be sold on the market, and often the companies make claims that have not been studied and cannot be proven. So it is always a good idea to check with our MotherToBaby information specialists and let us research the product and its ingredients for you.

Many times during pregnancy and breastfeeding, people worry about the use of retinoids (a class of chemical compounds contained in treatments for acne, psoriasis, wrinkles, and other skin conditions), high dose salicylic acid (a common ingredient in topical acne treatments), formaldehyde (often used as a preservative in cosmetic products), hydroquinone (a skin-lightening agent that can be used to treat age spots and sun spots), and chemical sunscreens to name a few. These products do have some concerns and should be used with caution when pregnant and nursing.

Other products that are applied to your skin have less concerns in most instances. These include over-the-counter antibiotic creams, corticosteroid creams (used to reduce skin inflammation and irritation from things insect bites or poison oak/ivy, but also in treatments for eczema and psoriasis), essential oils, menthol and lidocaine type products (used in products to cool or numb the skin), hydrogen peroxide (used in treatments for acne, sun spots, and age spots), fluoride and dental products, homeopathic creams and gels, vitamin C products (used in treatments to reduce fine lines and as an antioxidant to protect the skin), and things that you put on your hair and nails.  

So that is the skinny on skin care! You might be able to use more products on your skin than you thought you could during pregnancy and breastfeeding. Even with a product that is considered low risk, you may want to check with your healthcare provider or with us if you have any concerns before using. We have a number of fact sheets and blogs that can answer some of your questions about topical products, and our information specialists are always happy to answer your questions by phone, text, email, or chat.

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