Managing Skin Diseases that Flare During Pregnancy and in the Postpartum period: Part 1-Classification, Epidemiology & Pathogenesis.

Lyons, Catherine E; Smith, Aaron D; Schwartzman, Gabrielle; Hickman, Alexandra; Grant-Kels, Jane M · J Am Acad Dermatol · 2026

review · Level V

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Abstract

Pregnancy induces immunologic, hormonal, vascular, neurogenic and skin barrier changes that may exacerbate inflammatory dermatoses as atopic dermatitis (AD), and psoriasis. Part I of this CME reviews pregnancy-induced shifts in immunity, hormones, vascular dynamics and barrier function that can change the course of common dermatoses, including AD, psoriasis, acne, melasma, hidradenitisi suppurativa, and other conditions. Additionally, in Part II we present updated safety and pharmacokinetic data that supports the judicious use of topical, systemic and procedural therapies (eg, phototherapy, biologics) through gestation and lactation, replacing reliance solely on FDA categories. We include practical treatment options to enhance the balancing of maternal disease control with fetal and neonatal safety.