Most people with psoriasis would probably agree that it can be best described as unpredictable. I spent 20 years trying to figure out which treatments and preventative measures worked best for me — largely with little success, it has to be said. I still want to throw up when I think about the "miracle" herbal tea I concocted twice a day, much to the disgust of my roommates. Its smell was indescribable — and not in a good way. By the time I was in my late 20s, I'd tried every remedy under the sun and had reconciled myself to the fact that my stubborn skin wasn't going to play ball and was focused on enjoying the times when I could wear a sleeveless top without feeling as if there were a flashing sign over my head.
Then I got pregnant, and everything I thought I knew about managing my disorder went out the window.
Let's start with the good news first. Up to 60 percent of women find their psoriasis symptoms improve during pregnancy thanks to a progesterone surge that dampens the overactive immune response responsible for psoriasis symptoms. But for 10 to 20 percent of women with psoriasis, pregnancy makes their symptoms worse.
Before I first became pregnant in 2007, I would typically have a severe outbreak once or twice a year. But as soon as I became pregnant with my first child, my breakouts became much more frequent and more severe. Psoriasis is a bastard, both mentally and physically, people.
It turned out I was firmly in the camp of women for whom psoriasis and pregnancy do not co-exist harmoniously. But with a baby growing inside me, I had to think twice about my treatment options. Guidelines released in 2012 by the National Psoriasis Foundation recommend topical treatments (moisturizers and emollients such as petroleum jelly and mineral oil) as the first choice, but when the psoriasis is moderate to severe, these aren't enough.
So to manage my psoriasis during my pregnancy, I started implementing a few new steps in my daily routine:
I did my best to forget what was underneath my clothes. I knew obsessing over the state of my skin wouldn't make it better, and was in fact highly likely to make it even worse. So I was kind to myself. Whenever I noticed a new patch of redness appearing on the back of my hand or behind my knee, I'd tell myself — several times, if necessary — that it was only there temporarily. I refused to let my psoriasis take control of my state of mind when I had something so amazing to plan for and look forward to.
My baby was born, 8 pounds of perfection, and a few months later, my skin began to clear.
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