Patients With Psoriasis Seek Better Family Planning Guidance

Patients with psoriasis want clearer guidance from dermatologists and general practitioners on family planning and pregnancy (FPP), according to a new study.¹ With no formal guidelines currently in place, the research highlights key concerns, including fertility, heredity of psoriasis, treatment safety, and disease management during pregnancy and breastfeeding.

This cross-sectional questionnaire study is published in Journal of Dermatological Treatment.

Clearer information on fertility, heredity, and medication use is necessary during family planning for patients with psoriasis. | Image credit: Satori Studio - stock.adobe.com

“This questionnaire study among patients with psoriasis provides perspectives of both males and females on health care and information provision regarding FPP,” wrote the researchers of the study. “Twenty percent of the female and 6.5% of the male respondents had no children or doubted having children because of their psoriasis.”

Anyone can develop psoriasis, but having a family history significantly increases the risk, according to The National Psoriasis Foundation.² If neither parent has psoriasis, the lifetime risk is about 4%. The risk rises to between 14% and 28% if 1 parent is affected and to 40% to 65% if both parents have the disease. When a sibling has psoriasis, the risk increases further: to 24% with unaffected parents, 51% with 1 affected parent, and as high as 83% if both parents have the condition.

The study was based on a survey developed using Castor Electronic Data Capture and codesigned with dermatology specialists and patient representatives from a Dutch psoriasis association.¹ The questionnaire featured closed-ended questions covering disease characteristics, treatment experiences during conception or pregnancy, and preferences for FPP information, along with open text fields for elaboration. The survey was active from December 2023 to May 2024 and was distributed through patient association channels and a dermatology clinic in The Netherlands.

A total of 102 patients with psoriasis completed the questionnaire. Among female respondents, 52.5% did not have children, of whom 16.2% reported their psoriasis influenced their decision not to have children due to concerns about heredity, medication safety, and disease management during pregnancy. Among those who had had children, 46.7% experienced postpartum disease flare-ups.

Among male respondents, 58.1% did not have children, and none reported that psoriasis was the reason for not having children. Only 16.7% of their pregnancies involved prior systemic medication use, all of which was discontinued before conception. Just 29.2% had discussed their treatment with a dermatologist prior to conception.

Overall, 39.2% of respondents had received or searched for information about psoriasis and family planning, with more females (43.7%) than males (29.0%) who sought or received this information. The internet was the most common information source (68.8%), followed by health care providers (65.7%). Of those who received information, 89.5% cited dermatologists as the source. Still, only 7.9% felt they had “complete access” to FPP-related information.

Over half of participants (55%) said they would like to—or would have liked to—receive FPP information. This was also more common among females than males (64.3% vs. 35.5%; P = .008) and among parents compared with nonparents (77.1% vs. 52.7%; P = .021).

Furthermore, dermatologists and general practitioners were the most preferred sources. Timing preferences included the moment of diagnosis, medication changes, or upon request. Information about fertility, medication use during pregnancy, and heredity were among the most desired topics, especially among those with prior biologic use or children.

However, the researchers noted some limitations on their findings. First, the study included more patients with prior biologic use than the general psoriasis population. Second, it was conducted in The Netherlands, for which the cultural and health care system differences may limit broader applicability. Third, self-reported data may have been subjected to recall bias, and the absence of participants using systemic medication during conception or pregnancy left a gap in representing that subgroup’s perspective.

Despite these limitations, the researchers believe the findings underscore a demand for more proactive and tailored communication on reproductive health in psoriasis care.

“We showed that a significant number of patients are concerned about how psoriasis and/or its treatments may impact their child’s life,” wrote the researchers. “These findings underscore the importance of improving information delivery to better support patients with psoriasis during this important phase of life.”

References

1. Barenbrug L, Van Ee I, Van der Molen R. G, et al. Family planning and pregnancy among patients with psoriasis: incorporating the patients’ voice in health care practice and information provision. J Dermatolg Treat. 2025;36(1):2532676. doi:10.1080/09546634.2025.2532676

2. Psoriasis risk factors. National Psoriasis Foundation. Accessed August 5, 2025. https://www.psoriasis.org/psoriasis-risk-factors/#:~:text=Anyone%20can%20develop%20psoriasis.,if%20both%20parents%20have%20psoriasis