All women who are or may become pregnant should discuss the use of any psoriasis medication with their physician. Many psoriasis medications should not be used by women who are or may become pregnant. This is particularly true of oral retinoids, methotrexate and PUVA phototherapy. These are absolutely not recommended for pregnant women because of a very high risk of miscarriage or severe birth defects. The Food and Drug Administration (FDA) strictly monitors many of these medications and may require women to have two negative pregnancy tests prior to receiving a prescription.

In addition, women may be required to have monthly pregnancy tests throughout the course of isotretinoin treatment. Some of these medications (e.g., the retinoid etretinate) may remain in the system for a very long time, requiring adequate contraception for as long as two or three years following therapy. These medications are also not recommended when breastfeeding.

Topical retinoids are typically not recommended for women who are or may become pregnant. Certain topical retinoids, including tazarotene, must not be used in pregnancy.

The safety of many other psoriasis medications (e.g., anthralin, corticosteroids, vitamin D analogs) during pregnancy has not been established. Because of this, these medications are not recommended for women who are or may become pregnant. Most of these medications may also be excreted in breast milk, so they are not recommended for women who are breastfeeding.