While it may be best to avoid any therapies during pregnancy, when treatment is necessary, several options exist. Most topical therapies pose little risk during pregnancy with the notable exception of tazarotene. Phototherapy with broad-band UVB or narrow-band UVB is probably as safe as sunlight. PUVA is rated pregnancy category C because of its mechanism of action. Of the currently available oral medications, methotrexate and acitretin are clearly teratogenic, while cyclosporine appears to be the safest of these medications. With the introduction of biologic agents, we now have many new therapies that may be safely administered during pregnancy if psoriasis is severe.
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