Safety in Lactation: Topical preparations for eczema and psoriasis

Sarah Fenner, Specialist MI Pharmacist, Midlands and East Medicines Advice Service (Midlands site) & UK Drugs in Lactation Advisory ServicePublished

Topical preparations for eczema and psoriasis are considered to pose a negligible risk to a breastfeeding infant as long as precautions are taken to avoid direct contact of the breastfeeding infant with treated areas. There is no published evidence on the safe use of these topical preparations in breastfeeding.
Care should be taken if changing from one product to another (including topical corticosteroids or systemic preparations) because of specificity of indications.
It is advisable to remove all topical products from the breast before feeding, and to avoid all use of ichthammol, coal tar, and tacrolimus preparations on the nipple and areola.
When applied to the breast, the use of creams are preferred to ointments due to ease of removal before breastfeeding.