Dealing With Itching and Rashes During Pregnancy

Pregnant woman applying cream on tummy

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Itching, with or without a rash, is a common symptom for many people. Itching can be the result of a skin disease, such as an allergic skin rash, or an internal medical issue, such as liver or thyroid disease. Itching during pregnancy can be caused by a few unique diseases related to being pregnant. Sometimes it may have nothing to do with the pregnancy. Either way, having an itchy rash during pregnancy can add anxiety to an otherwise stressful time for many women.

Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP)

PUPPP is the most common itchy rash that women can experience during pregnancy, and it affects up to 1 in 160 pregnancies. PUPPP usually occurs during a woman’s first pregnancy in the third trimester and results in an extremely itchy rash that resembles hives. The rash usually occurs on the abdomen and may be related to trauma from skin stretching.

Treatment of PUPPP involves oral antihistamines and topical steroids; sometimes oral steroids are needed.

PUPPP does not harm the baby, and the rash usually fades within a few weeks after delivery.

Prurigo of Pregnancy

Prurigo of pregnancy is another common form of itching during pregnancy, affecting 1 in 300 mothers to be. Affected women experience itchy bumps along the extensor surfaces of the arms and legs, and occasionally on the abdomen. Prurigo can occur at any time during the pregnancy and is treated with moisturizers, topical steroids, and oral antihistamines. The rash usually resolves shortly after delivery but may occur again in future pregnancies.

Cholestasis of Pregnancy

Itching from cholestasis of pregnancy typically occurs in the third trimester. It's related to the buildup of bile acids in the bloodstream from the gallbladder and biliary system. There is no associated rash, but affected women may experience skin jaundice (yellowing). The itching usually goes away after delivery but may recur in future pregnancies.

Cholestasis can affect the baby, causing fetal distress and pre-term labor. If that happens, prompt medical attention is required.

Pemphigoid Gestationis

Pemphigoid gestationis (PG) (formerly called herpes gestationis) is a rare autoimmune rash that occurs during late pregnancy (second and third trimester) and affects 1 in 50,000 pregnancies. It is not caused by a herpes virus infection; the rash, however, may look like herpes—with blisters and vesicles that may form rings—and occurs mostly on the abdomen, especially around the umbilicus (belly button).

Treatment usually involves topical, and sometimes oral, corticosteroids. Occasionally, pemphigoid gestationis is associated with premature delivery and low birth weights, but it does not otherwise affect the baby. The rash commonly flares at delivery, then resolves shortly thereafter, but is likely to recur with future pregnancies.

Pruritic Folliculitis of Pregnancy

Pruritic folliculitis of pregnancy most commonly occurs during the second and third trimesters, affecting 1 in 3,000 pregnancies. An itchy rash that looks like acne is present on the chest, arms, shoulders, and back. Treatment includes topical acne treatments such as benzoyl peroxide and, occasionally, topical steroids and oral antihistamines. This rash usually goes away within a month or two after delivery and does not affect the baby.

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