Dealing With Itching and Rashes During Pregnancy

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Itching, with or without a rash, is a common symptom during pregnancy. It can be due to several reasons:

  • Skin disease, such as an allergic skin rash
  • Internal medical issue, such as liver or thyroid disease
  • One of several diseases that are unique to pregnancy

No matter the cause, an itchy rash during pregnancy can add anxiety and discomfort to an already difficult time.

Pregnant woman applying cream on tummy
IAN HOOTON/SCIENCE PHOTO LIBRARY / Getty Images

Pruritic Urticarial Papules and Plaques

Pruritic urticarial papules and plaques of pregnancy, or PUPPP, is the most common pregnancy-related itchy rash, affecting up to 1 in 160 pregnancies.

PUPPP usually occurs during the third trimester of your first pregnancy. It 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

Prurigo of pregnancy is another common form of itching you may experience while pregnant. Affecting 1 in 300 pregnancies, it causes itchy bumps along the extensor surfaces of your arms and legs and occasionally 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

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's no associated rash, but you 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's 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 and resolves shortly thereafter. It's likely to recur with future pregnancies.

Pruritic Folliculitis

Pruritic folliculitis of pregnancy most commonly occurs during the second and third trimesters, affecting 1 in 3,000 pregnancies.

It causes an itchy rash that looks like acne 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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