Skin conditions and skin changes are a normal, albeit frustrating, part of pregnancy. And while most of these rashes are nothing to be afraid of, some of them might be a sign that something’s wrong.
Here’s everything you need to know about the different types of pregnancy rashes and how to alleviate them quickly.
Hives
Even if you’re not pregnant, you might still experience hives. Hives are a physical allergic reaction to medications, insect bites, food, or another trigger.
During pregnancy, when your body becomes flooded with hormonal changes, you can become more sensitive to pathogens and more likely to experience itchy skin and hives.
Hives can also be caused by scratching or increased stress.
Symptoms
Hives present as pale, red bumps or welts on the skin that vary in size.
They appear suddenly without warning. Hives are often itchy, and they can sometimes even be painful.
Treatment
In most cases, a minor set of hives can go away on their own. It’s important not to scrub or scratch the area with soap or your hands, as this can aggravate and worsen the condition.
Some people have found that home remedies like taking an oatmeal bath or baking soda can help reduce the symptoms and decrease itching.
You also want to ensure your skin stays moisturized with lotion to help with eczema (skin dryness).
If allergic reactions cause hives, several over-the-counter antihistamines are generally safe for pregnant women. Of course, always speak with your healthcare provider before taking any new medications while pregnant.
Atopic Eruption of Pregnancy
Atopic eruption of pregnancy, or AEP, is the most common form of pregnancy-specific skin disorder.
It groups together three similar pregnancy rashes:
- Prurigo of pregnancy. A rash involving papules (small fluid-filled bumps)
- Pruritic folliculitis. Acne-like bumps in areas of the body where hair follicles have become infected
- Atopic eczema. A dry, itchy rash that appears reddish or pink. Eczema tends to flare up worse in the first and second trimesters.
The good news about AEP is that these conditions do not risk the fetus. However, it can be very uncomfortable.
Symptoms
Symptoms of AEP can vary based on the specific type of skin rash you’re experiencing. Eczema, or reddened dry skin, is the most common symptom.
However, some individuals also experience difficulty sleeping due to discomfort and tiny raised bumps in the body’s creases like the elbows or knees.
Treatment
Most of these rashes need time to go away on their own, so treatment revolves around eliminating itching and decreasing discomfort.
Steroid creams, moisturizers, or ointments are most common, especially since topical therapies are less likely to pose a risk for the baby.
Some individuals might benefit from alternative treatments like ultraviolet light (UVB), which is considered safe for pregnancy.
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Heat Rash
When pregnant, the body’s blood volume increases, causing some people to feel unusually warm due to increased blood supply to the skin.
Heat rash can lead to a patch of tiny, itchy blisters caused by sweat trapped under the skin.
Symptoms
Mild forms of heat rash include small fluid-filled bumps on the skin that break easily.
However, some more severe forms of heat rash include deeper bumps below the skin. These look like inflamed blister-like bumps and itching in the affected area.
Treatments
Preventing heat rash is one of the best ways to treat it, and you can do this by wearing looser clothing, changing out of wet clothing as soon as possible, and trying to stay cool as much as possible.
If heat rashes are already bothering you, try using a cool water compress and applying gentle pressure to the rash for 15-minute increments.
Cold compresses can reduce the size of the blisters and soothe itchiness and discomfort.
PUPPP Rash
PUPPP stands for pruritic urticarial papules and plaques of pregnancy.
And while the shortened acronym is fun to say, this rash can be extremely uncomfortable for a pregnant individual.
PUPPP is a set of itchy, hive-like bumps that form in the stretch marks of the stomach and can spread to other parts of the body while pregnant.
No one knows what causes PUPPP, but many theorists believe it has to do with the fact that the skin cells cannot keep up with the rate at which the stomach skin expands during pregnancy.
Symptoms
PUPPP looks and feels a lot like hives, but one of the main differences is that these appear on the stretch marks of the belly. You might also notice the rash spreading to the butt, breasts, arms, or thighs.
These bumps might look pink or red, and there’s a good chance that they’re super itchy.
This itchiness can affect your daily life and interfere with sleep.
Treatment
PUPPP usually lasts about four to six weeks and goes away on its own within a few days or weeks after delivery. Primary treatments are focused on alleviating itching.
From home, you can increase comfort by taking cool baths and showers or taking an oatmeal bath. You also want to stay moisturized and wear light-weight cotton clothes to reduce chafing.
A provider might also be able to prescribe you medications like anti-itch creams or pills.
Again, you should always gain doctor approval before using or taking new medications while pregnant.
ICP
ICP, or intrahepatic cholestasis of pregnancy, is a liver disorder that can develop in pregnancy.
While the cause is within the body, some of the most common symptoms include itching on the skin’s surface.
Bile acids flow from your liver to your gut to digest food, but with ICP, the acids don’t flow as they should and start to build up in the body. It’s unclear why this happens, but it’s thought to be genetic.
Symptoms
The most common symptom is noticeable itching on the hands and feet, which typically worsens at night.
There is not often a physical rash that accompanies the itching.
Other symptoms can include dark urine or pale feces. Jaundice, or yellowing of the eyes and skin, is less common but still possible.
Treatments
ICP is potentially serious, and there is no cure. However, it should go away once the baby is delivered.
If you have ICP, your doctor will probably advise you to give birth in a hospital under a specialty maternity team.
Additionally, since there’s a link between ICP and stillbirth, you might be offered induction of labor (giving birth before the scheduled due date).
Impetigo Herpetiformis
This rare skin condition most often appears during the last trimester of pregnancy. It involves severe skin inflammation similar to pustular psoriasis. It’s unclear what causes it.
Symptoms
The rash starts as lesions in skin folds, but these can spread across the surface and cover large patches.
This skin can become crusty and likely infected.
In addition, individuals might start to feel fever, diarrhea, dehydration, or rapid heartbeat. In severe cases, some individuals experience seizures.
Treatment
Impetigo herpetiformis usually resolves after giving birth, but there can be a risk of stillbirth.
A healthcare provider can help you manage the condition by offering antibiotics, creams, ointments, and other medications.
In rare cases, this condition can be fatal. If you experience any of its symptoms, contact your healthcare provider as soon as possible to seek treatment.
Pemphigoid Gestationis
This rare skin condition during pregnancy causes an itchy rash that begins around the belly button and spreads to other parts of the body.
It is most common in the second or third trimester. It is an autoimmune disease in which a woman’s immune system attacks components of their skin.
While this might resolve itself, it often flares up before delivery. After birth, your menstrual cycle or taking oral birth control pills can cause the rash to return.
The condition can lead to premature delivery and skin lesions on the newborn if left untreated.
Symptoms
The most common symptom of pemphigoid gestationis is a red, itchy rash around the navel (belly button). However, this rash can spread to other parts of the body. You might also notice some blistering.
Treatments
The goal of treatment is to relieve itching while also preventing blistering and secondary infection.
Topical steroids or creams are most common and can alleviate discomfort without posing any risk to the fetus. Oral antihistamines can also help relieve itching.
If none of these work, a doctor might recommend more aggressive medications. As always, consult your doctor or OBGYN (obstetrics and gynecology) before you start taking any new medications.
In Conclusion
Rashes during pregnancy are common; most of the time, they do not represent something you need to worry about.
Hives, heat rashes, and an atopic eruption of pregnancy are annoying and frustrating to deal with, but they do not pose a risk to your newborn.
However, rashes caused by conditions like pemphigoid gestationis, ICP, PUPPP, and impetigo herpetiformis can cause complications before, during, or after delivery.
As a rule of thumb, you should always contact your healthcare provider if you notice any abnormal changes to your body during pregnancy.
Most treatments involve finding ways to alleviate itching and discomfort, typically through topical itch relievers or antihistamine medications. However, a doctor might prescribe stronger medications for more severe cases.
References, Studies and Sources:
Hives During Pregnancy: Causes, Treatment & Prevention | American Pregnancy Association
Atopic Eruption of Pregnancy (AEP) | European Academy of Dermatology and Venereology
PUPPP Rash: Symptoms, Causes, Treatment & Prevention | Cleveland Clinic.
Itching and intrahepatic cholestasis of pregnancy | NHS
Pemphigoid Gestationis | DermNet N
Bridget Reed is a Tampa-based content development manager, writer, and editor at GR0; specializing in content related to varying fields including medicine, health, and small businesses. Bridget went to St. Petersburg College and majored in Management and Organizational Leadership.
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