Itchy thighs in pregnancy

Itching in pregnancy: five things you need to know | Pregnancy, Worries and discomforts articles & support

Feeling itchy is actually one of the most common skin problems in pregnancy. Here’s what you need to know about it.

1. Itching in pregnancy has a logical cause

That super-irritating itch is caused by your skin stretching. Your growing uterus causes the skin around the belly to stretch yet the oil glands cannot meet their normal moisture requirement. That’s why you’ll find you have dry and itchy skin that’s often worse on your tummy and legs (Kenyon et al, 2010; NHS Choices, 2016a).

Your hormones changing can also make the itch worse (British Association of Dermatologists, 2018). If you usually get eczema, it can get worse while you’re pregnant (Ambros-Rudolph, 2011; NHS Choices, 2016b).

2. It is normal for severe itching to get you down

While friends and family may not take itching as a symptom seriously, a severe itch can be more than irritating. Severe itching can lead to poor sleep, exhaustion and can really get you down (Rungsiprakarn, et al, 2016).

3. Itching in pregnancy can be a sign of something more serious

Itching can be a symptom of a liver condition called intrahepatic cholestasis of pregnancy (ICP), also known as obstetric cholestasis (OC). Obstetric cholestasis is often different to a normal itch as it affects the palms of your hands and soles of your feet.

Obstetric cholestasis can also cause your wee to be dark and your poo to be pale (RCOG, 2011). Obstetric cholestasis affects 1 in 140 women pregnant women in the UK and it needs medical attention (NHS Choices, 2016c).

4. Evening or night itching could ring alarm bells

Mild itching is not usually harmful to you or your baby. But if you’re notice itching more during the evening or at night, it could be a sign of a more serious condition. Make sure you talk to your midwife or doctor about this as they can decide whether you need any further investigations (NHS Choices, 2016c).

5. It is possible to ease the itching

You could help prevent mild itching by wearing loose clothes in natural materials like cotton to let air circulate. You could also try having cool baths and applying moisturiser or lotion to help soothe the itching. Make sure you avoid any strongly perfumed products as they can make your itch worse (NHS Choices, 2016c).

This page was last reviewed in April 2018.

Further information

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Find out more about other pregnancy symptoms that you can expect or look out for along the way here.

References

Ambros-Rudolph CM. (2011) Dermatoses of pregnancy - clues to diagnosis, fetal risk and therapy. Ann Dermatol. (3):265-275. doi: 10.5021/ad.2011.23.3.265. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21909194 [Accessed 1st March 2018].

British Association of Dermatologists. (2018) Polymorphic eruption of pregnancy. http://www.bad.org.uk/shared/get-file.ashx?id=227&itemtype=document

Kenyon AP, Tribe RM, Nelson-Piercy C, Girling JC, Williamson C, Seed PT, Vaughan-Jones S, Shennan AH. (2010) Pruritus in pregnancy: a study of anatomical distribution and prevalence in relation to the development of obstetric cholestasis. Obstet Med. 3(1):25-29. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27582836 [Accessed 1st March 2018].

NHS. (2016a) Itching and intrahepatic cholestasis of pregnancy. Available from: https://www.nhs.uk/conditions/pregnancy-and-baby/itching-obstetric-cholestasis-pregnant/ [Accessed 1st March 2018].

NHS. (2016b) Atopic eczema - causes. Available from: https://www.nhs.uk/conditions/atopic-eczema/causes/ [Accessed 1st March 2018].

NHS. (2016c) Itching and intrahepatic cholestasis of pregnancy. Available from: https://www.nhs.uk/conditions/pregnancy-and-baby/itching-obstetric-cholestasis-pregnant/ [Accessed 1st March 2018].

RCOG. (2011) Obstetric cholestasis. Available from: https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg43/ [Accessed 1st March 2018].

Rungsiprakarn P, Laopaiboon M, Sangkomkamhang US, Lumbiganon P. (2016) Pharmacological interventions for generalised itching (not caused by systemic disease or skin lesions) in pregnancy. Cochrane Database Syst Rev. (2):CD011351. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26891962 [Accessed 1st March 2018].

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Causes, Treatments, When to See Your OB

Scratch, scratch, scratch. All of a sudden it feels like all you can think about it how much you itch. Your pregnancy may have brought on a whole host of new “fun” experiences: dizziness, nausea, heartburn, or even trouble breathing.

You’d likely been warned about all of these from other pregnant women and weren’t shocked when you hit these milestones in your pregnancy journey. The last thing you imagined you’d be feeling though was itchy!

You hadn’t heard about intense itching during pregnancy from a lot of your friends, so now you’re wondering: What’s causing this? Is this normal? Should I be worried?

Although we can’t diagnose the exact cause of your itchiness, we’ve compiled a list of some common reasons pregnant women may be feeling the urge to scratch — and some signs you should head in to see your doctor.

There are many reasons why you may feel itchy during pregnancy. These might include:

Stretching skin. First pregnancies and pregnancies with multiples tend to cause skin to stretch quite a bit more than it is used to.
Dryness. Hormone changes in pregnancy can cause itchy, flaky dry skin.
Perfumes or fabrics. Different materials and chemicals can literally rub you the wrong way.
Hormones. The hormonal changes you experience in pregnancy can affect everything from mood to circulation to, yes, itchiness.
Cholestasis. This is a liver disorder that can result in the buildup of bile acids in the blood that cause feelings of itchiness.
Pruritic urticarial papules and plaques of pregnancy (PUPPP). This is an itchy rash that occurs around stretch marks during late pregnancy.
Prurigo. These crusty, itchy bumps on the arms, legs, or abdomen that can appear in any trimester.

It’s important to consider where on your body you are experiencing itching. Most pregnancies will involve some itching belly and itching breasts because the skin in these areas is going through so many changes.

Itching around your stretch marks may be a result of PUPPP, while itchy arm and leg areas are more likely to be a result of fabrics rubbing you the wrong way or prurigo.

Occasionally feeling slight itchiness is normal, but intense itching of the abdomen, arms, and legs can be a sign that your body needs some attention. Some people also experience vaginal itching during pregnancy, which may require treatment. In addition, sometimes there may be rashes associated with pregnancy itching.

Itching is not generally considered an early pregnancy symptom. In fact, many types of rashes typically only appear later in pregnancy and some may not resolve until after your baby is born.

That said, any time intense or prolonged itching appears during the course of your pregnancy it should be reported to your doctor.

Just as there are many potential causes for itchiness in pregnancy, there are a variety of ways to help alleviate any itching that you may be feeling. Consider these natural remedies you can try at home:

Change perfumes or detergents. You may even consider making your own soap/perfumes/detergents to avoid chemicals in commercial products that irritate your skin.
Wear loose clothing made from natural fabrics. (This will help keep potentially irritating fabrics away from your skin AND help keep you cool to avoid any heat-related rashes!)
Take an oatmeal bath or use a yogurt skin treatment. Lathering up with pine tar soap is a common home remedy for PUPPP.
Use a moisturizer to help with dry skin. Olive oil and coconut oil are both very moisturizing as are shea and coconut butter.
Apply some calamine lotion. This chalky pink liquid isn’t just for bug bites and poison ivy!
Increase your water intake and make sure that you’re staying hydrated. Don’t forget to include electrolytes in your hydration. Making sure to include some coconut water or a water with electrolytes added will help your body to make the most of the water that you’re providing it.
Turn on your humidifier and/or a fan. Keeping the air moist and cool will help with dry skin and itchy heat-related rashes.

Remember: If itching doesn’t improve or gets worse, it’s time to make plans to visit your doctor!

You should see your doctor if you have any of the following.

Signs of cholestasis

jaundice (a yellowing of the skin and the white area of the eye)
dark urine
lack of appetite
nausea
light stool
depression
intense itchiness, including itching feet

Cholestasis is a liver condition that results in a build-up of bile acids in the blood. There is not usually a rash, but the skin may develop a more yellow tone. In pregnancy, the condition, if it does appear, occurs in the third trimester.

Your doctor will diagnosis cholestasis with a blood test. A medical history will also typically be taken, because cholestasis can be an inherited condition and is more common if your mother or sister also had it during one of their pregnancies.

Many over-the-counter anti-itch medications will not be effective if cholestasis is the cause of your itch, but your doctor may be able to prescribe other drugs that can help alleviate some of the itchiness and reduce the amount of bile acid in the blood.

Ultimately, the solution to cholestasis is delivering the baby, and the itch will usually clear up within a few days of giving birth.

Because there is an increased chance of stillbirth, fetal distress, and preterm delivery, your doctor may want to discuss an earlier induction or more frequent monitoring during your pregnancy (and for a period after delivery) if you are diagnosed with cholestasis.

Signs of PUPPP

rash made up of small, pimple-like dots, typically spreading from stretch mark areas and not extending beyond the breasts
blisters around the rash
feeling extra itchy at night

Typically, your doctor will diagnose PUPPP through a skin examination. In rare cases a skin biopsy may be ordered. Blood work to rule out an infection may be done as well.

The ultimate cure for PUPPP is to deliver the baby, and the rash will usually be gone within a few weeks of delivery. Moisturizers, steroid creams, and antihistamines prescribed by your doctor, as well as itch relieving baths, can help to temporarily relieve itchiness until your due date.

Signs of prurigo

itchy, crusty bumps on the arms, legs, or abdomen

While moisturizers may help with the itch from prurigo, treatment typically involves topical steroids and oral antihistamines. If you’ve had prurigo during one pregnancy, there’s an increased chance that you’ll experience it in future pregnancies. While it may clear up shortly after giving birth, it can also unfortunately last for weeks or even months after giving birth.

If you feel intensely itchy or itchy for a prolonged time during your pregnancy, it’s a good idea to check in with your OB or midwife. They can prescribe medications, rule out various illnesses, and make sure that you and your little one are safe.

That intense itch you’re feeling during pregnancy could be due to many different things. It’s important to think about any other symptoms you’re experiencing, the timeline of your itchiness, and even just your daily activities to figure out how to solve this uncomfortable problem.

Because itchiness can be a symptom of a more serious condition, it’s important to consult with your doctor if it continues or any other symptoms appear.

After all, you don’t want your itching to distract you from experiencing the morning sickness, heartburn, and frequent trips to the bathroom you’ve been warned about from other pregnant women!

Why does the skin itch during pregnancy?

Skin itching during pregnancy is not a very common phenomenon. Most often, the skin begins to itch unbearably (as after mosquito bites) in the evening, closer to night, which can provoke insomnia and generally worsen a woman’s mood. Usually itching does not harm the baby and goes away after childbirth. However, it is still worth consulting with a gynecologist and dermatologist.

What does it come from? nine0005

The cause of itching during pregnancy in most cases is a violation of the liver: the production and outflow of bile, a general increase in the level of bilirubin in the blood. This is due to a hormonal failure in the body of the future mother - a violation of the synthesis of estrogens, as well as due to fetal pressure on the bile ducts. The fatty acids produced in large quantities enter the woman's skin with the bloodstream and irritate the nerve endings, causing excruciating itching. Similar phenomena associated with stagnation of bile in the body can make themselves felt in the third trimester of pregnancy. Sometimes itching is accompanied by such dangerous diseases as diabetes mellitus. nine0003

Who is predisposed?

Itching during pregnancy is usually observed in women with chronic diseases of the biliary tract and with high levels of cholesterol in the blood. Such future mothers need to regularly (at least once a month) do a biochemical blood test to exclude toxic effects on liver cells.

How to fight?

A pregnant woman should tell her gynecologist about the discomfort associated with skin itching. In some cases, itching can be a sign of the development of such a dangerous disease as hepatitis. The doctor will conduct appropriate examinations. If, according to an objective examination, itching does not pose any danger, it is often possible to get rid of discomfort simply by following a diet aimed at lowering cholesterol levels, limiting the intake of fatty, spicy and salty foods that prevent the liver from coping with the function of bile secretion, as well as drinking plenty of water - it is necessary to eliminate dry skin. If the diet does not help, the doctor may prescribe choleretic drugs suitable for pregnant women. nine0003

It is important to find the cause of the bothersome itching, eliminating a whole group of skin diseases that can occur during pregnancy.

Itching in the abdomen and chest

This itch is worth mentioning separately. As a rule, the skin on the abdomen or chest itches in the second and third trimesters due to its stretching, because it is these parts of the body that increase in volume during pregnancy. In this case, it is very important not to scratch the skin - this will lead to the appearance of stretch marks, which, unlike itching, will not go away after childbirth. Regularly use moisturizing creams, special products for stretch marks, do a light massage of the chest and abdomen with circular movements of your fingers and do not take hot showers. nine0003

You can get answers to any questions about pregnancy and childbirth from leading EMC experts in the classes of the School of Moms.

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Itchy skin during pregnancy: causes and remedies

Itching of the skin during pregnancy can be psychogenic. In this case, itching is a consequence of stress, an early symptom of multiple sclerosis. nine0003

In the early stages, itching occurs due to loss of skin elasticity caused by hormonal changes and excessive dryness of the skin. In the second and third trimester, the reasons may be the rapid weight gain of the expectant mother, the developing stretching of the skin of the abdomen as it increases.

Some expectant mothers experience intimate itching. It is provoked by genital infections, urological and proctological diseases.

The causes of skin itching also include dermatoses of pregnant women (atopic dermatitis, cholestasis of pregnancy). They are provoked by hereditary predisposition, decreased immunity, physiological changes (stretching of the skin with damage to the connective tissue).

Atopic dermatitis is the most common cause of itching during pregnancy. A specific condition is caused by hormonal immune restructuring of the whole organism. In 80% of cases, the disease manifests itself exclusively during pregnancy, and all signs disappear after childbirth without specific treatment. nine0003

Atopic dermatitis is more common in nulliparous women in the early stages and in the second trimester. Itching is caused by papular and exametic rashes localized on the face, neck, limbs, elbows, palms.

Atopic dermatitis is the most benign form of dermatosis of pregnancy and usually does not adversely affect the fetus. However, children born to mothers who suffered from this disease at the stage of gestation are also prone to allergic skin diseases. nine0003

Itching of the skin, as a symptom of cholestasis, is provoked by intrahepatic stagnation of bile as a reaction to increased estrogen production. The disease occurs at the end of the second - beginning of the third trimester, closer to the date of birth. A pregnant woman experiences severe itching in the abdomen, back, palms, legs.

Cholestasis is dangerous for the health of the mother and unborn child in severe cases of the disease. There is a risk of fetal hypoxia, delayed development and even premature birth. nine0003

Symptoms

The main sign of pathological changes is the appearance of irritating-itchy sensations in different parts of the body. Locally, a woman may also feel a tingling and burning sensation.

Other symptoms include:

blistering or eruption of blistering character;
peeling, irritation and redness of the skin;
formation of scaly spots;
sores and sores caused by scratching; nine0057
deterioration in general condition caused by sleep disorders and emotional depression.

In most cases, itching of the skin during pregnancy does not pose a real danger to the intrauterine development of the fetus, but significantly worsens the quality of life of the expectant mother, acts depressingly on the state of her nervous system and general well-being.

Diagnostics

In order to successfully deal with itching, it is necessary to establish the cause that causes it. The choice of diagnostic methods is determined based on the degree of intensity and localization of itching, the presence of concomitant symptoms and chronic diseases, the duration of pregnancy, and the individual characteristics of the health of the expectant mother. nine0003

Treatment is prescribed only after the exact cause of the itching is established.

At the initial examination, the doctor listens to the patient's complaints, examines the condition of the skin, paying attention to the appearance of rashes or spots. This allows you to draw a preliminary conclusion and determine what laboratory tests and instrumental studies will be needed.

The main diagnostic measures for itchy skin in pregnant women include: nine0003

general urine and blood tests;
biochemical blood test;
studies of hormone levels - if endocrine pathologies are suspected;
analysis of vaginal smear for microflora;
skin scraping examination;
allergy testing;
Ultrasound of the digestive tract, liver and kidneys;
histological examination;
analysis of feces for the detection of helminth eggs. nine0057

The choice of research methods is determined individually. In some cases, a pregnant woman is shown a consultation with an endocrinologist, urologist, gastroenterologist, venereologist.

Identification of atopic dermatitis is usually not difficult. In addition to the general examination, such types of diagnostics as dermatoscopy and examination under the Voodoo lamp are carried out.

If itching in a pregnant woman is allergic in nature, a mandatory diagnostic measure is the determination of the allergen (pathogen). nine0003

Treatment of itching

Although itching during pregnancy is not dangerous in many cases, it should not be tolerated either. You need to tell the gynecologist about unpleasant sensations, who will determine the diagnostic methods and, if necessary, give a referral to other specialists. Treatment of itching during pregnancy is carried out by the attending gynecologist together with a dermatologist.

You can not self-medicate and use medicines without the approval of a doctor. Many of them have contraindications and can cause severe side effects. A pregnant woman should remember the prohibition of scratching itchy places. This leads to a violation of the integrity of the skin, the appearance of wounds and abrasions, which will become sites of infection. nine0003

The treatment regimen depends on the disease that causes itching. When choosing drug therapy, the risks of negative effects on the fetus are taken into account. This is especially true in the case of the appointment of antibiotics, hormonal and antifungal drugs. Self-medication is unacceptable!

In the treatment of itching during pregnancy, the following types of drugs can be prescribed:

antihistamines - to eliminate itching caused by dermatitis, urticaria; nine0057
glucocorticoids - used to treat dermatitis;
emollients - have a moisturizing and regenerating effect in case of excessive dryness and dehydration of the skin;
adsorbents and hepatoprotectors - to normalize the liver;
choleretic preparations - for the correction of the state of the digestive tract;
sedatives - to normalize the state of the nervous system, if a pregnant woman has signs of increased anxiety and sleep disturbances. nine0057

With moderate itching, a pregnant woman is shown taking baths with a decoction of a string or oatmeal. An oatmeal bath is effective for itching caused by stretch marks, eczema, or psoriasis. To prepare it, crushed oatmeal is mixed with baking soda and a little milk is added, the mixture is poured into a warm bath.

Lotions on herbal decoctions can be applied to itchy areas of the skin. Chamomile, succession or St. John's wort is poured with boiling water and insisted. After a few hours, the decoction for lotions is ready for use. nine0003

To eliminate itching of the genital organs, medicinal suppositories with local action are prescribed. Of great benefit are sitz baths of decoctions of sage or chamomile.

Itching in the abdomen, caused by skin tension, can cause stretch marks. To prevent aesthetic imperfections, it is necessary to moisturize the skin with special means.

To reduce itching, a pregnant woman should only wear clothes made from natural fabrics, preferably cotton. Natural fabrics allow the skin to breathe freely. It is useful for future mothers to take a cool shower without the use of soaps or bathing gels. The skin needs to be effectively protected from external aggressive factors: sun, frost and wind. nine0003

When itching of the skin appears, it is better to refuse the use of perfumes, take the choice of cosmetics very responsibly.

Prophylaxis

Itching during pregnancy can be prevented if you follow the doctor's recommendations and preventive measures. Tips for expectant mothers:

carefully observe body hygiene, take regular showers or baths without the use of fragrances;
refuse underwear and clothes made of synthetic fabrics; nine0057
after taking a shower or bath, moisturize the skin of the body with special products, with a neutral pH level, creams, lotions, emulsions are suitable for this;
use phosphate-free laundry detergents;
wear loose clothing that does not restrict movement;
avoid stuffy rooms or open places under the scorching summer sun;
exclude intense physical activity that provokes increased sweating; nine0057
provide the expectant mother with a plentiful drinking regimen that prevents dehydration of the body;
avoid stressful situations, get positive impressions.

Proper nutrition plays an important role in the prevention of itching of the skin. This is especially important if itching is provoked by various foods. The woman is recommended a hypoallergenic diet, with the exception of fast food, smoked, salty and pickled foods, as well as foods with preservatives, emulsifiers and artificial flavors. The diet of the future mother should be rich in vitamins, minerals, fatty acids, antioxidants. To do this, the menu includes sour-milk products, meat and fish of low-fat varieties, vegetable dishes, fruits. nine0003

Itching during pregnancy when following medical recommendations has a favorable prognosis and is not an obstacle to natural childbirth.

If a woman had signs of atopic dermatitis during her first pregnancy, the likelihood of a recurrence of the disease during subsequent pregnancies is high. At the stage of planning a child, it is necessary to visit a dermatologist.

Itching

A series of products "Emolium" effectively eliminates the symptoms of skin diseases, including itching, peeling, irritability. They are prescribed to moisturize the skin, eliminate dryness and tightness in atopic dermatitis, psoriasis, eczema, and allergies. Means of the Emolium series are used in the complex treatment of these and other diseases that provoke itching. nine0003

The main advantages of the series:

have a mild anti-inflammatory effect;
ensure the normal functioning of the skin;
restore skin structure;
retain moisture in cells and intercellular space;
restore the water-lipid layer;
relieve irritation and itching.

The delicate and delicate consistency of the products makes it easy to apply and distribute them over the entire surface of the affected areas. nine0003

With severe itching of pregnant women, a triactive series is recommended, taking care of atopic and damaged skin. Triactive cream enriched with rapeseed oil and sodium hyaluronate has anti-inflammatory, antibacterial and antipruritic effects.