Pregnancy symptoms itchy skin

Itching and intrahepatic cholestasis of pregnancy

Itching is common in pregnancy. Usually it's thought to be caused by raised levels of certain chemicals in the blood, such as hormones.

Later, as your bump grows, the skin of your tummy (abdomen) is stretched and this may also feel itchy.

However, itching can be a symptom of a liver condition called intrahepatic cholestasis of pregnancy (ICP), also known as obstetric cholestasis (OC).

ICP needs medical attention. It affects 1 in 140 pregnant women in the UK.

Symptoms of ICP

The main symptom is itching, usually without a rash. For many women with ICP, the itching is often:

more noticeable on the hands and feet, but can be all over the body
worse at night

Other symptoms can include:

dark urine
pale poo
yellowing of the skin and whites of the eyes (jaundice), but this is less common

Symptoms of ICP typically start from around 30 weeks of pregnancy, but it's possible to develop the condition as early as 8 weeks.

Non-urgent advice: Call your midwife or GP if you have itching that's:

mild or distressing, possibly worse at night
anywhere on your body, but may be worse on the palms of your hands and soles of your feet

Feeling itchy like this can be a sign of ICP and needs to be checked.

Mild itching

Wearing loose clothes may help prevent itching, as your clothes are less likely to rub against your skin and cause irritation.

You may also want to avoid synthetic materials and opt for natural ones, such as cotton, instead. These are "breathable" and allow the air to circulate close to your skin.

You may find having a cool bath or applying lotion or moisturiser can help soothe the itching.

Some women find that products with strong perfumes can irritate their skin, so you could try using unperfumed lotion or soap.

Mild itching is not usually harmful to you or your baby, but it can sometimes be a sign of a more serious condition, particularly if you notice it more in the evenings or at night.

Let your midwife or doctor know if you are experiencing itching so they can decide whether you need to have any further investigations.

Intrahepatic cholestasis of pregnancy

Intrahepatic cholestasis of pregnancy (ICP) is a potentially serious liver disorder that can develop in pregnancy.

Normally, bile acids flow from your liver to your gut to help you digest food.

In ICP, the bile acids do not flow properly and build up in your body instead. There's no cure for ICP, but it should go once you've had your baby.

ICP seems to run in families, but it can happen even if there is no family history. It is more common in women of south Asian origin, affecting around 1 in 70 to 80 pregnancies.

If you have had ICP in a previous pregnancy, you have a high chance of developing it again in another pregnancy.

Some studies have found that babies whose mothers have ICP have a higher chance of being born prematurely or stillborn.

Because of the link with stillbirth, you may be offered induction of labour. This could be any time from 35 weeks, depending on the level of bile acids in your blood.

If you have ICP, you will probably be advised to give birth in hospital under a consultant-led maternity team.

Diagnosis and treatment of ICP

ICP is diagnosed by excluding other causes of the itch. Your doctor will probably talk to you about your medical and family history and order a variety of blood tests.

These will include tests to check your liver function (LFT) and measure your bile acid levels (BA).

Monitoring your condition

If you are diagnosed with ICP, you will have regular liver function tests so your doctor can monitor your condition.

There is no agreed guideline on how often these tests should happen, but the Royal College of Obstetricians & Gynaecologists (RCOG) and the British Liver Trust advise weekly tests.

ICP Support, the UK's largest research group investigating ICP, also recommends weekly bile acid measurements. These readings help doctors recommend when your baby should be born.

If your LFTs and bile acids are normal and you continue to have severe itching, the blood tests should be repeated every week or 2, to keep an eye on them.

Creams and medicines for ICP

Creams, such as aqueous cream with menthol, are safe to use in pregnancy and can provide some relief from itching.

There are some medicines, such as ursodeoxycholic acid (UDCA), that help reduce bile acids and ease itching.

UDCA is considered safe to take in pregnancy, although it is prescribed on what is known as an "informed consent" basis as it has not been properly tested in pregnancy.

You may also be offered a vitamin K supplement. This is because ICP can affect your absorption of vitamin K, which is important for healthy blood clotting.

Most experts on ICP only prescribe vitamin K if the mother-to-be reports pale stools, has a known blood clotting problem, or has very severe ICP from early in pregnancy.

If you are diagnosed with ICP, your midwife and doctor will discuss your health and your options with you.

Further information

The Royal College of Obstetricians & Gynaecologists (RCOG) has more information about obstetric cholestasis, including what it means for you and your baby, and the treatment that's available. You can also get information about ICP from the British Liver Trust.

The charity ICP Support provides information about ICP. You can also watch their video about ICP featuring mums and clinical experts.

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Itching during pregnancy | Pregnancy Birth and Baby

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Mild itching is common in pregnancy because of the increased blood supply to the skin. As your pregnancy progresses and as your baby grows, the skin of your abdomen is stretched and this may also feel itchy.

Mild itching is usually nothing to worry about, but if the itching becomes severe it can be a sign of a serious liver condition called obstetric cholestasis. This affects fewer than 1 in 100 pregnant women, but needs medical attention.

Mild itching

Wearing loose clothes may help prevent itching, as your clothes are less likely to rub against your skin and cause irritation. You may also want to avoid synthetic materials and choose natural fabrics such as cotton that allow the air to circulate close to your skin. You may find that having a cool bath or applying lotion or moisturiser can help to soothe the itching.

Some women find that products with strong perfumes can irritate their skin, so you could try using plain lotion or soap.

Serious itching: obstetric cholestasis

If you’re worried about your itching, or if you have severe itching, it’s important to see your midwife or doctor.

Obstetric cholestasis (OC), also called intrahepatic cholestasis of pregnancy, is a serious liver disorder that affects a small number of pregnant women, usually in the last 3 months of pregnancy.

Causes of obstetric cholestasis

The cause of OC is unclear, but it’s thought the rise of pregnancy hormones later in pregnancy may slow the normal flow of bile — the digestive fluid made in the liver that helps your digestive system break down fats. In OC, bile salts build up rather than leaving the liver, eventually entering the bloodstream, which can make you feel itchy.

OC seems to run in families, although it can occur with no family history. It is also more common in women of Indian and Pakistani origin. If you have had OC in a previous pregnancy, you're more likely to develop it again in a subsequent pregnancy.

Babies of women with OC are more likely to be born prematurely or to be stillborn, or to have lung problems from breathing in meconium. Because of these complications, your doctor may consider inducing labour before you are due.

Symptoms of obstetric cholestasis

The classic symptom of OC is itching without rash, usually on the palms and soles of the feet, but it may be more widespread. The itching can be non-stop or unbearable, and worse at night.

Other symptoms include dark urine, jaundice (yellowing of the skin and whites of the eyes), and pale bowel movements (poo).

The itchiness usually goes away within a few days after giving birth.

Treatment of obstetric cholestasis

OC is diagnosed through taking a medical and family history, and blood tests that check your liver function (liver functions tests — LFTs). Once OC is diagnosed, you will have regular LFTs until your baby is born, so that your doctor can monitor your condition.

Creams, such as calamine lotion, are safe to use in pregnancy and can provide some relief from itching. Your doctor may prescribe a medication to reduce bile salts and ease itching.

OC can affect your absorption of vitamin K, which is important for healthy blood clotting so you may be offered a vitamin K supplement.

If you are diagnosed with OC, your midwife and doctor will discuss your health and your options with you.

Sources:

Mayo Clinic (Cholestasis of pregnancy), NSW Health (Having a baby), Royal Women’s Hospital (Common concerns in early pregnancy), SA Health Department (Clinical guideline obstetric cholestasis), Women's and Children's Health Network (Itching in pregnancy), King Edward Memorial Hospital (Cholestasis in pregnancy - clinical guidelines)

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: November 2020

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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?

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.

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.

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.

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

Subscribe to our Instagram. You will find useful information about pregnancy and childbirth from leading EMC obstetricians and gynecologists.

Itchy skin / Dermatology / Health Articles / Articles and Encyclopedia / madez.ru

Itchy skin is the most common symptom that comes from the skin, which is defined as “a special feeling of irritation that makes you want to scratch it”.

Pruritus is in most cases the first symptom encountered by the patient and his doctor.

Itching may be a symptom of a skin disease, and in 10-50% of cases, itching may be the first visible symptom of a systemic disease. Therefore, it is very important to consult a dermatologist in the presence of pruritus in order to determine the true cause of pruritus.

Pruritus may be localized, involving a limited area of the skin, but may also be generalized, involving most of the skin.

If left untreated, itching leads to secondary skin rashes in the form of: redness, scratching, bloody crusts, erosions. Very often, when combing, an infection joins and pyoderma occurs.

Pruritus can occur in different age groups and has its own characteristics of the course.

Chronic itching in children can be caused by skin diseases such as:

Lamellar and X-linked ichthyosis
Epidermolysis bullosa
Atopic dermatitis, the prevalence of which in pediatrics is up to 22%.
Mild to moderate itching occurs in 13.8% of adolescents with acne.

The incidence of pruritus due to systemic diseases is lower in children than in adults.

Itching in pregnant women occurs in about 18% of pregnant women and is the dominant symptom in specific dermatosis of pregnancy: polymorphic dermatosis of pregnancy, pemphigoid of pregnancy, intrahepatic cholestasis of pregnancy, atopic rashes in pregnancy.
The prevalence of pruritus in the elderly ranges from 11.5 to 29%. The most common cause is xerosis of the skin. Patients note increased itching in winter and autumn.

Skin itching, as one of the symptoms of a skin disease, is often observed in:

Inflammatory dermatoses: atopic dermatitis, allergic, irritant contact dermatitis, pink lichen, seborrheic dermatitis, mastocytosis, miliaria, etc.
Infectious dermatoses: mycoses, scabies, pediculosis, bacterial and viral infections, insect bites.
Autoimmune dermatoses: bullous dermatoses, Dühring's dermatitis herpetiformis, bullous pemphigoid.
Genodermatosis: Darier disease, Hailey-Hailey disease.
Dermatosis of pregnancy: polymorphic exanthema of pregnancy, infectious vulvovaginitis, pemphigoid of pregnancy.
Neoplasia: cutaneous T-cell lymphoma, cutaneous B-cell lymphoma, leukemic infiltrates.

Skin itching as one of the symptoms of a systemic disease can be observed in:

Metabolic disorders (chronic renal morbidity, hepatopathy (cholestasis), hyper-, hypothyroidism, diabetes mellitus, malabsorption, celiac enteropathy, pruritus during menopause)
Hematological diseases (iron deficiency, polycythemia vera, hypereosinophilia syndrome, Hodgkin's disease, non-Hodgkin's lymphoma, systemic mastocytosis)
Malignant neoplasms (carcinoma of the cervix, prostate, colon)
HIV/AIDS
Complications of drug therapy
Neuropsychiatric diseases (postherpetic neuralgia, multiple sclerosis; tumors, abscesses, infarctions of the central nervous system or spinal cord, stress, overwork; psychiatric diseases (depression, tactile hallucinosis, schizophrenia))

consult a dermatologist, in order for the doctor to establish the true cause of the itching and prescribe the appropriate treatment.