Rash on skin during pregnancy

Symptoms and what they look like

Some people develop skin rashes during pregnancy. The medical name for this is pregnancy dermatosis. Rashes can vary in severity and duration, depending on what causes them.

Hormone levels, stretching skin, genetics, and blood flow can all play a role.

This article discusses seven types of rash that can occur during pregnancy, including their symptoms and treatments. It also looks at how people can manage the symptoms at home.

Itchy skin is common during pregnancy, and some people also develop rashes. Some types of rash are specific to pregnancy, while others can occur at any time. However, some rashes may be more likely during pregnancy for some people due to the physical changes their body is going through.

In most cases, skin rashes are not serious and do not indicate a problem with the fetus. However, identifying the cause early on is important, as some rashes are a symptom of an underlying condition.

Some rashes that can occur during pregnancy include:

• heat rash
• hives
• atopic eruption of pregnancy
• pruritic urticarial papules and plaques of pregnancy (PUPPP) rash
• intrahepatic cholestasis of pregnancy (ICP)
• impetigo herpetiformis
• pemphigoid gestationis

Pregnancy can cause people to feel unusually warm because of increased blood supply to the skin. As a result, a person may find that they sweat more, which, in some cases, may lead to a heat rash.

A heat rash, or prickly heat, causes an itchy patch of tiny blisters on the skin. Staying cool and dry can help heat rashes heal. If a person experiences heat rashes, they can try:

• wearing loose clothing made from natural fibers, such as cotton
• working and sleeping in cool, well-ventilated rooms
• changing out of wet clothing as soon as possible
• using cool water compresses on the rash

Hives look like raised bumps or welts on the skin. They itch and often occur due to an allergic reaction. However, there are other possible causes, including:

• heat
• scratching the skin
• stress
• pressure on the skin

Feeling hot and itchy is common during pregnancy and may lead to hives. In addition, the authors of a 2013 article suggest that hormonal changes may also induce hives.

A person can treat mild hives at home by cooling the skin. If the hives are severe or occur alongside swelling or difficulty breathing, a person should seek immediate medical help.

Atopic eruption of pregnancy is the most common pregnancy-specific skin disorder. The term groups several similar pregnancy rashes together. These include:

• atopic eczema
• prurigo of pregnancy
• pruritic folliculitis of pregnancy

Eczema is a very dry and itchy rash that appears red in lighter skin and gray or brown in darker skin. People who develop eczema during pregnancy may find that lesions flare up more than usual during the first and second trimesters.

Prurigo of pregnancy involves a rash that consists of papules, which are small bumps filled with fluid. Pruritic folliculitis causes papules that resemble pimples, or acne.

These conditions are uncomfortable but do not pose a risk to the pregnant person or the fetus. The rash will often disappear after delivery. Until then, a doctor may prescribe emollients, steroid creams, or antihistamines to reduce itching.

PUPPP rash affects about 1 in every 160 pregnancies. This condition is more common in people carrying multiple fetuses, as with twins or triplets.

A PUPPP rash develops when the skin stretches, damaging the layer of tissue underneath. This causes inflammation, which appears as a rash. A PUPPP rash sometimes begins in the second trimester but usually develops in the final 3 months of pregnancy. It goes away after giving birth.

A PUPPP rash is itchy and produces bumps on the skin, but it does not cause complications. A doctor may suggest using oral antihistamines, skin emollients, or steroid medication to treat it.

ICP, or obstetric cholestasis (OC), is a potentially serious liver condition that can occur during pregnancy. It causes severe itching that begins on the palms of the hands and the soles of the feet before spreading to other parts of the body. The itching may occur with or without a rash.

Sometimes, itching is the only symptom of ICP. Occasionally, a person may also develop jaundice, which causes the nails, skin, and eyes to become slightly yellow. ICP typically occurs in the third trimester.

The likelihood of developing ICP differs among ethnic groups. The condition affects 1% of females of Northern European ancestry. It is more common in people of Scandinavian or Araucanian Indian descent.

ICP can cause pregnancy complications, so early recognition, diagnosis, treatment, and close surveillance are very important. Severe itching in pregnancy is not normal, so a person should see a doctor immediately if this occurs.

Impetigo herpetiformis is a rare skin condition that appears during pregnancy, often in the last trimester. It is similar to pustular psoriasis, which causes severe skin inflammation.

This rash begins as lesions in the skin folds. These can then spread across the surface of the skin, covering large patches. The skin may crust or become infected. People can also experience:

• fever
• diarrhea
• dehydration
• rapid heartbeat
• seizures

Impetigo herpetiformis usually resolves after a person gives birth, but there is a risk of stillbirth. In rare cases, this condition is fatal. Doctors manage the condition and reduce these risks by prescribing systemic corticosteroids and antibiotics.

If a person experiences impetigo herpetiformis during one pregnancy, they may experience it again in future pregnancies.

Pemphigoid gestationis is a rare autoimmune disease that affects 1 in every 50,000 pregnancies. It causes an itchy, hive-like rash that begins around the navel and then spreads to other parts of the body. The rash may also include blisters.

This condition often begins in the second or third trimester. It can resolve during late pregnancy, but it often flares up before delivery. After pregnancy, the menstrual cycle or use of oral birth control pills may trigger the rash to return.

In 5–10% of pemphigoid gestationis cases, newborns are born with skin lesions. However, the exact risk that this condition poses to the fetus is unclear.

Mild rashes, such as hives, heat rash, or mild eczema, can improve with home management. A person can try the following methods to soothe irritated skin and ease itching:

• keeping the skin clean and dry using a gentle, unscented cleanser
• washing with cool or lukewarm water rather than hot or cold water
• moisturizing the skin using an unscented emollient, particularly after bathing, showering, or washing the hands
• avoiding products that may irritate the skin, such as harsh soaps or perfumes
• wearing loose, soft fabrics, such as cotton or linen
• using cool compresses, colloidal oatmeal baths, or calamine lotion to soothe itching
• avoiding scratching the skin, as this can make some skin conditions worse

Many forms of pregnancy rash are harmless, but it is always best to see a doctor so that they can identify the cause and confirm that a person does not need medical treatment. A doctor can also advise on the best way to care for skin conditions during pregnancy.

A person should seek immediate treatment if a rash:

• appears suddenly and spreads quickly
• causes severe itching or pain
• co-occurs with difficulty breathing and swelling
• is weeping pus or looks infected

A person should also see a doctor as soon as possible if they experience severe itchiness without a rash.

Rashes and itchy skin are common during pregnancy. Many rashes are harmless and may resolve after giving birth. However, in rare cases, rashes can be a sign of a more serious condition.

If a person does not know the cause of a pregnancy rash, they should see a doctor for a diagnosis.

PUPPP rash in pregnancy: Natural treatments and prevention

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Medically reviewed by Valinda Riggins Nwadike, MD, MPH — By Jennifer Huizen on August 9, 2018

A pruritic urticarial papules and plaques of pregnancy rash is a common skin condition. Natural remedies, including oatmeal, chamomile, and peppermint, can help.

This type of rash usually starts in stretch marks on the abdomen and spreads to the legs and chest.

It causes itchy, red, hive-like bumps to form in the creases of stretch marks, and the rash can develop into larger red, swollen patches. In lighter-skinned people, the rashes may appear to be surrounded by a thin, white halo.

Pruritic urticarial papules and plaques of pregnancy (PUPPP) often develop in the third trimester of pregnancy. In most cases, the rash resolves within 15 days of giving birth.

While some medications can reduce the symptoms of a PUPPP rash, there is currently no cure.

Last medically reviewed on August 9, 2018

• Dermatology
• Pregnancy / Obstetrics
• Complementary Medicine / Alternative Medicine
• Parenthood
• 3rd Trimester

How we reviewed this article:

Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

• Akhavan Amjadi, M., Mojab, F., & Kamranpour, S. B. (2012, Autumn). The effect of peppermint oil on symptomatic treatment of pruritus in pregnant women. Iranian Journal of Pharmaceutical Research : IJPR, 11(4), 1073–1077
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3813175/
• Chamomile. (2016, November 29)
  https://nccih.nih.gov/health/chamomile/ataglance.htm
• Cortés-Rojas, D. F., Fernandes de Souza, C. R., & Oliveira, W. P. (2014, February). Clove (Syzygium aromaticum): A precious spice. Asian Pacific Journal of Tropical Biomedicine, 4(2), 90–96
  https://www. ncbi.nlm.nih.gov/pmc/articles/PMC3819475/
• Fowler, J. F. (2014, October). Colloidal oatmeal formulations and the treatment of atopic dermatitis. Journal of Drugs in Dermatology: JDD, 13(10), 1180–1183
  http://jddonline.com/articles/dermatology/S1545961614P1180X/1
• Ibrahim, I. M., Elsaie, M. L., Almohsen, A. M., & Mohey‐Eddin, M. H. (2017, April 5). Effectiveness of topical clove oil on symptomatic treatment of chronic pruritus [Abstract]. Journal of Cosmetic Dermatology, 16(4), 508–511
  https://onlinelibrary.wiley.com/doi/abs/10.1111/jocd.12342
• Lopez Jornet, P., & Aznar‐Cayuela, C. (2016, June 21). Efficacy of topical chamomile management vs. placebo in patients with oral lichen planus: A randomized double‐blind study. Journal of the European Academy of Dermatology and Venereology, 30(10), 1783–1786
  https://onlinelibrary.wiley.com/doi/full/10. 1111/jdv.13770
• Oakley, A., & Elghblawi, E. (2017, September). Polymorphic eruption of pregnancy
  https://www.dermnetnz.org/topics/polymorphic-eruption-of-pregnancy/
• Pruritic urticarial papules and plaques of pregnancy. (n.d.)
  https://www.aocd.org/page/PUPPP

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Medically reviewed by Valinda Riggins Nwadike, MD, MPH — By Jennifer Huizen on August 9, 2018

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Dermatoses of pregnancy

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Pregnancy is a wonderful time for any woman, especially when it is a planned and desired event in the life of a couple. Unfortunately, due to various circumstances, pregnancy does not always occur naturally - in such cases, modern medicine offers various procedures for assisted reproductive technologies. This makes the woman's attitude to such a natural process even more reverent. And here, often, our skin can present surprises. A number of skin conditions can worsen during pregnancy. However, traditionally prescribed drugs have limitations for use in such a situation. And here it is important that the specialist has experience in treating such situations. nine0006

Our Clinic is unique in some way, since many years of experience in managing women with skin diseases during pregnancy is not only the head doctor, who has been a consultant at the D.O. Ott, but also other specialists who are employees of the Department of Skin Diseases of the First Medical University. Academician I.P. Pavlov.

Now let's try to explain the causes and identify the most common skin diseases during pregnancy. nine0006

During pregnancy, the main cause of skin lesions is considered to be changes in the immune system of the pregnant woman. Pathological processes can be manifested by an exacerbation of chronic skin diseases or the appearance of specific pregnancy-associated dermatosis, the so-called "pregnancy dermatosis".

Changes on the skin are very diverse both in manifestations and in the mechanisms of development. Conventionally, they can be divided into 3 groups:

I. Pregnancy stigmas:

Chloasma is the most famous of them. As a development mechanism, various functional endocrine-metabolic changes during pregnancy are assumed. It appears as brownish spots of indefinite outlines, often symmetrical, on the skin of the cheeks, forehead, chin, neck without subjective sensations. Chloasma can occur at different gestational ages, intensifying as it develops and disappearing without a trace shortly after childbirth. But with subsequent pregnancies, chloasma occurs again. Exposure to sunlight enhances the severity of spots. nine0006

Pregnancy melanosis - skin changes in the form of hyperpigmentation in the nipples, genitals, white line of the abdomen, also without subjective sensations or inflammation. After childbirth, these disorders disappear. Chloasma and melanosis usually do not require special treatment and spontaneously regress after delivery.

II. Skin diseases that are relatively often registered during pregnancy:

This group includes a variety of skin changes and diseases that often accompany pregnancy, as well as some common dermatoses, the course of which usually worsens during gestation. The main mechanism is a change in hormonal ratios in the body of a pregnant woman. This, in turn, affects the functionality of the immune and nervous systems, the state of the gastrointestinal tract, kidneys, cardiovascular activity, water-salt metabolism, etc. nine0006

This group includes: hyperhidrosis

• hypertrichosis
• palmoplantar telangiectasias
• erythema of the palms
• alopecia - hair loss
• onychodystrophy - changes in the nail plates

Most of these and other conditions, as a rule, disappear after childbirth. Their treatment, if necessary, is symptomatic.

The course and severity of symptoms of other skin diseases also change during pregnancy. nine0013 These primarily include eczema, atopic dermatitis, psoriasis, lichen planus, acne, Dühring's herpetiformis. During pregnancy, they often worsen, and exacerbations are usually more pronounced, more severe than before gestation. Sometimes, on the contrary, during pregnancy, a remission occurs, which continues until childbirth, after which another exacerbation occurs. Correction of exacerbations of these dermatoses during pregnancy is very difficult. Many medicines used under normal conditions affect the development of the fetus. Therefore, external symptomatic therapy becomes the leading method. nine0006

III. Actually dermatoses of pregnant women