Pregnancy Rash: Is it PUPPPs?

Feeling the itch and what you can do to relieve it.


Pregnancy brings with it many things, some joyous and some...not. For about 1 in 160 expectant moms (less than 1 percent), one of the unfortunate side effects can be a rash with a mean itch known as PUPPPs, or pruritic urticarial papules and plaques of pregnancy.

That mouthful basically means an inflamed red rash that usually starts during the third trimester for first-time moms or mothers of multiples on the abdomen, often in stretch marks. It may also spread to the buttocks, arms and legs and, and its worst, only spares the face and soles of the hands and feet. Why? That's one of the most frustrating things about PUPPPs. There is no clear-cut answer.

Unlike many other unpleasant pregnancy side effects that can be blamed on surging hormones, this condition can't. "Some studies suggest a relationship between skin distention (stretching/expanding of the skin) and the development of this condition; this is because the rash usually starts in stretch marks and there is a higher incidence of PUPPPs in multiple gestation pregnancies, as well as pregnancies with increased maternal weight," says Ray Kamali, M.D., FACOG, New Mommy Media Contributor and Department Chair at Sharp Chula Vista Medical Center in Chula Vista, Calif. "Other studies suggest a possible immunologic response to the circulating fetal antigens."

Interesting stat

Approximately 70 percent of women who have PUPPPs have one other thing in common: They're having boys. This leads some experts to believe that it is attributable to hormones from the male fetus.

One positive about PUPPPs is that it poses no harm to baby, and no long-term or dangerous consequences to you.

Can you prevent PUPPPs?

Sadly, no. There's no way to predict who will get it, and there's nothing you can do to prevent it. All you can do if you do experience it is try to manage it as best you can; the itch may range from mild to very severe, but it does clear up within a couple of weeks after delivery.

Treatment options

A quick internet search will turn up dozens of home remedies by moms who swore by them when they were experiencing PUPPPs. Note that these are not scientifically tested, but many moms have had good results in reducing or relieving the itch with them.

Caveat! Remember to share your condition with your healthcare provider to get a proper diagnosis; there are other causes for rashes and dermatitis in pregnancy (including a viral infection), so a proper evaluation is important. Get the OK before you start experimenting with remedies.

1. Drink V8 juice (be careful not to overindulge, or choose the lower-sodium option; the original version has quite a bit of sodium per glass).

2. Wash with a product called Grandpa's Wonder Pine Tar Soap, a soothing soap containing allantoin (anti-inflammatory), aloe vera gel, baking soda and coconut oil (emollient). Available online and at health food stores such as Whole Foods.

3. Take oatmeal baths.

4. Apply aloe vera gel or Cetaphil to your skin.

Dr. Kamali's suggestions for treatment:

1. Non-sedating anti-histamines, such as Benadryl.

2. Topical corticosteroids (AKA over-the-counter hydrocortisone creams) such as Aveeno Active Naturals 1% Hydrocortisone Anti-Itch Cream.

3. For severe cases, systemic corticosteroids such as prednisone may be used.

4. Steroids may be prescribed by your healthcare provider.

Although some women have begged for early delivery to relieve the extreme discomfort, Dr. Kamali notes this is rarely, if ever, necessary, due to the risks associated with early birth.

Life after PUPPPs

Delivering your baby is the only "cure" for this condition, although Dr. Kamali notes that it may actually get worse right after birth before clearing up within approximately two weeks.

The good news: There are no long-term effects aside from scar tissue caused by scratching. "Most studies report small risks for recurrence in subsequent pregnancies," he says.

Soon after you welcome your baby, you will be free from the itch to enjoy the new little life you and your partner created.

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