Pregnancy brings to light many kinds of issues for different women. One that can be pretty alarming is a rash. When a pregnant woman is suddenly experiencing itching or the presence of a rash on the skin, she might worry that something could be wrong with the baby. Taking to Google or other Internet search engines might only fuel her fears, and unnecessarily so. Rest assured that not every bout of itching and rashes while pregnant is worth worrying over.
Table of Contents
PUPPPS During Pregnancy
Pruritic Urticarial Papules and Plaques of Pregnancy — PUPPPS for short — affects approximately 1 in 160 women during pregnancy, per Fit Pregnancy. Sometimes also referred to as polymorphic eruption of pregnancy, this condition presents with an itchy rash that can be quite problematic and bothersome for the sufferer.
Typically, this rash occurs in the final three months of pregnancy. On rare occasions, it has shown up earlier than that, but generally not as soon as the first trimester. The rash starts to form in stretch marks. Thus, women who have none are at little to no risk of developing it. Yes, there’s actually more damage that can be incurred as a result of stretch marks than just unsightliness and loose skin – one more reason for women to pray they don’t get them. PUPPPS is most common in first pregnancies, when the skin is less lax and more inclined to be stretched uncomfortably.
The rash develops as a sort of intolerance within the body toward the stretch marks. While this might sound kind of comical, it’s no laughing matter for the women who are incessantly itching because of it. It generally begins around the navel, where the skin is stretched the tightest. From there it spreads upward and toward the sides and lower region of the belly. PUPPPS rarely spreads beyond the stomach and thighs, but some women have been known to develop the rash on their breasts and arms.
PUPPPS looks more severe than it is, especially on fair-skinned complexions. The papules are small, raised, pinkish colored spots. In some cases, so many small spots form that the rash takes on more of a hives-like appearance. The bumps have little rings around them, individually, that somewhat look akin to a halo because the rings are pale in color — not pink or red like the raised bump itself.
There is no way to cure PUPPPS rash. Only time and delivery of the baby will do that. Instead, women can seek help through their doctor to help manage the primary symptom of PUPPPS — the itching. Although many women find that lotions and topical creams are far from enough to help tame the itching they feel, they are definitely worth a shot. If they don’t work, prescription steroid creams can be given to women by their doctors. These products, applied once or twice a day in very thin layers on the skin, can temporarily relieve itching. For some women, the creams work all day. For others, they provide a half hour to an hour of relief at best.
Those women may also need to make use of antihistamines. These over-the-counter medications, like diphenhydramine, work by shutting off the body’s response to allergens and irritants. Typically, this response is histamine, and that is what causes the itching and bumps to appear. The bumps don’t have to go away for the itching to stop, and they won’t no matter how much lotion or steroidal cream is used. However, blocking histamine reactions can dampen the itchiness that expectant moms feel so they can get the sleep they need at night, go to work during the day and take care of business as though PUPPPS wasn’t trying to stand in their way.
This drug should only be used as needed and when other, safer options have been exhausted. While it has been approved for use in pregnancy, long term use can cause drowsiness in both the mother and the baby. Likewise, the drug is known to be habit forming. After weeks or months of persistent use, women may find that they have trouble sleeping if they aren’t using the diphenhydramine. In addition, they may have withdrawal effects when stopping the medication.
Rash After Pregnancy
PUPPPS does not onset in the postpartum period. For the majority of women who are unfortunate enough to suffer from PUPPPS while pregnant, the rash will persist until they give birth. After giving birth, the rash tends to spontaneously resolve within days following birth since the skin is able to become loose again. In rarer cases, PUPPPS may continue on for weeks or months after birth. This isn’t something that most women should concern themselves with ahead of time. It is not common for it to continue persisting. However, if it does it is worth making a call to your doctor since persistent postpartum hives or postpartum PUPPPS is often due to retained pregnancy products. This means remnants of the pregnancy, such as pieces of placenta, are still in the uterus. Sometimes the placenta will fail to detach fully, and bits and pieces will remain in the womb. These may come out over the weeks that follow birth as lochia and discharge continues to be expelled from the uterus. If this doesn’t happen, a dilation and curettage procedure may need to be performed to manually remove what’s left. Then the PUPPPS should completely resolve.
Can PUPPPS harm my baby?
What is most interesting is that although PUPPPS appears to be a topical reaction to stretch marks, it must actually have some kind of biological makeup, because babies can contract it from their mothers. That’s right; moms with PUPPPS can actually develop PUPPPS in utero and be born that way. They can also develop it postpartum after being born without it, even if mom’s condition has already resolved. That being said, PUPPPS doesn’t present any kind of harm to the developing baby. Aside from mom’s discomfort while carrying the baby, there is no reason to worry about birth defects or other issues that parents commonly worry about when postpartum complications arise.