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PUPPP During Pregnancy: Everything That You Need To Know

Pruritic Urticarial Papules And Plaques of Pregnancy (PUPPP)

Persistent cold, spotting during pregnancy, bad headaches, morning sickness, skin rashes, back pain, fatigue, heartburn, acne, heat rash and what not - Pregnancy is a package of the symptoms you thought that would never happen to you. It is a period when everything you complain about is weird and awful for you but pretty normal for your gynaecologist. But you know what could make your life even worse? The itchy skin rashes during pregnancy such as Pruritic Urticarial Papules And Plaques of Pregnancy (PUPPP). Why does it happen and how to deal with it? Here is everything you need to know.

Table to Contents:

- What is rash?

- Types of skin rashes during pregnancy

- What is PUPPP?

- Causes of PUPPP

- Symptoms of PUPPP

- Treatments for PUPPP

What is rash?

Pregnancy rashes or skin rashes during pregnancy is a condition that might surface along with the other symptoms of pregnancy. It could cause itchy legs during pregnancy and also itchy skin.

The itchy skin rash could be caused due to some irritants. As matter of fact, different types of rashes are caused due to different reasons. But there may be no specific reason or any underlying cause for the skin problems during pregnancy. In any case, if you notice a rash, it is always best to consult your doctor for the diagnosis.

The possible reasons for itchy skin during pregnancy could be Hormonal changes, infections, foetal cell attack and inflammation.

Types of Skin Rashes During Pregnancy:

Pruritic Urticarial Papules And Plaques of Pregnancy (PUPPP)

Skin rashes during pregnancy could be various and could be of varying degree of severity too. Some of the common types of rashes are as follows. 

1. Pruritic Urticarial Papules And Plaques of Pregnancy (PUPPP): Thin skin rash is characterized by red spots or raised bumps paired with itching. What makes this kind of skin rashes different is, it appears on the abdomen first and spread to other parts.

2. Prurigo of Pregnancy/Eczema of Pregnancy: For the women who are suffering from this kind of skin rashes during pregnancy, they will notive tiny itchy red spots on differnt parts of the body. Although they appear like PUPPP, they gradually turn into dry patches and appear like eczema spots.

3. Intrahepatic Cholestasis of Pregnancy: This type of skin rashes during pregnancy is due to the rise in the hormones which in turn affects the bile flow from the liver. The leakage of bile into the bloodstream causes the persistent itchy skin rash. Although this skin condition could cause itchy skin rash all over the body, it could also cause itchy hands and itchy legs during pregnancy.

4. Pemphigoid Gestationis: It is an autoimmune disease. This type of skin rashes is due to the attack of immunoglobulin type G autoantibodies on the cells of the skin.

5. Impetigo Herpetiformis: It is one of the skin problems during pregnancy that causes the blisters around the groin region, at elbows and knees in the early pregnancy period. It is a fatal condition.

6. Pruritic Folliculitis of Pregnancy: In this condition, you could encounter a tiny bump and most of the time, it is mistaken as bacterial folliculitis.

7. Heat Rash: Heat rash during pregnancy is due to excessive sweating or friction against the clothing.

8. Other skin Conditions: Acne, itchy skin rash, itchy legs, melasma rash, skin tags, Stretch Marks, Varicose Veins.

What is PUPPP?

Pruritic Urticarial Papules And Plaques of Pregnancy (PUPPP)

PUPPP or Pruritic Urticarial Papules and Plaques of Pregnancy is one of the types of skin rashes during pregnancy. These hive-like and are extremely itchy bumps usually appear on stomach during pregnancy. Although this itchy skin rash could cause severe discomfort in the mother, it poses no harm to the mother or the baby. The other names of PUPPP are Nurse’s late-onset prurigo, Polymorphic Eruption of Pregnancy (PEP), toxic erythema of pregnancy, Bourne’s toxemic rash, a toxemic rash of pregnancy.

Causes of PUPPP:

Although the exact cause of PUPPP is not known, there is some evidence that could be linked to the causes of PUPPP.

1. Toxic overload: When you are pregnant, the toxic load on the main detoxifying organ, Liver, increases. It is because the fetal waste is also mixed in the mother’s blood. This causes the toxic overload on the liver and which could result in inefficient detoxification. And the toxins in the mother’s blood could trigger the skin rashes during pregnancy. Another potentially involved organ in the formation of PUPPP could be the kidney.

2. Stretching of the skin: PUPPP usually appears in the third trimester which implies it might because of the extra stress on the skin due to the growth of the fetus and an increase in the size of the abdomen. This kind of rapid skin stretching could cause connective tissue damage and skin inflammation which could lead to skin rashes during pregnancy.

3. Fetal cell migration: Often foetal cells could cross the placenta and enter the maternal circulation system. The mother’s immunity system considers these foetal cells and triggers antibodies against them. And these antibodies could produce skin rashes during pregnancy.

In most of the mothers who had this kind of skin problems during pregnancy, had a baby boy. The possible cause of PUPPP is the male DNA.

Symptoms of PUPPP:

Pruritic Urticarial Papules And Plaques of Pregnancy (PUPPP)

The important symptom of PUPPP is itchy skin during pregnancy. The other symptoms are as follows:

‣ Tiny and itchy bumps that appear on the abdomen at first and gradually turn red and more significant patches.

‣ Often appear within the stretch marks. Hence, in the beginning, it just appears like stretch marks on the abdomen and with time, it grows larger.

‣ At a later stage, they become red, eczema-like patches.

‣ Extreme itching and it worsens at night.

‣ In severe cases, the skin rashes are surrounded by blisters.

‣ With time, the skin rashes spread towards extremities of the body such as stomach, chest, hands and legs. But it doesn’t include face, palms and soles of feet.

Treatments of PUPPP:

Pruritic Urticarial Papules And Plaques of Pregnancy (PUPPP)

Medical Treatments:

1. Moisturizers: Moisturizers containing vitamin E, Shea butter, collagen, cocoa butter and elastin ideally works towards providing you relief from itching. The moisturizer that contains the following ingredients needs to be avoided if you are suffering from this kind of itchy skin rash: retinol, salicylic acid, tropic acid.

2. Topical steroids: The steroid cream with one percent of hydrocortisone could help in providing the relief.

3. Oral antihistamines: The oral antihistamines reduce itching. Some of these are cetirizine and diphenhydramine.

Although the above conventional treatments could be used, they just manage the signs and symptoms. They don’t get to the root of the problems. That is when the home remedies for skin rashes come into the picture.

Home remedies for skin rashes:

Pruritic Urticarial Papules And Plaques of Pregnancy (PUPPP)

Home remedies for skin rashes are of natural ingredients with minimal side-effects and lots of benefits. Here are a few.

1. Vegetable juice: Although there is no clinical evidence to prove the effectiveness of vegetable juice in treating PUPPP, it cleanses and detoxes the whole body and thereby reducing the chances of itchy skin rashes.

2. Flaxseed Oil: Flaxseed oil is known as one of the best home remedies for skin rashes as it is highly effective in soothing the skin inflammation and reducing the burning effect. It also alleviates the itching.

3. Dandelion Root or Nettle Leaf Tea: It is a treatment to purify the blood and liver system. Dandelion root supports liver functioning and the nettle leaf has the properties such as anti-histamine and anti-inflammatory properties. These, in turn, helps in treating the women with PUPPP successfully.

4. Oatmeal bath: The oatmeal bath for 20 minutes could provide relief from itching, moisturizes the skin and soothes itching during pregnancy.

5. Anti-inflammatory herbs: Chamomile, calendula and Chinese skullcap extracts are known for their ability to reduce the skin inflammation. Topical application of these herbs could help in treating the itchy skin rash. These could also be combined with aloe vera, witch hazel or other mild lotion.

Mothers suffering from PUPPP can give birth to the babies with a milder form of the skin rash. However, it could be downright annoying for the mother to have an itchy skin during pregnancy. So, Instead of feeling worse due to these skin rashes, try out the above home remedies and have a happy and safe pregnancy.


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