Skin Rash in Pregnancy: A Guide by Dr. Anu Vij

Skin Rash in Pregnancy

Different types of skin rashes can occur during pregnancy.Hormone levels, stretching skin, genetics, allergy and increased blood flow can all play a role.

Rashes can vary in severity and duration, depending on what causes them.The medical name for a pregnancy rash is pregnancy dermatosis.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 (IHCP)
• • impetigo herpetiformis
• • pemphigoid gestationis

Heat Rash: A heat rash, or prickly heat, causes an itchy patch of tiny blisters on the skin. Pregnancy can cause people to feel unusually warm because of increased blood supply to the skin, as a result of hormone Progesterone. As a result, the lady may find that she sweats more, which, in some cases, may lead to a heat rash.

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
• • using prickly heat powders in the affected areas

Hives

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

Atopic eruption of pregnancy

Atopic eruption of pregnancy groups several similar pregnancy rashes together. These include:

• • Atopic eczema
• • Prurigo of pregnancy
• • Pruritic folliculitis of pregnancy

Atopic eczema is a very dry and itchy rash. 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. Symptomatic relief with emollients, anti histamines and steroids is recommended.

PUPP rash

Pruritic urticarial papules and plaques of pregnancy (PUPPP) rash affects about 1 in every 160 pregnancies. This condition is seen more 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.

IHCP (Intra Hepatic Cholestasis of Pregnancy)

IHCP, 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 IHCP. Occasionally, a person may also develop jaundice. IHCP typically occurs in the late second or early third trimester.

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

Impetigo herpetiformis

Impetigo herpetiformis, also known as pulsator psoriasis of pregnancy, is a rare skin condition that appears during pregnancy, often in the last trimester. It 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. The following may also be seen:

• • Fever
• • Diarrhea
• • Dehydration
• • Rapid heartbeat
• • Seizures

Pemphigoid gestationis

Pemphigoid gestationis is a rare autoimmune disease that affects anywhere from 1 in every 2,000–50,000 pregnancies. It causes an itchy, hives-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, though it can happen in the first trimester or immediately after the birth. 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% cases, newborns may be born with skin lesions.

How to treat rashes during pregnancy ?

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

When to contact a doctor ?

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
• • Only itchiness without a rash.