Oh, PUPPP rash! Not fun at all. Are you dealing with an itchy rash while pregnant? Relax, it’s common and there are things you can do.

An itchy growing belly is not comfortable. It’s annoying but benign. Learn the facts about PUPPP rash and soothing measures you can take. 

WHAT IS PUPPP RASH?

PUPPP stands for pruritic urticarial papules and plaques of pregnancy. It’s a hives-like skin rash that you may get in your late pregnancy, the third trimester to be exact. 

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Consult your doctor before using anything mentioned in this article. 

It affects 1 in 150 pregnancies and while the itch may last for one week the rash comes and goes. 

PUPPP has been called many names throughout the years:

  • Nurse’s late-onset prurigo
  • Bourne’s toxemic rash of pregnancy 
  • Toxic erythema of pregnancy
  • Polymorphic eruption of pregnancy

WHAT CAUSES PUPPP RASH?

There is no exact cause for the PUPPP rash, and believe it or not, it’s not because of your crazy pregnancy hormones. Most of the times any pregnancy issue (like pregnancy acne) is caused by your hormones but not in this case.

Your growing belly may be to blame. As your belly grows your skin stretches and that may trigger the annoying rash. There are some theories that say that PUPPP rash may be genetic (and traced on the father’s side).

What you need to know is that it usually appears in your third trimester and disappears after you give birth. No worries. 

So third trimester is when it’s most likely to happen because your baby grows faster. If this is your first pregnancy that could also be a cause.

First pregnancy or multiples pregnancy (skin stretches even more) trigger PUPPP rash. 

Possible PUPPP rash causes:

1. ABDOMINAL STRETCHING

Carrying large babies or multiple babies is traumatizing for your skin and damaging for your connective tissue. Stretch marks are almost inevitable which cause skin inflammation that will eventually turn into PUPPP rash.

2. FETAL CELLS

Cells from your fetus may migrate to the mother, including the skin. In some cases, the skin will treat these cells as being foreign triggering a skin rash. 

WHAT ARE THE SYMPTOMS OF PUPPP RASH?

The good thing about this rash is that it’s specific to the third trimester of pregnancy. What’s good about that? Well, it happens towards the end of your pregnancy so you don’t have to deal with it for too long. 

The process goes like this: you have a growing belly that stretches your skin. Sometimes your skin stretches so fast (mainly in the last 5 weeks) that your skin cells can’t keep up with. 

You’ll end up with stretch marks, that may further develop PUPPP rash mainly around your bellybutton (where stretching is the greatest). 

PUPPP rash can extend to your other extremities in just a matter of days: buttocks, thighs, arms and legs (it won’t go higher than your breasts). And never on the face, thank you, Lord. 

The rash looks like small hive-like bumps wherever you have stretch marks and eventually turns into large red plaques. These lesions may be surrounded by a white halo in women with light skin.

Blisters may form as well.  This is not a pretty picture. For example, how can you get a good night’s sleep in these conditions? Here’s how.

HOW IS PUPPP RASH DIAGNOSED?

You go to the doctor. Your doctor will examine you and determine if this is the type of rash you have.

He may order further testing (complete blood count or CBC, liver function test, serum cortisol, serum human choriogonadotropin) to rule out other possible infections, like rabies and fungal infections. 

PUPPP RASH RISK FACTORS

Some pregnant women are more likely to get PUPPP rash because:

  • They are Caucasian
  • Are expecting a boy
  • They are overweight 
  • The baby is overweight
  • It’s their first pregnancy
  • Multiples pregnancy (triplet pregnancies have a higher risk than twin pregnancies)
  • Maternal hypertension
  • Rapid gain weight during pregnancy

These are possible risk factors but that does not mean that you can’t get PUPPP rash if none of the risk factors mentioned apply to you.

HOW TO GET RID OF PUPPP RASH

The best way is to give birth. Seriously. PUPPP rash will go away within two weeks after childbirth without medical intervention.

You can either be patient and wait till that happens or you can try to manage it during your late pregnancy. 

Here are some things you can do to control and relieve the symptoms.

1. USE MOISTURIZERS

 A skin moisturizer will soothe your PUPPP rash but make sure it’s baby-friendly. You definitely don’t want to put your baby at risk.

Amazon offers many options for baby safe anti-itch moisturizers. Stay away from salicylic acids, retinol, vitamin A, retinyl-palmitate and tropic acid, as they may harm your baby.

Instead, use anti-itch moisturizers containing vitamin E, cocoa butter, Shea butter, collagen, glycerin, and elastin.  

2. TOPICAL STEROIDS

Steroid creams with 1% hydrocortisone are considered the first-line treatment to soothe pregnancy rash. Always check with your doctor before using anything. He may actually prescribe you something stronger. 

*Stay away from oral steroids as they may cause birth defects and preterm birth. 

3. ANTIHISTAMINES

As the name suggests antihistamines block histamines, and they stop allergy symptoms, itchy skin being one of them. And since you’re dealing with PUPPP rash these medications may help.

Benadryl and Zyrtec would be your first choice but consult with your doctor. 

The problem with these conventional treatments is that they may help you cope with the signs and symptoms, but they may not take care of the actual problem.

They may just relieve the itching in one way or another. Keep in mind that steroids are harmful in general, so they are not 100% safe for your pregnancy. Topical steroids are associated with low birth weight babies.

Be aware of the risks. 

With that being said, here are some home remedies that are safe to use. Still discuss it with your doctor.

1. TAKE A BATH

But not any bath. Oatmeal or baking soda bath may reduce the itchy feeling. You need 1 cup of rolled oats, 1 cup organic chamomile loose tea and tie them together in a cloth. Dip it in your tub filled with lukewarm water. 

2. ALOE VERA

Aloe vera gel has soothing effects and it may help you. You can apply it after you shower. 

3. COLD COMPRESSES

Cool wet compresses are another option. You can ask for your partner’s help with this one. Ice packs will also do the job.

4. PEPPERMINT OIL

Peppermint oil helps with pregnancy nausea but it has anti-itching properties also. You can dilute it with some coconut oil and apply it to the affected area to get a cooling effect.

5. CLOVE OIL

This oil reduces skin inflammation so you may consider using it. 

6. FLAXSEED OIL

Flaxseed oil is another anti-inflammatory oil and may relieve your itch. Mix 2 teaspoons of flaxseed oil with 1 cup of milk and drink. 

7. OLIVE OIL

After shower when your skin is still wet apply olive oil and pat dry. This helps your skin stay moisturized.

8. DANDELION ROOT

This is a detox tea that supports liver function. But it’s also believed to reduce the symptoms of PUPPP rash. 

9. ANTI INFLAMMATORY HERBS

Combine calendula and chamomille with aloe vera or witch hazel and apply to the affected area. You can do it up to three times a week. 

10. ADDITIONAL TOPICAL REMEDIES

Coconut oil, cornstarch water paste or banana peel are other options you may want to try to help you find some relief. 

11. DON’T SCRATCH

It’s important not to scratch the areas. I know it’s hard and addicting (once you start scratching you can’t stop) but your rash will become worse.

Scratching the rash may expose it to even more bacteria from your fingernails. You don’t need another infection.

12. COMFORTABLE COTTON CLOTHING

Loose and soft clothing help alleviate the symptoms of PUPPP rash and prevent them from getting worse. 

13. GOOD PERSONAL HYGIENE

Stay clean and keep a healthy diet. Avoid sweating (turn your A/C down) because moisture triggers itching. 

14. VEGGIE JUICE

Make yourself some veggie juice to detoxify your body and soothe the inflammation.

IS PUPPP RASH DANGEROUS?

Your baby may be born with a mild PUPPP rash, but it presents no danger for neither you nor your baby. If you get PUPPP rash with one pregnancy you may not get it with your next pregnancy.

You are more likely to experience PUPPP rash with your first pregnancy.

 CAN I PREVENT PUPPP RASH?

No, unfortunately. You can’t control your growing belly and the extent your skin may stretch. If you get it, you get it.

You can try to soothe the symptoms, but you can’t prevent it. To make you feel better, remember it’s temporary. 

IS PUPPP RASH CONTAGIOUS?

No, it’s not contagious. It develops as a response to the changes in your body. PUPPP rash occurs only in pregnant women because of either the stretching of the skin of migrating fetal cells. 

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