Identifying Common Pregnancy Rashes

Pregnancy brings many changes to a woman’s body and skin changes are no exception. Pregnancy rashes are a common concern for many expectant mothers, causing discomfort and worry. These skin conditions, such as pregnancy eczema and PUPPP (pruritic urticarial papules and plaques of pregnancy) can range from mild irritation to more severe symptoms, affecting various parts of the body. By understanding these skin issues, you’ll be better equipped to manage any rashes that may occur during your pregnancy journey.

Common Types of Pregnancy Rashes

Pregnancy can bring about various skin changes, including rashes that may cause discomfort or concern. While many of these rashes are benign, some require medical attention due to potential risks to the mother or baby.

PUPPP (Pruritic Urticarial Papules and Plaques of Pregnancy)

PUPPP, also known as polymorphic eruption of pregnancy (PEP), is the most common pregnancy rash, affecting about 1 in 160 pregnancies. It typically appears in the third trimester as an extremely itchy rash resembling hives or an allergic skin reaction. The rash usually starts on the abdomen, often along stretch marks, and may spread to the thighs, buttocks, breasts and arms. PUPPP does not pose any risk to the mother or baby and resolves on its own after delivery. Treatment focuses on relieving the intense itching with oral antihistamines, topical steroids, and, in severe cases, oral steroids.

Intrahepatic Cholestasis of Pregnancy

Intrahepatic cholestasis of pregnancy (ICP) is a liver condition that causes severe itching, typically starting on the palms and soles before spreading to other parts of the body. The itching may occur with or without a rash and is most common in the third trimester. ICP affects about 1 to 2 in 1,000 pregnancies in the United States and is more prevalent in Latina women. This condition is associated with an increased risk of premature delivery, meconium-stained amniotic fluid, and, in rare cases, stillbirth. Timely diagnosis and close monitoring are crucial. See your obstetrician or dermatology provider immediately if these symptoms occur. Treatment involves the use of ursodeoxycholic acid (ursodiol) to lower bile acid levels and relieve itching.

Pemphigoid Gestationis

Pemphigoid gestationis, formerly known as herpes gestationis, is a rare autoimmune skin disorder that affects 1 in 50,000 pregnancies. It usually appears in the second or third trimester as an itchy, hive-like rash that begins around the navel and spreads to other parts of the body. The rash may progress to form blisters and is often accompanied by severe itching. Pemphigoid gestationis tends to recur in subsequent pregnancies and may be associated with an increased risk of premature delivery and low birth weight. Treatment typically involves topical corticosteroids and oral antihistamines for mild cases, while severe cases may require oral corticosteroids.

Prurigo of Pregnancy

Prurigo of pregnancy is a less common pregnancy rash that appears as small, itchy bumps on the extensor surfaces of the arms and legs. The exact cause is unknown, but it is believed to be related to changes in the immune system during pregnancy. Prurigo of pregnancy does not pose any significant risks to the mother or baby and usually resolves after delivery. Treatment aims to relieve itching and may include topical corticosteroids, oral antihistamines and moisturizers.

Pruritic Folliculitis of Pregnancy

Pruritic folliculitis of pregnancy is a rare condition characterized by acne-like pustules that develop on the chest, back and arms. It typically occurs during the second or third trimester and affects about 1 in 3,000 pregnancies. While the condition can cause significant discomfort due to itching, it is not harmful to the mother or baby and usually resolves after childbirth. The cause of pruritic folliculitis is unclear, but it may be related to hormonal changes and increased sebum production. Treatment often involves the use of topical corticosteroids and soothing moisturizers to reduce inflammation and itching. In more severe cases, a doctor may recommend antibiotics to prevent infection.

Heat Rash (Miliaria)

Heat rash, also known as miliaria, is another common skin condition during pregnancy, particularly in warmer months or climates. Pregnant women may be more prone to heat rash because of increased blood flow and metabolic heat. Miliaria occurs when sweat ducts become blocked, causing small, red, itchy bumps to develop on areas where sweat accumulates, such as under the breasts, in the armpits and around the abdomen. While heat rash is not unique to pregnancy, it can be more bothersome during this time. Treatment includes staying cool, wearing loose-fitting clothing and using mild, fragrance-free moisturizers to soothe the skin.

Eczema (Atopic Eruption of Pregnancy)

Pregnancy can also exacerbate eczema, a chronic inflammatory skin condition that leads to dry, itchy and inflamed skin. Hormonal changes, along with increased blood flow and stress, can trigger or worsen eczema during pregnancy. Women with a history of eczema may find their symptoms intensifying. Treatment of different types of eczema focuses on moisturizing the skin regularly and may include topical corticosteroids to reduce inflammation.

When to See a Provider for Pregnancy Rashes

While many pregnancy rashes are harmless and resolve with basic treatment, some conditions, like intrahepatic cholestasis of pregnancy and pemphigoid gestationis, require close medical monitoring. If you experience severe itching, blisters or symptoms that worsen over time, it’s important to seek medical advice. A dermatology specialist can provide personalized care and determine if prescription medications or additional tests are necessary to protect both you and your baby’s health.

Additionally, if you notice a sudden onset of a rash or itchiness that persists despite home treatments, contact a dermatology specialist. This is especially important for conditions like ICP, which can have serious implications for both maternal and fetal health if left untreated.

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At Schweiger Dermatology Group, we understand the unique skin concerns that arise during pregnancy. Our board-certified dermatology providers are here to deliver care and expert guidance for managing pregnancy rashes and other skin conditions. If you’re experiencing discomfort or need help managing a skin condition during pregnancy, schedule an appointment by calling 844-DERM-DOC/(844) 337-6362 or book online today.