Are you in the last few months of your pregnancy? Everything was going well, but suddenly your stomach started itching violently? Do you notice small red bumps that seem to be spreading all over your body? When that happens, it's normal to be scared, wondering, "What is this? Will something happen to the baby?" But don't worry. Today we're talking about this skin condition that many pregnant women experience, but it's not dangerous.
What exactly is PUPPP Rash?
PUPPP is an abbreviation for `(Pruritic Urticarial Papules and Plaques of Pregnancy)`. It is sometimes also called `(Polymorphic Eruption of Pregnancy - PEP)`. Both names refer to the same thing.
Simply put, this is the most common type of skin rash that can occur during pregnancy. It is not dangerous and does not harm you or your baby. However, it can be unbearably itchy.
This usually starts in the third trimester of pregnancy, that is, in the last three months. It first starts in the areas where the skin stretches (`stretch marks`) on the stomach. Then, it can gradually spread to areas like the arms, legs, breasts, and buttocks. The best thing is, after the baby is born, this rash disappears almost completely without any scars or changes in skin color.
What is the specific reason for this?
Doctors still haven't found a single, definitive cause for this, but there are several factors that are thought to contribute to it.
The main theory is that the skin is stretching rapidly . Think about it, when the baby is growing rapidly inside the womb, your stomach is stretching rapidly at the same time. Sometimes the skin cells cannot adapt to this speed. Then, the tissue under the skin is slightly damaged, and our body reacts like an allergy to some of the proteins that are released from it. That is what is believed to be the result of this eczema.
This is another clear point:
- Pregnant mothers with twins or triplets are more likely to experience this because as the babies grow, they gain weight faster and the amount of skin stretching increases significantly.
- This is also common for first-time mothers because their skin has never stretched like this before.
Some other research suggests that this reaction is caused by the baby's DNA particles entering the mother's skin during late pregnancy. However, this has not yet been confirmed.
The good news is that after the first birth, it is very rare for this to recur in subsequent pregnancies. This means that our bodies may develop an immunity to it.
What exactly are the symptoms of this?
The symptoms of this rash can feel like hives. First, the skin starts to itch intensely, especially in areas where the skin has been stretched (stretch marks). Then small blisters appear, which merge together and spread like a large rash.
Be aware of the following symptoms.
| Symptom | Description |
|---|---|
| Severe itching | Itching can be so severe that it is impossible to perform daily activities, especially at night. |
| The nature of eczema | It can look like a mixture of bumps, raised bumps, small water blisters, and large red, swollen spots. |
| Spread | It starts on the stomach and can spread to the breasts, arms, thighs, and buttocks. However, it rarely affects the face, palms, and soles of the feet. |
| When scratching | When the blisters are broken, a yellow fluid may ooze out. Later, a crust may form on top. |
How does the doctor recognize this?
There is no specific test for PUPPP rash. Your doctor can usually diagnose it by examining your skin and talking about your symptoms .
However, sometimes if the appearance of the rash is a little unusual, several tests may be done to make sure there are no other medical conditions. For example:
- Skin scrapings
- A blood test `( Complete Blood Count )`
- Liver function tests
Sometimes there is another skin condition that is very similar to PUPPP Rash, but a little more serious, called ``pemphigoid gestationis (PG)``. It is very rare. But because it can affect the baby, if the doctor is in doubt, he can take a small piece of skin and do a special test called ``immunofluorescence`` to rule it out.
But remember, most of the time, such tests are not necessary . The doctor can tell it's a PUPPP rash right away.
What can be done about this severe itching?
This rash usually clears up on its own within 3-4 weeks after the baby is born. Therefore, medical treatment is not required. However, since this severe itching can be difficult to live with, there are ways to control it.
Treatments you can do at home
- Bathe in cold water: Bathing in cold water is very good for reducing inflammation and itching. Use a fragrance-free body wash. Add colloidal oatmeal, which you can buy at pharmacies, to the bathtub and soak for 10-15 minutes to reduce itching.
- Apply a moisturizer: After bathing, apply a fragrance-free, anti-itch moisturizer (`fragrance-free lotion`) or ointment (`ointment`). Sometimes petroleum jelly (also known as Vaseline) helps control itching better than a regular cream.
- Wear loose clothing: Wear loose clothing made of cotton that is not tight on the body.
- Apply a cold, damp cloth: Soak a clean cloth in cold water, wring it out well, and apply it to the itchy areas. This will provide great relief.
Medicines available at the pharmacy
If home remedies do not relieve the itching, there are medications you can buy at the pharmacy.
But remember, before using any medication during pregnancy, you should definitely consult your doctor and get his approval. Some medications are not suitable for pregnancy.
Your doctor may recommend using an anti-itch cream, such as hydrocortisone, if the rash is only on a small area. Your doctor may also recommend newer allergy medications, such as cetirizine.
Treatment prescribed by the doctor
If the itching is unbearable, if it's making you feel tired or stressed, tell your doctor . He or she may prescribe stronger treatments. These may include:
- Strong steroid creams (`prescription steroid creams`) that reduce inflammation and itching.
- If the rash has spread throughout the body, you may be given steroid pills for a few days.
Does this increase with food and drink?
No. There is no known link between the foods you eat and this type of eczema. Therefore, there are no specific foods that you should avoid if you have this type of eczema.
Take-Home Message
- PUPPP Rash is a very itchy, but common, eczematous condition that occurs in late pregnancy.
- This is not dangerous for you or your unborn baby at all . So don't be afraid.
- This is often caused by rapid skin tightening.
- Home remedies like taking a cold bath, applying moisturizer, and applying a cold compress can provide great relief.
- Be sure to talk to your doctor before using any medication, even if it's purchased from a pharmacy.
- This rash will heal completely on its own within a few days or weeks after childbirth.
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