Pregnancy brings immense changes to the female body. Changes that can be seen physically as well as mentally experienced by the woman herself. Physical changes other than a bumpy abdomen can be seen in her skin, hair, and nails during pregnancy. These changes can be due to fluctuation in hormonal levels or various triggers.
Skin hypersensitivity appears as rashes over the body. These rashes can be spotted on any part of the body. Most rashes are benign and do not cause any harm to the mother or the baby. But few may be a symptom of any underlying condition which needs proper medical care to ensure the safety of both, mother and the baby.
It is important to observe the symptoms to identify and treat them. Usually, one can be relieved from severe itching through home remedies only or rashes may disappear on their own soon after delivery.
What is the prurigo of pregnancy?
Prurigo of pregnancy is defined as a benign non-specific itchy (pruritic) rash seen during pregnancy. It is described by the use of plenty of terms such as prurigo gestationis, early onset prurigo of pregnancy, papular dermatitis, and pruritic folliculitis of pregnancy.
Who gets it?
Prurigo of pregnancy is not very common and is seen in 1 in 300 pregnancies. Prurigo is often seen during the 2nd and 3rd trimester but can also occur in any phase or trimester of pregnancy.
Causes for prurigo of pregnancy
The cause for prurigo of pregnancy is idiopathic i.e. not known yet. But it is known to have a close association with atopic dermatitis. But this association is controversial.
The following can be considered as factors causing itching :
- Stretching of skin: Due to pregnancy, the skin stretches with multiple tend.
- Dryness: Hormonal fluctuation is usually considered as a cause of itchy, flaky dry skin.
- Perfumes or fabrics: The skin may be hypersensitive enough to get irritated by various chemicals or materials.
- Hormones: Hormonal changes can cause a change in everything starting from mood swings to blood circulation.
- Cholestasis: A liver disease that ends up in the accumulation of bile acids in the blood causing a feeling of itchiness.
- Pruritic urticarial papules and plaques of pregnancy (PUPPP): itchy rash usually seen in late pregnancy around the stretch marks.
Usually, it is determined as papular dermatitis and appears quite similar to nodular prurigo –
- These papules are in a cluster
- Usually occur on the extensor surface of limbs and rarely on Trunk.
- They are about 0.5-1 cm in size.
- It may originate from the hair follicle.
- Few lesions have a central crust.
- Other than papules, pustules can also be seen.
- Due to itch, the papules are excoriated.
It is a clinical diagnosis. It is important to rule out all other non-pregnancy related differential diagnoses as there is no specific diagnostic test available.
The histopathological slide shows, non-specific dermatitis, and when Direct immunofluorescence is performed, it is negative. In the case of prurigo due to cholestasis, liver function can be affected and therefore, result in abnormal blood test reports.
As such, there is no definitive treatment for prurigo of pregnancy. But symptomatic relief can be obtained through:
- Benzoyl peroxide
- Emollient with menthol
- Moderate potency topical steroid ointment
- Oral anti-allergic (antihistamines)
Some of the safe home remedies for itch relief are –
- Use of lather pine tar soap. It has a strong odor but its antiseptic quality makes its treatment of choice for different skin conditions, like psoriasis.
- Go for an oatmeal bath. A cup of rolled oats inside the center of the cheesecloth piece and secure with the help of a rubber band. Now take a tub of warm water and place this cheesecloth inside it and start squeezing to release milky oat-infused water. This water provides proper moisture to the skin.
- For heat rash, it is advised to cool off the skin and prevent sweating and overheating.
The outcome of prurigo of pregnancy
Usually, the prurigo of pregnancy resolves soon after the delivery of the baby. But, this resolution may take a long time varying from weeks to months after delivery. One can not be sure about the recurrence of upcoming pregnancies. Moreover, it causes no harm to the mother or baby. But in case of severe discomfort, one must visit a doctor and seek medical attention. With proper medication and care, the prurigo of pregnancy can be dealt with ease.