Skin Rashes During Pregnancy: What Are the Most Common Causes?
Some women enjoy the way pregnancy makes them look. When pregnant, some women say their skin has a beautiful glow, thanks to all of the estrogen your body is producing. Unfortunately, some moms-to-be experience a less desirable skin change – an itchy skin rash
Like the rest of your body, your skin changes when you’re pregnant. Along with the rise in pregnancy-related hormones, some women experience a resurgence of acne. Also, relatively common is another kind of rash – one that often starts on the abdomen and spreads to the lower extremities. If you experience small red bumps that are itchy, a possible cause is a condition called pruritic urticarial papules and plaques of pregnancy, also known as PUPPP.
What is PUPPP?
PUPPP is the most common cause of a pregnancy-related rash, affecting about 1 out of 200 women. The rash usually starts on the tummy and often spreads to the legs. PUPPP is more common in women who have had multiple babies, although you can still get it during your first pregnancy. Though the rash is red and sometimes intensely itchy, it won’t harm your unborn baby – or you. The rash usually completely goes away within a few weeks after delivery.
Prurigo of Pregnancy
A less common cause of a pregnancy-related rash is prurigo of pregnancy, a skin condition and rash that affects about one in 300 pregnant women. This condition causes itchy, red bumps, usually on the legs but also may spread to other areas, including your abdomen. You can experience this rash at any time during pregnancy – from your first trimester to your third – although it’s most common during the second half of pregnancy. This rash can be hard to distinguish from PUPPP. Unfortunately, no one knows exactly what causes it.
PUPPP and prurigo of pregnancy, although uncomfortable and annoying, aren’t dangerous and won’t harm your developing baby. Another condition called cholestatic pruritus DOES increase the risk of pregnancy-related issues. Because it’s itchy, it can sometimes be mistaken for prurigo of pregnancy or PUPPP.
What is cholestatic pruritus? It’s a condition where the flow of bile out of your liver is impaired. Your liver is the organ that produces bile, a dark green liquid that helps you digest fats. After your liver makes bile, it delivers a portion to your small intestine tract to help with fat digestion. Some is also stored in your gallbladder. When bile can’t flow out of your liver, it builds up and enters your bloodstream. When this happens, one of the symptoms you might experience is intense itching.
Cholestatic pruritus causes no serious problems for pregnant moms-to-be but it IS linked with problems for an unborn baby. For example, this condition is associated with an increased risk of delivering prematurely and, less commonly, stillbirth. Babies sometimes develop breathing problems upon delivery as a result of a mom having cholestatic pruritus and may have other birth-related problems like an abnormally slow heart rate. Some obstetricians recommend delivering babies whose mom have this condition early – as soon as the lungs have matured.
No one knows exactly what causes cholestatic pruritis, although it’s most likely to occur in the second or third trimester. It may be related to the increase in hormones during pregnancy. It also tends to run in families, so there may be a genetic component. The itching and bile flow impairment in affected moms usually resolves 2 to 3 weeks after delivery.
Other Causes of Rashes During Pregnancy
These aren’t the only conditions that can cause a rash during pregnancy but there are some of the more common causes that are directly related to being pregnant. Don’t forget, if you have a rash, it could be caused by something unrelated to your pregnancy. Some skin conditions, such as psoriasis and eczema, worsen when you’re pregnant.
You can also experience an itchy, red rash when you’re exposed to skin irritants or allergens you’re allergic too – think of poison ivy. Another highly contagious condition called scabies, brought on by infestation with tiny creatures called mites, also causes an intensely itchy rash.
The Bottom Line
Because rashes are common during pregnancy and there’s a variety of reasons you might have one, don’t try to self-diagnose. Let your doctor have a look – just to be sure.
Am Fam Physician. 2007 Jan 15;75(2):211-218.
Mayo Clinic. “Cholestasis of Pregnancy”