Pregnancy Rash: Pruritic urticarial papules and plaques of pregnancy (PUPPP)
In my first trimester, I notice some rashes and itchiness on my skin. Even my underarms were so sensitive. I stopped using deodorant that time because of irritation. I consulted my doctor about it but he told me it’s normal for pregnant women and there’s nothing I should worry about, it is just due to my skin stretching as I was gaining weight and the baby was growing. My ob-gyn suggested using some lotion and bath treatment with colloidal oatmeal for relief. He also told me to buy some over-the-counter ointment for itchiness. It did help me after three weeks of the bath treatment and using some ointment I noticed the rashes were gone.
In my second trimester everything went well but later of this trimester, I notice dark stretch marks on my tummy. I was very concerned about the burning sensation whenever I bathe or after applying lotion on that area. The next check-up, I ask my doctor about what to do with the stretch marks he suggested to used cocoa butter to soothe the stretch marks and to wear light and very loose outfit.
The problem continued in my third trimester, and cocoa butter not really been of help. In my 34weeks of pregnancy, I noticed red and itchy bumps on some area of my body; a little miracle was it never did show up on my face. When I scratch it, I’ll never stop even if it is bleeding. As I advised my doctor about it, he said it is common and normal during pregnancy. It is common because Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) occurs in 1 out of 160-240 initial pregnancies. He said right after the delivery I would be free from it. He prescribed triamcinolone acetonide cream 0.1% and antihistamine capsule. The capsule made me sleepy and the cream soothed the red bumps but still just a couple hours of relief. I also continued the 15 minutes bath using the colloidal oatmeal treatment but never did give me 100% solution to the itchiness. I slept 2-3 hours and been awake until morning. I did more naps to feel better since I could only take my medicine every 4 hours and apply the cream twice daily. I also refrain from eating food that might cause the itchiness or can lead to skin allergy, any food with chicken and egg as well as seafood like crab and shrimp.
Even if the doctor was so certain of my case I was still skeptical and ask for a urine test to make sure that it is not a case of intrahepatic cholestasis of pregnancy, (a liver problem that affects less than 1 percent of pregnant women in the United States). But after those test, they confirmed that it is really PUPPP.
In the Clinic (Scott & White Clinic) for birthing, the nurse said that she already forgot how PUPPP was. They have a 1 is to 1000 case of pregnancies who have PUPPP. I don’t really care anymore about my condition; all I am concerned was the baby and her health. Because i was under medication before she came. Luckily, she's been doing perfectly fine.
After birthing, I still suffered some itchiness for 2 months but the red bumps were gone. I notice my skin was so dry and it might be due to hormonal change after pregnancy. The stretch marks were much more than I expected.
These were my experiences during my first pregnancy. Now, we should learn more about PUPPP rash during pregnancy.
PUPPP - (PRURITIC URTICARIAL PAPULES AND PLAQUES OF PREGNANCY)
This condition is the most common dermatosis (skin condition) of pregnancy. The cause was unknown until recently when Dr. Selim Aracting and colleagues from France reported studies linking PUPPP with cells from the developing baby (fetus). Their studies suggest that fetal cells can invade the mother's skin during pregnancy, and in some way cause this skin disorder to develop.
The rash usually starts on the abdomen and spreads to the buttocks and thighs. Occasionally, the rash spreads to legs, feet, arms, chest, and neck. The face is never involved. It appears as red raised spots or bumps that itch strongly. It usually appears after 34 weeks of pregnancy and some cases disappear after childbirth. It presents no long-term risk for either the mother or unborn child.
No treatment 100% treatment for the itch only some Corticosteroids that could be applied to the skin (topical) are known to give prompt temporary relief. Sometimes oral corticosteroids (eg prednisolone) are needed.