PUPPP Rash During Pregnancy: Causes, Symptoms And Treatment

7 min read

Written by Ambili Kartha

Ambili Kartha

Ambili Kartha is engaged in content creation and editing for more than 6 years and has the additional experience of being the mother of two children. She is part of content team.

PUPPP Rash During Pregnancy

Pruritic urticarial papules and plaques of pregnancy or PUPPP rash during pregnancy is a common skin condition. This can lead to acute rashes in the abdominal area in and around the stretch marks. The main cause of the triggering PUPP rash is the stretching of the skin. Rashes of these kinds can be very itchy, and the itchiness lasts for a week or more. The rashes are red patches on the skin and have different names like toxic erythema, Bournes’s toxemic rash, etc.

PUPP is a dermatologic condition common in pregnant patients. This condition is predominant in the third trimester and its only solution is delivering the baby. This condition disappears post-delivery, but treatment can be taken if the itching is intense and unbearable. Let us study the various aspects of PUPP as under.

In This Article

What Is PUPPP Rash During Pregnancy?

PUPPP rash is common in the last leg of pregnancy. These rashes start from the abdominal region and then go to the thighs as well as the buttocks. These rashes are not harmful but can be uncomfortable for the pregnant woman. PUPP rashes can spurt big time around the 35th week. These red bumps look like pimples and are found in clusters that spread to distinct parts of the body except the face.

This is not common with all pregnant ladies, but few face this situation. The ones who are at notable risk are:

  • This is not common with all pregnant ladies, but few face this situation, for example, a pregnant lady who
  • Is having the first baby
  • Has heart-related issues such as hypertension resulting in high blood pressure.
  • Has RH positive type blood
  • Is pregnant with a boy
  • Going through in vitro fertilization with progesterone treatment.
  • Carrying multiple babies.
  • Has abnormal weight gain.
  • The foetus weighs more than the usual parameters.

What Triggers PUPPP Rash?

What Triggers PUPPP Rash

Medical research is still not able to identify the root cause behind the spread of PUPPP rashes in mothers during pregnancy. But there are a few theories that support the cause. The causes given below are the ones that can trigger a PUPP rash.

1. Abdominal Stretching And Connective Tissue Damage: If the pregnant lady is carrying multiple twins or overweight and large babies it can damage the connective tissue. This starts with stretch marks, resulting in skin inflammation and finally a PUPP rash.

2. Allergic Reaction Between Mother’s Blood And Fetal Cells: One theory states that this eruption can be like an allergic reaction that takes place in the fetal cells in the mother’s blood. As per the theory, the mothers carrying male fetuses are more prone to PUPP rashes than the ones carrying female ones.

3. Common In The Third Trimester: As per yet another research PUPP rashes occur primarily in the third trimester as the skin excessively stretches for keeping the fetus.

4. Migration Of The Fetal Cells: Fetal cells keep migrating to the various parts of the mother, especially the skin. The skin then starts treating the fetal cells as a foreign entity that can result in a skin rash.

What Are The Signs And Symptoms of PUPPP Rash During Pregnancy?

Signs And Symptoms of PUPPP Rash During Pregnancy

The Pruritic Urticarial Papules and Plaques of Pregnancy begin with stretch marks in the abdominal region that looks like hives and tiny red pimples clusters. These hives then join to form an expanding and raised region known as Plaques. The blisters start spreading to the thighs, back region, buttocks, and seldom on the legs and arms or above the breasts.

The plaques are itchy during the night leading to discomfort and even loss of sleep in acute conditions. The blisters usually do not stay for an exceedingly long time and tend to disappear after the delivery is over. The span of the rashes ranges from four to six weeks when the delivery takes place.

Under severe itching conditions, PUPP is the reason for the itchiness around the abdominal area. Itchiness in the arms and the legs can be due to clothing though. It is therefore advisable to wear soft-fabric material during pregnancy to avoid any discomfort.

Itching is the worst symptom of PUPP. Along with the red marks that are distinct, a few other signs and symptoms that one can look for are:

  • Stretch marks
  • Small blisters
  • Redness
  • Eczema
  • Itchy rashes

PUPPP shows as tiny, itchy bumps that turn red over time. They are seen in the abdominal area and then start spreading around the stomach, chest, armpits, hands, thighs, and back. The PUPP would however not spread to the soles of the feet, palms, and face. One can never witness any rash in the naval region as well.

How Can PUPPP Rash Be Diagnosed?

The health care expert can advise on examining fungal infections and scabies. An autoimmune rash known as PG occurs in the second and third trimesters and is more severe than a PUPP rash.

The health care expert can suggest undergoing a few blood tests to rule out other infections like

  • Serum Cortisol
  • Liver function test
  • Serum Human Choriogonadotropin (HCG)
  • Complete blood count

How Do You Treat PUPPP Rash At Home?

How Do You Treat PUPPP Rash At Home_

If patients cannot afford to consult a healthcare professional or the PUPP rash on the belly starts spreading too much, few natural remedies are useful for reducing the itchiness. Home remedies like oatmeal baths, coconut oil, aloe vera gel, calamine lotion, bathing in lukewarm water, baking soda paste, and wet compress are a few things that help in getting some relief from the intense scratching.

1. Oatmeal Bath

Having a bath in oatmeal or baking soda is beneficial if a person is experiencing severe itching. Oatmeal has anti-inflammatory properties which can reduce swelling on the skin and leave it smooth and cool. For better results, an oatmeal bath can be made at home by buying regular oats and blending them in a grinder till it becomes a fine powder. Soak in the bathtub till the itchiness reduces.

2. Moisturizers

Moisturizers are good for the body even if there is no itchiness on the skin. During pregnancy, the skin becomes dehydrated and applying a moisturizer or a similar product helps in leaving the skin smooth. It helps in maintaining the skin’s moisture balance, also signalling when the skin is dry and cracked. If moisturizers are not available, coconut oil can be a good option as it has anti-bacterial properties that help in reducing the irritation of the skin, leaving it hydrated and smooth.

3. Aloe Vera Gel

Aloe Vera is another home remedy that is effective for treating PUPPP rashes. Applying the inner gel of the aloe vera leaf to the affected and inflamed region helps. Aloe Vera has hydrating and moisturizing components. This plant helps in relieving minor cuts, scrapes, injuries, etc.

4. Wet Compress

When itchiness occurs, it is impossible not to scratch. Doing this, however, worsens the condition of the skin. A cold compress is applied at this time helps to reduce the itchiness in the affected region. A cold compress could be anything from an ice pack to a wet towel. Leaving it on the itchy area for about 5-6 minutes helps in getting satisfactory results.

What Are The Treatment Options For PUPPP Rashes?

What Are The Treatment Options For PUPPP Rashes_

Treating PUPP rashes reduces itching and relieves the rash. The common ways of treatment are:

Topical Corticosteroids: For relieving itching and to prevent the spread of rashes, ointments are given. These reduce inflammation to a great extent and suppress the immune response of the body. If the itching is under control, the health expert will shift to corticosteroids of lower strength.

Oral Steroids: Oral steroids are not suitable during pregnancy. However, it is effective under severe conditions.

Oral Antihistamines: These are not effective for treating PUPP rashes but are helpful for helping with side effects like sleeping.

When To See A Doctor?

In case there is no relief from home remedies and other symptoms are seen with it, it is best to see a doctor. However, when getting a diagnosis from the doctor, always inform the span of time the home remedy is taken, in case of extreme cases of PUPP, one must seek medical advice and go for alternate medicines as well.

Rashes with stretch marks can be quite an uncomfortable experience for the pregnant woman. With persistent itching, it is best to consult a doctor or try home remedies for quick relief. Women suffering from PUPP must be reassured that this condition is not a serious one and will resolve post-delivery. It has no risk for the child or the mother and needs no special treatment unless the condition gets very severe.

1. Is PUPPP Rash Contagious?

PUPPP rashes are not contagious as they are a result of the response that is due to the changes in the body.

2. Does The PUPPP Rash Get Worse At Night?

PUPPP rash is extremely itchy primarily at night. This lasts for from four to six weeks and even disappears a few days post-delivery or can even persist a few weeks post the delivery.

3.  Can I Use Calamine Lotion For PUPPP?

It is always a promising idea to use the anti-itch creams that the doctor suggests. However, using over-the-counter medicines like calamine lotion also helps. Corticosteroid pills can be given in case the itching is bad.

4. Can PUPPP Rash Cause Early Labor?

PUPP rashes are like pemphigoid gestationis but not harmful. They can have an association with early labour.

5. Does Benadryl Help With PUPPP Rash?

The health practitioner can easily identify the PUPP rashes. Taking an over-the-counter oral- antihistamine like Benadryl or Claritin helps as well.

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Ambili Kartha,B. Sc Zoology (St Xavier’s college for women)

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