PUPPPS Rash During Pregnancy

PUPPPs, short for pruritic urticarial papules and plaques of pregnancy is the most common skin rash found in pregnant women. Normally occurring around 35 weeks gestation, PUPPPs tends to only happen to woman during her first pregnancy, and more commonly when she is expecting a boy. PUPPPS has many other names, most commonly is PEP (polymorphic eruption of pregnancy) found in the United Kingdom, late-onset prurigo of pregnancy, toxemic rash of pregnancy and toxic erythema of pregnancy. PUPPPs occurs in 1 out of 200 first-time pregnancies on average, and has extremely notable signs and symptoms.

The itchiest stage lasts about one week, however the itch ‘never really goes away’ as explained by previous sufferers. Even though PUPPPs is extremely uncomfortable, doctors and experts alike have not found any threats to mom or baby.

Signs and Symptoms of PUPPPs

Many women find that the itching part of PUPPPs is what is so difficult. Although, PUPPPs does cause distinguishing red marks on the abdomen, there are specific details a woman should pay attention too before diagnosis to determine whether or not she is suffering from this condition.

  • Color appearance changes over time
  • Very itchy
  • Redness
  • Small blisters
  • Eczema-like lesions
  • Appears on abdomen first
  • Is not found on the belly button
  • Stretching of the skin, stretch marks are generally the first sign

The appearance of PUPPPs has been described as bumpy, itchy papules that turn to red, scalded skin with welts over time. They begin as though they are stretch marks, then as time passes, the rash begins to become bumpy, red, and bigger. As mentioned above, oddly there is never a rash on the belly button, only around it on the abdomen. From the abdomen, the rash will begin to spread to all parts of the body including the chest, legs, feet, neck, armpits and face of the expectant mother.

Cause of PUPPPs

Unfortunately there is no known cause of PUPPPs, however experts and doctors do see similarities in cases. These similarities, although they are not specific causes, include:

  • Women carrying boys (70% of sufferers deliver boys)
  • First pregnancy
  • Carrying multiples (twins, triplets, etc.)
  • Hypertension

One thing that most experts agree on is that this is a pregnancy-related condition. It only happens to women during their first pregnancy, and generally when they are carrying either multiples or males. If a woman is at or past her term (37 weeks) she may or may not want to consider being induced to help the condition.

Treating PUPPPs

Depending on the severity of PUPPPs, doctors usually use topical moisturizing creams or aqueous ointments to help treat mild cases. Corticosteroid creams and ointments are usually used when the condition has reached extreme severity, and if the condition is too out of control, the doctor will treat the patient with oral corticosteroids. Antihistamine tablets may be prescribed to provide relief from the itchiness, however they are not said to work as well as the corticosteroid creams and ointments. The important thing to remember is that after delivery of your baby, the condition and symptoms go away within a week or so. Still, not all women are so lucky and continue to experience symptoms during their postpartum period.

Other times, women prefer to use home remedies to treat their PUPPPs. Aloe and oatmeal baths are said to help soothe the itch, while decreasing the red appearance of the condition. Ice packs can also take down the redness and swelling (if any). Wearing baggy clothes can also help prevent discomfort when you’re pregnant, and especially if you’re prone to skin rashes such as PUPPPs. The sun, heat, warm water and clothing can aggravate the rash, so staying cool is essential to help contain the itch and other symptoms.

[Page updated November 2013]