Garden-variety itchy skin is a common complaint during pregnancy, along with other pregnancy-related discomforts like swollen feet. About one in five pregnant women will suffer itchy skin. While it's usually more annoying than serious, knowing what you can do to relieve the itch -- and when it's time to alert your doctor -- can let you rest a little easier.

The most common reason is the most obvious: As your baby grows, the skin on your belly stretches and tightens, making it feel dry and itchy. Pregnancy hormones contribute to the itchiness on your belly and can also make your palms and the soles of your feet red and itchy.

Besides dry skin, a number of other conditions can cause itchiness during pregnancy. Women who already had eczema, a disease characterized by itchy, irritated patches of skin, are likely to see their condition worsen during pregnancy, while other women may get eczema for the first time while pregnant.

If itchy, red, raised patches (sometimes with tiny fluid-filled blisters in the center) appear on your abdomen late in your third trimester you probably have a condition called PUPPP (pruritic urticarial papules and plaques of pregnancy). Another name for this condition is polymorphic eruption of pregnancy. About one in 150 pregnant women wind up with PUPPP, which can spread to the thighs, buttocks, breasts, or arms. It usually only occurs in first pregnancies. It's unsightly -- and the itching may drive you crazy -- but the condition is otherwise harmless and usually goes away after your baby is born.

Less common is an itchy skin condition called pemphigoid gestationis or herpes gestationis -- oddly named, because it is not related to herpes or any other virus. It typically begins in the second or third trimester with blisters that first appear on the abdomen and then spread to other body parts. It may get better towards the end of your pregnancy only to flare up again when your baby is born or immediately afterwards.

The rash will usually go away within a few weeks or months of delivery, though in some cases it's been known to reappear with a woman's menstrual period, the use of birth control pills, or with subsequent pregnancies. The rash may look nasty, but it's not a threat to your health. However, it has been linked to premature delivery and low birth weight. If you have herpes gestationis, there's less than a ten percent chance that your baby will be born with a similar rash. If your baby gets the rash, it typically disappears without treatment within a few weeks.

Itching that doesn't go away easily should always be checked out by your doctor. If you have intense itching or itching that grows progressively worse in your third trimester (though it can appear earlier), you might have a serious pregnancy-related liver disorder called intrahepatic cholestasis of pregnancy, or ICP. The itching of ICP is usually worse on the palms of the hands and soles of the feet, and may be accompanied by nausea, loss of appetite, vomiting, fatigue, dark urine or light stools, or yellowing of the skin and the whites of the eyes. Up to seven in 1,000 pregnant women develop ICP. It is more common in Swedish and Chilean women, and about half of the women who develop ICP have a family history of related liver disease.

With this condition, the normal flow of bile -- a substance in the body that aids digestion -- is slowed or stopped. This causes a build-up of bile acids in the liver, which then spill over into the blood stream, triggering intense itching all over your body. In fact, itching may be your only clue to the condition -- you won't see a red rash or oozing lesions erupt on your skin with this disorder. The cause of ICP is not known, though pregnancy hormones are thought to be a factor. Blood tests measuring liver function and bile acids can confirm a diagnosis.

ICP can have serious consequences for your baby. It can increase the risk of fetal distress, premature birth or stillbirth. It may also increase your risk of bleeding following delivery and make you more susceptible to developing gallstones. But prompt treatment to reduce the bile acids in the body and restore proper liver function can greatly reduce the risk to both mother and baby.

Your doctor will monitor your baby carefully and may want you to deliver early to minimize health risks. The good news is that your symptoms will usually go away within a few days of delivery. Unfortunately, once you've had ICP, you're about 70 percent likely to get it again with subsequent pregnancies.

If dryness is a factor, slathering on some moisturizer may help. Try not to scratch -- it only brings temporary relief and can actually make itching worse in the long run. Avoid getting over-heated -- a case of heat rash will make your itching even worse.

Don't take long, hot baths that tend to dry skin out. Instead, soak in a lukewarm oatmeal bath, or try this home remedy: Add a cup of cornstarch and a half-cup of baking soda to your bath. Pat your skin almost dry after bathing and generously apply color- and fragrance-free moisturizer, as scents and dyes may irritate your skin further. If you don't have time for a tub soak, add a tablespoon of cornstarch and a tablespoon of baking soda to a quart of warm water, wet a towel in it, and use it as a compress on itchy areas.

Use gentle soaps and avoid skincare products with alcohol in them and limit your exposure to chlorinated water. If you live in a dry climate, try a humidifier at home to increase the moisture in your environment. Calamine lotion or other over-the-counter anti-itch creams may also help.

If you suffer from PUPPP or herpes gestationis, your doctor may suggest prescription corticosteroid creams or ointments, or in severe cases, a daily oral steroid.

-- Sarah Henry is a freelance writer whose health and parenting stories have appeared in The Washington Post, Los Angeles Times Magazine, Health, Hippocrates, Parenting, and other publications.

Further Resources

Online resource for ICP sufferers, http://www.itchymoms.com/

References

Copyright © 2005 Consumer Health Interactive

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