Skin Rashes and Pregnancy: Is It Allergies or Something Else?

Pregnancy is a time of great change for your body. Along with the growing baby, pregnant people often notice other changes such as sense of smell, digestion, and even their shoe size.^1,2

Changes in hormones, blood flow, and rapid skin stretching all mean that pregnant people are especially prone to skin conditions. These can include:^1,2

• Acne
• Stretch marks
• Itchy hives

It is important to know the difference between hives from allergies and other pregnancy-related skin conditions.^1,2

Skin allergies

Atopic eruption of pregnancy is when people with a history of eczema or allergic hives have multiple flare-ups while pregnant. This most commonly occurs in the first or second trimester. People with this condition report much more frequent flare-ups than they had before becoming pregnant.²

If this happens to you, it is important to try to avoid allergens. Also make sure to tell your doctor about any allergies you may have. Over-the-counter moisturizers and emollients like Vaseline or CeraVe ointment may help soothe and moisturize hives. Other common allergy drugs often used to treat skin allergies in pregnancy include:³

• Cetirizine
• Levocetirizine
• Loratadine

Your doctor may also recommend over-the-counter or prescription steroid creams.³

Pruritic urticarial papules and plaques of pregnancy (PUPPP)

PUPPP is a very uncomfortable rash that only occurs during pregnancy. PUPPP rash looks like very itchy bumps that start in the stretch marks on your belly around the third trimester. The bumps can also spread to other parts of your body.^4,5

While PUPPP can be uncomfortable, it is not harmful to the pregnant person or their baby. PUPPP is often treated with allergy medicines and steroid creams.^4,5

Gestational pemphigoid

Gestational pemphigoid is a rash that is almost only seen during pregnancy. It is rarer than PUPPP. Gestational pemphigoid is an autoimmune disorder that causes blisters and itchy bumps around the belly button (navel). It can also move to other areas. It is often seen during the second trimester and resolves within a few weeks after delivery.^4,5

Gestational pemphigoid is usually not dangerous for the pregnant person or their baby. But in rare cases, it can cause pregnancy complications. Your doctor may recommend treating it with topical (applied to your skin) or oral (taken by mouth) steroids.^4,5

Intrahepatic cholestasis of pregnancy

The hormone changes in pregnancy can affect many different organs. Occasionally, pregnancy hormones can affect how bile flows from the liver into the intestines. If this bile backs up into the liver, you may develop a disorder called cholestasis. This can cause intense itching that starts with your palms and the soles of your feet and may spread to other areas. It is most common in the third trimester.⁵

This condition usually does not cause any damage to the liver. But it is very uncomfortable and the buildup of bile may not be good for the baby. Your doctor will likely prescribe a drug called ursodiol or ursodeoxycholic acid. This reduces the amount of bile acid in your body.⁵

If you are pregnant and experience rashes or allergy flares, speak to your obstetrician.