Pruritic Urticarial Papules and Plaques of Pregnancy. Quite nicely alliterative, but also quite tricky to pronounce. No problem; this skin condition has several aliases from which to choose.
It is also known as several other things, including:
- Nurse’s late-onset prurigo
- Bourne’s toxemic rash of pregnancy
- Toxic erythema of pregnancy,
- Polymorphic eruption of pregnancy.
But for the sake of simplicity, let’s just go with PUPPP.
What is PUPPP?
Well, for starters, it is the most common dermatology problem directly related to pregnancy.
A PUPPP rash occurs almost always in a first pregnancy or in multiple pregnancies (twins, triplets, etc.) So, most pregnant women have to endure it only once. And PUPPP is benign. Although it can make your pregnancy a thoroughly miserable experience, it will not present any long-term danger to either you or your child.
What does pregnancy rash look like?
PUPPP usually delays its emergence until the third trimester of pregnancy, when a mom-to-be’s abdomen has become significantly distended.
The hive-like rash appears as small, pink pimple-like spots that appear in the stretch marks. It usually spreads into the upper thighs and buttocks and ultimately extend over a woman’s, back, torso, arms, and breasts. And it itches. Fiercely.
What causes PUPPP?
That’s a good question, and one without any definitive answer. The bumpy rash of PUPPP generally begins in the striations (stretch marks) that appear on an abdomen swollen with child.
The symptoms are worse in multiple pregnancies and those with an unusual amount of weight gain. So, some sources blame PUPPP on inflammation brought on by excessive stretching of the skin’s connective tissue. Others point to an allergic reaction to the fetal antigens circulating through the mother’s blood system.
Some signs even point to a genetic link. Who knows? Your baby’s gender may also play a role. 70s% of PUPPP sufferers give birth to a boy.
What are PUPPP symptoms?
“Pruritic” means itchy, and intense itchiness is the sensation most commonly associated with PUPPP. A PUPPP itchy rash can be mean enough to demand unrestrained scratching, which can, in turn, cause some level of pain.
What is PUPPP rash treatment?
The most reliably effective cure is simply to deliver your baby. PUPPP generally resolves soon after birth. But that PUPPP itchy rash can be vicious preterm, and you’re for sure going to require some symptomatic treatment well before delivery.
- A combination of over-the-counter topical corticosteroids, like hydrocortisone creams, and oral antihistamines, such as Benadryl, will generally provide significant relief. When the itching is severe enough to interfere with sleep, a short course of systemic corticosteroids, like prednisone, can be helpful.
- Use moisturizers. Regular use of emollient lotions will help alleviate the dryness that contributes to the misery of PUPPP.
- Cold compresses and oatmeal baths can provide some relief. A tepid bath with added baking soda can also help.
- And, as difficult as it may be, try to refrain from scratching that darn itch.
Don’t ignore any rash during pregnancy!
Even though PUPPP itself is ultimately benign, it can mimic far more serious conditions. As just one example, the symptoms of PUPPP can overlap with those of urticarial pemphigoid gestationis. This nasty condition can be life-threatening to both mother and child. So, consult with both your obstetrician and your dermatologist about any and all rashes that you contract during your pregnancy.
About Dr. Thaïs Aliabadi
As one of the nation’s leading obstetricians, Dr. Thaïs Aliabadi offers the very best in gynecology and obstetrics care. Together with her warm professional team, Dr. Aliabadi supports women through all phases of life. She fosters a special one-on-one relationship between patient and doctor.
We invite you to establish care with Dr. Aliabadi. Please click here to make an appointment or call us at (844) 863-6700.