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1. Life / Health & Healing / Medical Conditions, Procedures & Prevention

Created: 12th October 2004
PUPPPs - Itchiness in Pregnancy
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First there was Victoria Beckham, then Kate Moss and Catherine Zeta Jones, and then more recently Gwyneth Paltrow - constant reminders that pregnancy should be a time for women to blossom and look and feel absolutely fantastic, in a state of sheer and utter bliss with skin looking fuller and smoother and oozing radiance. Or so many magazines would have you believe.

For many women, pregnancy is fraught with difficulties - from morning sickness to tiredness and fatigue. Still, imagine walking into your doctor's surgery with your body looking as if boiling water has been thrown over you. A horrendous, all-over body itch has set in and is wreaking havoc with what should be the last few relaxing months before the impending birth. And worse still, your doctor tells you it's just a little pregnancy rash that is there to stay until your baby is born. In fact, everywhere you turn nobody knows anything about this horrendous rash!

Now let's not get carried away. Most expectant mums know only too well that itchiness is part and parcel of pregnancy. After all, it's to be expected as your skin is expanding rapidly trying to accommodate the newly-acquired belly that seems to march ten yards ahead of you before the rest of your body catches up.

But there's the occasional itch, and then there's the 'climbing-the-walls, I can't bear this, I want this baby out now'-type of itch.

What is PUPPPs?

It stands for Pruritic Urticarial Papules and Plaques of Pregnancy (or just itchy skin bumps). PUPPPs is a benign, harmless skin condition, but nonetheless a thoroughly annoying one, and is often very distressing for the mother-to-be. Typically characterised by a rash, which appears in the later stages of pregnancy, it tends to develop on the abdomen near the umbilical area and spreads to the arms, thighs and extremities. Often the itching becomes very intense. It can, and usually does, spread to the rest of the body but rarely involves the face. Many women compare their appearances to scalds. Others remark that the itch becomes so unbearable late at night that they must tape gloves to their hands to ensure they won't scratch themselves to the point of bleeding while they sleep.

What Causes It?

Research in America suggests that it's more common in first pregnancies and is triggered by your body's reaction to the cells of the growing foetus. In other words, you're allergic to your own baby! It's also worth noting the condition is hereditary and can be traced through the father's side. In most cases, PUPPPs disappear within a few days of delivery and rarely reoccurs in subsequent pregnancies. However, there have been exceptions to this where women have experienced PUPPPs in second, third and even fourth pregnancies.

Possible Remedies

When all is said and done, what can sufferers do to ease the terrible discomfort caused by the endless itch?

  • Wear loose cotton clothing - tight lycra has a lot to answer for!

  • Itching may be soothed by dissolving a cupful of bicarbonate of soda in your bathwater.

  • Try dabbing calamine lotion onto itchy skin - this is especially soothing if you keep the bottle in the fridge.

  • Treat sweat rashes by washing frequently in cool water and dabbing cold flannels on the rashes.

  • If a rash does not improve with these simple measures consult your doctor, as specific anti-fungal or other treatments may be appropriate. Alternatively he or she may prescribe antihistamine cream or tablets.

  • Many sufferers have reported complete elimination of the rash by taking dandelion root herbs - either as tea or in capsule form. Dandelion root is a herbal remedy that acts by cleansing the liver and ridding the body of bile acids (often the very cause of the itch). Sufferers have taken up to six capsules per day (three in the morning and three in the evening) and reported how the lesions have completely disappeared within five to seven days. Please note, dandelion contains a high level of vitamin A and high levels of this may be harmful to your growing baby, particularly in the first trimester of pregnancy.

Some women may suffer adverse reactions to dandelion; as with all medications, please consult your doctor before taking such remedies.

A Personal Perspective

One researcher describes a day in the life of PUPPPs:

PUPPPs started up when I was 34 weeks pregnant. It was by far the worst part of my pregnancy, worse than labour or delivery. The eruptions started on my hands and spread to my stomach, thighs, calves, feet, but never on my face or neck. It seemed to be very similar to hives and started to develop from underneath the skin. I saw two different dermatologists who told me it was the worse case of PUPPPs they'd ever seen.

I was climbing the walls for a good 18-20 hours a day, seven days a week. I tried lotions, moisturisers, creams, powders and peppermint, including various brand names - yet nothing helped. I concluded that chemists must have stocked up in all of the above products and were making pots of money on us women with PUPPPs, buying and trying absolutely anything they could get their hands on. The itchiness got particularly bad during the night when I would wake from my sleep scratching myself in a violent frenzy. Anyway, one night I woke at three o'clock and was itching so badly that I thought that I was almost losing my mind; I mean I was scratching myself raw, over and over, and over again. I got up at and told myself I had to find a cure. I marched over to my computer, logged onto the internet and started searching for information on the condition. What a sight I was, sitting in my shorts and T-shirt, draped in cold flannels and ice packs, all to control the itch.

I was horrified, yet at the same time almost pleased, to discover there were many others like me. In fact there were messageboards dedicated to discussing the condition, where women were tearing their hair out trying to find a miraculous remedy. Like me they had been raiding the chemists' shelves, only to find the itch returned with a vengeance within minutes. But suddenly I stumbled across a rather interesting post from one sufferer that mentioned a possible cure. A cure? I must say, it cost me a fiver but it was worth my soul because it worked! It stopped my itching within days and my rash had completely vanished within the week. I was in heaven - I didn't itch; I lay in bed night after night just waiting for the itching to start, I just knew at any moment I would be scratching like a dog infested with fleas, but it didn't happen. In fact, I actually felt kind of weird not itching. What was this cure? It was dandelion root herbs. Yep, that's right - dandelion, both as a cup of tea and as a capsule (well three in the morning and three in the evening to be exact). It's a herbal remedy, one which most medical doctors knew nothing about. I forwarded a lot of my Internet research onto the dermatologist who was shocked at my level of knowledge but seemed grateful to finally have an answer. I only hope it triggered discussion about the condition so that in the future other mothers are able to enjoy the rest of their pregnancies without itching.

On a Brighter Note, it Could be Worse...

If you experience even more itching, particularly on the palms of your hands and soles of your feet as well as your arms, legs and the rest of your body, consult your midwife or doctor urgently and ask for a blood test. It could be a symptom of a rare liver disease called obstetric cholestasis. Other symptoms of the disease may include loss of appetite and generally feeling unwell. Left untreated the disease may cause premature birth or (more rarely) stillbirth. If obstetric cholestasis is diagnosed, you will be given drugs to control the condition. You and your baby will be closely watched, and your doctor or midwife will probably recommend that your baby be delivered early. While PUPPPs is distressing, we should perhaps thank our lucky stars it's not as harmful and serious a condition as this.

Seek Medical Attention

A doctor or medical professional should always be consulted for any health issues during pregnancy to ensure that the correct treatment can be given.



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ENTRY DATA
Written and Researched by:

mightyAyesha

Edited by:

Mort - a middle aged Girl Interrupted

Referenced Entries:

Stillbirth
Human Skin
Taraxacum Officinale - the Common Dandelion
The Needs of Pregnant Women
Vitamins in Nutrition
Hives - the Causes, Symptoms and Treatments

Related BBC Pages:

BBC Health



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