Pregnancy Rashes: Why They Happen and What To Do

Pregnancy can do all kinds of surprising things to your body. You were probably already expecting the expanding belly, the back pain and the morning sickness. But pregnancy rashes? What gives?

Yes, it’s true: During your pregnancy, you can come down with a serious case of the itch. But in most cases, pregnancy rashes are just a pesky side effect, not something serious.

“Rashes are uncomfortable, but most aren’t dangerous, and they go away after giving birth,” reassures Ob/Gyn Stacie Jhaveri, MD.

Here’s why they happen and tips to tame the itch.

Causes of pregnancy rashes

Some rashes are specific to pregnancy, while others can be caused by existing skin conditions. Dr. Jhaveri shares why they happen.

Hormonal changes

During pregnancy, the hormones estrogen and progesterone increase dramatically — and that’s a good thing. They help to sustain a healthy pregnancy by supporting the placenta, encouraging fetal development, and preparing your body for birth and breastfeeding.

But they can affect your skin, too.

For example, hormonal changes can cause hyperpigmentation or patches of discolored skin, like melasma (“the mask of pregnancy”) and linea nigra (a dark line down the center of your belly).

They can also make your skin drier, itchier and more susceptible to rashes.

Immune system changes

During pregnancy, you may find that your immune system doesn’t work as well as it used to. There’s a reason for that. Your body dials down its defenses.

“During pregnancy, you’re actually in an immunosuppressed state,” Dr. Jhaveri reports. “During pregnancy, your immune system adapts so your body doesn’t reject the fetus.”

That can mean that skin conditions like eczema and psoriasis flare up during pregnancy. Even if you’ve never dealt with them before.

But that’s not always the case. Some people find that their skin is clearest during pregnancy.

“Pregnancy affects everyone’s skin differently — for better or worse,” she adds.

Sensitivity

When you’re pregnant, your skin can be extra sensitive. That’s in part because you have more blood flowing through your body. And that can make your skin a little ... touchy.

It may itch more and react strongly to things that didn’t affect you much before.

“You might find that your favorite scented body wash or lotion that you used all the time before pregnancy is suddenly irritating you,” Dr. Jhaveri says.

Friction

During the course of your pregnancy, your body changes in size and shape. That can lead to chafing and stretched skin. Sweat can accumulate in skin folds (hello, boob sweat!), and your clothes can rub up against your body in ways they didn’t before. All of which can set the stage for rashes.

Types of rashes in pregnancy

During pregnancy, you’re still susceptible to everyday rashes, like allergic reactions, heat rash, infections, hives and more. But there are some rashes that are specifically tied to pregnancy.

Common pregnancy-specific rashes

Two of the most common pregnancy-specific rashes are:

• Polymorphic eruption of pregnancy (PEP, formerly PUPPP) causes red, itchy bumps or plaques that start along stretch marks and can spread to your arms or thighs. It isn’t dangerous, but it can be very uncomfortable.
• Prurigo of pregnancy causes itchy, discolored bumps with a crusty center. It’s not dangerous, but it can be irritating.

Cholestasis

A liver disease called cholestasis of pregnancy can make you feel itchy. But it isn’t technically a rash.

“Cholestasis causes a buildup of bile acids and other metabolites that make you itchy,” Dr. Jhaveri explains. “Because you’re itchy, you scratch, which can make your skin red.”

That redness isn’t a rash. It’s irritated skin from scratching.

Cholestasis is usually just bothersome. But it has the potential to be very serious and needs to be closely monitored.

Rare rashes

And then, there are the rare and serious rashes that can happen during pregnancy. They include pemphigoid gestationis (occurs in 1 in 50,000 to 60,000 pregnancies) and pustular psoriasis of pregnancy (fewer than 400 cases reported in the past 25 years). Both can be dangerous, even life-threatening if they’re not treated.

“These are extremely rare rashes that can develop during pregnancy and become very serious,” Dr. Jhaveri states. “But by far, the vast majority of pregnancy rashes aren’t harmful.”

So, rest assured, if you find that you’re dealing with a rash during pregnancy, it’s very unlikely to be anything more than an annoyance.

Coping with pregnancy rashes

Of course, it’s comforting to know that a pregnancy rash isn’t likely to be harmful, but that doesn’t mean it’s not frustrating to deal with.

Relief is in sight. Dr. Jhaveri suggests these home remedies:

• Switch to fragrance-free soaps and moisturizers.
• Avoid hot showers and tight clothing that can worsen itching.
• Stay cool and well-hydrated.
• Take oatmeal baths.
• Use 1% hydrocortisone cream.
• Take pregnancy-safe antihistamines, like loratadine (Claritin®) or cetirizine (Zyrtec®). But talk with your healthcare provider before beginning a new medication.

If the itching doesn’t improve within a day or two with home treatment, let your pregnancy provider know. They may want to run tests to check for cholestasis and to rule out other concerns. They may also talk with you about adjusting any medications you take to ensure those aren’t making your rash worse.