PUPPPS: The Annoying Rash You Might Suffer During Your Pregnancy

What in the world is it? And what should you
When my sister was pregnant with her first child, she developed a red, bumpy rash on her belly that quickly spread to the rest of her body.

It was incredibly itchy and uncomfortable for a lady already in her third trimester who was also dealing with the usual pregnancy discomforts.  I felt so sorry for her because she couldn’t seem to find any relief from the constant itching.

When she went to her doctor, she found out she has PUPPPS or pruritic urticarial papules and plaques of pregnancy.

Neither of us had ever heard of this before. We both wanted to learn more about what it is and how to treat it.

What is PUPPPS?

As a first time mom, any illness that you experience immediately causes you to worry about the health of your baby.  Our bodies are busy growing a human, and we know that anything that happens to us can also affect our babies.

The most important fact to know about PUPPPS is that it is not dangerous for you or your baby.  This is the silver lining to the skin condition.

PUPPPS is a rash that usually starts in stretch marks on the abdomen.  It can spread over your stomach.  The rash looks like clusters of red pimple like hives.  Larger red blotches also develop.

Sometimes, like in the case of my sister, the rash can also spread to your legs and arms.  Usually, PUPPPS does not spread to the face, feet, or hands.  It typically develops during the third trimester.  According to What to Expect PUPPPS happens in one in one hundred fifty pregnancies.  While it is not common to develop PUPPPS, it is one of the most common dermatological skin issues women face during pregnancy.

PUPPPS is uncomfortable because it is incredibly itchy.  Think back to when you had chicken pox as a child or poison ivy.  All you wanted to do was itch, but you couldn’t do that without further irritating your skin.  The constant itching can make it hard for moms to sleep which we already know can be a challenge during the third trimester of pregnancy.


What Causes PUPPPS?

Doctors don’t have an exact reason why some women get PUPPPS.

Unlike other pregnancy conditions that can be traced back to changes in hormones, this doesn’t seem to be the culprit in the case of PUPPPS.   Doctors have found some commonalities between women with PUPPPS:  it usually occurs during the third trimester of a woman’s first pregnancy, and those who are expecting boys make up seventy percent of PUPPPS cases. Another trend in PUPPPS cases is women who are expecting multiples.

It is theorized that perhaps more women carrying boys experience PUPPPS because the male DNA reacts with the women’s’ bodies, causing the rash.  Another thought is that the rapid growth of the abdomen when women are pregnant with multiples causes the skin to become inflamed as stated by Bremmer, Driscoll, and Colgan.  The same theory applies if you rapidly gain weight with one child too.

Can you prevent PUPPPS?

Unfortunately, you cannot prevent PUPPPS.  Since little is understood about why PUPPPS develops, doctors can’t make any recommendations for preventing it.  The good news for first time moms with PUPPPS is that it typically does not reoccur during later pregnancies!  Moms who experience PUPPPS a second time around generally have a milder case.

How is PUPPPS diagnosed?

If you develop a rash on your abdomen, a trip to the doctor is in order.  Most doctors can identify PUPPPS just by looking at you and asking some questions.  The American Osteopathic College of Dermatology  suggests that doctors may run some blood tests to rule out other skin conditions.

How Can I Treat PUPPPS?

Bad news:  PUPPPS does not have a cure.

The only way to get rid of it is to deliver your baby.  Even then, some women continue to experience the rash for weeks after delivery.

My sister said after she had her son, the itching was much less.  She was so focused on taking care of her baby that it helped to keep her mind off of the discomfort.  The rash eventually went away.

Good news:  There are options out there to help manage the symptoms of PUPPPS.  Like other illness you experience during pregnancy, you must discuss these options with your doctor.  Some medications are not good for baby while others are safe.

Here are some ways to tame the itch:

  1. Topical Steroids: Hydrocortisone cream (one percent) can help to stop the itching.  Depending on the severity of your rash, your doctor may prescribe something stronger than what is available over the counter.
  2. Antihistamines: Benadryl can help to relieve the symptoms but check with your doctor first to make sure it is okay for you to take.
  3. Oatmeal baths: Some moms like to avoid any sort of drug while pregnant.  Soaking in the bath with oatmeal can help to soothe your skin.  I’d take advantage of this because once your little one is here, he may be graduating high school before you get to aimlessly soak in the tub again.
  4. Grandpa’s Wonder Pine Tar Soap: You can find this product here.  Fit Pregnancy suggests using this product.  While I didn’t find anything scientifically proven,  lots of moms have reported that using this soap greatly reduced their rashes and improved their symptoms.  Just make sure to get the okay from your doctor first.
  5. Cold Compress: Wet a few towels with water and keep them in the refrigerator.  At night, place a towel over your belly for some relief.  When the towel is warm and you need to get up anyway to use bathroom, switch the towel out for one from the fridge.

It can be so frustrating and discouraging to deal with PUPPPS during your pregnancy. We’ve been told that pregnancy is a wonderful experience, but when you don’t feel well, it’s hard to find that talked about excitement and enjoyment.

Remember that PUPPPS is only the first of many challenges you will face as a mom, but the entire reason you have PUPPPS is because you are bringing a sweet babe into the world.  When that sweet babe is a grumbling teenager, you can let him or her know that not only did you go through eighteen hours of labor, but you also dealt with PUPPPS.  So, he should be more than willing to take out the trash, right?

In all seriousness, hang in there mom.  While there is no quick cure, there are ways to manage the symptoms of PUPPPS.  Before you know it, you’ll be holding your baby and the itching will just be a memory.

1 comment
  1. Hello,
    A little over a year ago our son was born. About two weeks later I got postpartum PUPPP. It was THE. WORST. EXPERIENCE. but mainly because I could not seem to find anything online about how to treat it. So, after many prayers, hours scouring the Web, one urgent care doctor, two dermatologist, multiple creams (non-steroid and steroid) and pills (steroid)and one (VERY agonizing) month later I FINALLY happened upon a blog for Mothers with (postpartum) PUPPP, and like my own theory that it is hormone and stress related, one Mother also thought that it was hormone related and that stopping nursing/pumping would stop the rash. She took the leap of faith and it went away!
    So there it was, I had to make the very tough decision to stop nursing (and we had just gotten past the learning curve for nursing too, we finally had no more painful latching on!), and three days later the rash started to disappear! My husband and I were SO relieved! Thank You Lord Jesus!

    Ladies, or anyone else that has happened upon this looking for relief or just more information, there is a cure, you don’t have to suffer, yes we had to make the switch to formula and I do feel we missed out on a great nursing relationship, but our son Enoch is a happy healthy little boy and I am SO GREATFUL to have found that other Mother’s story, and thankful to know that it may not necessarily show up again with any subsequent pregnancies or births.

    A little something to take away:
    The more that we share our experiences the the more others learn and because of that the more we all grow.

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