Ever heard of PUPPP rash in pregnancy?

Try saying this after a night on the tiles, Pruritic Urticarial Papules and Plaques of Pregnancy!  Also known as Polymorphic eruption of pregnancy. In short, it is better known as a PUPPP rash.

When PUPPP strikes!

Hand on heart I had NEVER heard of such a thing before my first pregnancy with Little Bean but I soon became acutely aware of it and just how painfully uncomfortable it is.  Apparently it is actually quite a common rash suffered by pregnant women, usually in their first pregnancy during the third trimester with the onset being around 35 weeks.  This is roughly when I started with it.

Managing the pain

To begin with, I thought I just had a heat rash as it was such a hot summer but nothing I tried would make it go away.  I literally felt like I had a million tiny ants crawling under my skin and it would become really hot and painful.  Throughout the day I would shower 3-4 times in an effort to cool my skin down and through the night I would attempt to sleep with a wet flannel laid on my bump and a fan blowing directly on me to keep my skin cool.  Each night I took my Nintendo DS to bed with me so that when the itching became too unbearable I could play games to keep my mind and more importantly my hands busy to stop me scratching.

Abdomen Rash

In most cases, the rash starts on the abdomen in the stretch marks, though in my case I didn’t actually have any stretch marks until after I had scratched myself until I bled!  Unlike many common rashes in pregnancy, it didn’t affect my belly button – this apparently is a distinguishing factor for the PUPPP rash.

Onwards and outwards

Once the rash has taken hold on the abdomen it begins to work its way out of the body by spreading to the thighs, buttocks, breasts and then arms.  It itches like you would not believe but actually it is harmless to both mother and baby.  It lasts for around 6 weeks with the most severe itching lasting around 1-2 weeks (and believe me that is more than long enough).

What causes PUPPP?

The cause is unknown, it is not linked to pre-eclampsia, auto-immune disorders, hormonal abnormalities or fetal abnormalities.  It has been suggested that the rapid distension of the abdominal wall can cause damage to connective tissue with an inflammatory response but it is also often associated with women carrying a baby boy and their DNA “clashing”.  Though in my case, I was carrying a baby girl so it is not necessarily the rule.

Treating PUPPP

My doctor treated me with Steroid cream after speaking with a Consultant Dermatologist who confirmed that this would be safe for me to use.  They tried low doses initially but these didn’t seem to have any effect so they increased it to a high strength steroid cream clobetasol (Temovate) or betamethasone (Diprolene) which could be used 5 or 6 times a day to relieve the itching and prevent it from spreading further. Thankfully this kept the rash manageable until it had worked its way out.

After pregnancy, I cared for my skin with stretch mark oils which helped to get my skin back into good condition again following the horrendous PUPPP rash.

Were you affected by the PUPPP rash in your pregnancy?  How did you treat it and what was your experience of this condition? Drop me a comment below, together we can help future sufferers to overcome this or make it more manageable.