You might be happy about being pregnant but not so happy about the effects on your skin, which becomes more sensitive during pregnancy. The same hormones that help create a beautiful baby in nine months also contribute to rashes or to blotchy, itching and pimply skin. Some conditions, such as acne, are all too familiar and common, while others are seen only during pregnancy and can have more serious side effects. See your doctor any time you blossom out with a strange rash that lasts more than a day or two.
One of the most common skin reactions during pregnancy might be one you're already familiar with: the pimples you thought were gone forever with adolescence. While acne during pregnancy might not be as severe as the acne you had as a teen, it's no less annoying. Oils-plugged pores increase your chance of acne breakouts. Try oatmeal-based facial washes found at nutrition stores; they're gentle on your skin and will unplug the pores. Keep your face scrupulously clean and avoid oil-based cosmetics. Never take oral medications associated with birth defects, such as isotretinoin and other retinoids, and avoid antibiotics that can cause tooth staining in your baby, such as doxycycline or tetracycline. Topical erythromycin is considered safe in pregnancy. And, as your mom used to tell you, keep your hands off your face -- no picking!
During pregnancy, your skin often becomes dry and more easily irritated by fabrics, soaps, detergents and other substances that don't normally give you a rash. Using gentle cleaning products and moisturizing lotions helps keep your skin clear of transient rashes. You might also find yourself dipping into the baby's stash of prickly heat or heat rash remedies for yourself, as prickly heat, which often forms in skin creases of the groin and beneath your breasts, can make you miserable in the hot summer months. The increased productivity of sweat and oil glands can also cause miliaria, whiteheads caused by blocked sweat glands. Stretching skin on your abdomen can also itch.
Pruritic Urticarial Papules and Plaques of Pregnancy
This mouthful of a disorder -- pruritic urticarial papules and plaques of pregnancy, the most common pregnancy-related skin condition -- normally appears late in pregnancy. It's generally abbreviated to the acronym PUPPP. The rash of PUPPP, which affects around 1 percent of pregnant women, consists of raised, red, very itchy bumps that might be caused by fetal cells invading your skin. PUPPP doesn't affect your face; it develops mostly on your stomach and thighs, but can also spread to your buttocks or arms and legs. PUPPP may go away on its own after delivery, but topical corticosteroids can help reduce the itching.
If you spend hours scratching your skin without relief, especially in the latter part of pregnancy, you may have intrahepatic cholestasis of pregnancy, or ICP. There's no rash to be seen, but the itching can drive you nearly mad. This disorder occurs because your liver becomes less efficient at removing bile during pregnancy. When bile builds up in your skin, it causes not only severe itching but can also cause jaundice, a yellowish tint to the skin. Between 0.4 and 1 percent of pregnant women develop ICP, which can cause preterm delivery or fetal complications. See your doctor if you develop a yellowish tinge to your skin, since this could indicate serious liver conditions in addition to or other than ICP.
Serious but Rare Skin Conditions
Several very serious but rare rashes can appear during pregnancy. Impetigo herpetiformis causes blisters to form, usually in skin folds such as the groin, underarms or in the folds of knees and elbows. You will feel very ill if you develop this disorder, which can cause maternal or fetal death if not treated. Herpes gestationis is unrelated to viral herpes, but can cause lesions that range from blisters to raised dots or bumps that appear on the abdomen, arms and legs or soles and palms. This disorder often develops in mid-pregnancy and can cause kidney damage. Papular dermatitis of pregnancy causes an itchy rash that looks like bug bites; the bites crust over and can appear anywhere on your body.
Suzanne Robin is a registered nurse with more than 25 years of experience in oncology, labor/delivery, neonatal intensive care, infertility and ophthalmology. She also has extensive experience working in home health with developmentally delayed or medically fragile children. Robin received her RN degree from Western Oklahoma State College. She has coauthored and edited numerous books for the Wiley "Dummies" series.