Prurigo – The Itchy Rashes in the Third Trimester: What Causes it? How to Treat it?

Congratulations would-be-mummy! You’ve reached the last leg of your pregnancy – the Third Trimester! Your due date is knocking at the door, and very soon you’ll be holding a cute, cuddly newborn in your arms.

Before you welcome your child into your life, you’d have to welcome the different kinds of Third-trimester pregnancy challenges. You’ll not just undergo a roller-coaster of emotions – feeling sad, crying like a baby, or smiling while thinking about your baby-to-be, but also various physical changes, like hair falling, or changes on your skin.

What Skin Changes Would You Notice in Pregnancy?

With the final trimester, comes visible changes you can detect. You might notice a few unattractive acne, dark spots, stretch marks, heat rashes, hives, pruritic urticarial papules and plaques of pregnancy (PUPPP) rashes, and prurigo are also some examples of skin changes. You might even lose the moisture and lustre of your skin.

What is Prurigo?

Prurigo are 2- to 4-mm rashes on your body, which you might notice in the Second as well as Third Trimester. 1 in 300 of you get these rashes during your pregnancy. They are mostly characterised by an intense sensation of itching and appear on your body as small and bumpy reddish or pinkish spots (as small as the tip of the pencil). They look more like pimples or insect bites, sometimes form clusters together covering a large area of your body and they are a little painful. 

Are the Prurigo Rashes Similar to Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP)?

Yes! These Prurigo rashes may be quite similar to Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) but they look more like a patch of itchy, hive-like bumps erupting on your skin as the skin stretches. (The bumps or patches may be of the same colour as your skin or may be of darker shade). But just like Prurigo, it is not harmful either to you or the baby inside you. Except for that fact, when your little one is born, he or she may have an outburst of it.

Where Do These Rashes Appear?

Prurigo or the itchy rashes appear around your abdomen (stomach) first, and spread within a few days to the buttocks, thighs, back, and then to the arms and legs. There is a feeling of itch along with the rashes. You may feel extremely itchy at night, which might be quite discomforting and disturbing for you. Insomnia during pregnancy is not uncommon, so with these disturbing itchy rashes on your body, sleeping will become more of a problem for you.

Why Do Prurigo or Itchy Skin Rashes Occur?

Prurigo or itchy skin rashes can occur anytime during your pregnancy. Experts from the medical fraternity haven’t yet been able to clarify the reasons (aetiology and pathogenesis are unknown) for the occurrence of these rashes. But the soaring hormones, immunity, and blood volume are some of the common reasons behind it.

But, you’re going to see them more and feel them when you hit the third trimester. Why?

By the time you enter the last stage of your pregnancy, you’ll have an evolved baby bump and stretchy skin. When the skin stretches, getting an itchy feeling and sensing irritation will not be an uncommon factor for you. Also, there are allergic – reactions to foetal cells in the maternal blood, as well as insufficient or poor diet, which can give rise to this unwanted disturbance on your skin.

Along with the above-mentioned reasons, there are also other factors involved. Prurigo is the result if:

• You’re pregnant with twins,
• Pregnant for the first time,
• You’ve gained more weight than usual,
• You’ve Rh-positive blood type
• You have a history of atopy (allergic rhinitis, asthma, and atopic dermatitis (eczema)), or
• If you’re carrying your baby via IVF or In vitro fertilisation.

Furthermore, severe itching may indicate an underlying liver condition. 

How Does Prurigo Impact Your Pregnancy?

You wouldn’t have to worry about the healthy state of your pregnancy because of  Prurigo. Feeling the itch may be quite discomforting to you, but it wouldn’t impact your pregnancy or the health of the life you are nurturing inside you. Why? This skin disorder or condition is in no way linked with maternal or foetal morbidity. Only some studies have shown low birth weight in your baby as an outcome of Prurigo.

What are the Recommended Treatments for Prurigo?

Every problem has its solution. So, don’t miss your doctor’s appointment. He or she will make you undergo an ultrasound scan to check whether your pregnancy health is going well or not. The doctor won’t even give checking the foetal growth a miss. After all, the baby inside your womb has started taking the position to move out of your womb.

Now that you’ve reached the healthcare practitioner with your various third-trimester problems, your skin concerns will also be taken care of. He or she has already taken notice of the rashes and will recommend both medical and home remedial treatment options for this problem.

The Medical Treatments for Prurigo or Itchy Rashes on Your Skin

Before starting the treatment, your doctor will tell you to undergo a few urine or blood tests. The healthcare practitioner wants to make sure that this disorder is not from any kind of autoimmune condition or pre-existing eczema or cholestasis of pregnancy. Once the tests are done, the doctor will suggest: 

• A few (steroidal) creams or ointment and calamine lotions, which can soothe your skin after you’ve applied it
• You can alternatively, keep your skin moisturised by applying some hypoallergenic moisturiser on your skin.

However, try not to take any over-the-counter medicines without taking your doctor’s permission.

The Home-remedies for Prurigo or Itchy Rashes on Skin

In addition to medical treatments, there are also some home remedies you can try for relief from Prurigo such as:  

• Choose baggy-fitting and cotton fabrics for daily wear. Synthetics can further irritate your skin. Cotton fabric wear will help avoid skin agitation as well as keep you cool. 
• Here’s a quick recipe for an oatmeal bath, or you can try a cool water bath.  When you’re taking an oatmeal bath ensure that you:
• Take lukewarm water
• At the end, apply fragrance-free moisturiser on your skin (This water should feel soft on your skin. However, remember to soak it a little longer so as not to leave your skin dry)

Ensure that you do not bathe excessively. Bathing excessively may worsen the problem.

• Once you’ve taken a cool bath, pat yourself dry gently with a clean towel. Avoid rigorously scrubbing or wiping with the towel so that you don’t agitate the skin further.
• Do the wet compresses. (This is a wet-wrap technique in which the first layer of tubular bandage or gauze will be wet and the second layer will dry)
• Apply essential oils or aloe vera gel. Make sure that the aloe vera gel you’re using has as few chemicals as possible.
• Keep your nails well trimmed to avoid any accidental abrasions.,
• Whenever you’re going out in the sun, apply sunscreen with an SPF 30
• Try to avoid temperate environments that cause sweating.
• Try to avoid scented perfumes, soaps, shower gels or foam bathing products
• Avoid scratching/rubbing/scraping the affected areas as it might worsen the condition.

How Long Does Prurigo Last?

It may be difficult for you to deal with this kind of itch, as it will not let you sleep. But this is a pregnancy challenge that remains unavoidable for you. Moreso, because there is hardly any way to reduce the risks for it. There is no way out except waiting with a baited heart to hold your baby in your arms and let the Prurigo go away.

In most cases, these rashes wouldn’t reoccur after your first pregnancy. But, keep visiting your healthcare practitioners so that you can make use of preventive measures well in advance.

Above all, the itchy skin rashes in pregnancy are like some of the pregnancy challenges. You might have to accept the challenges, continuously visit the healthcare practitioner, and use the treatment options to enjoy your pregnancy to the fullest.

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