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PUPPP Is an Itchy Rash Throughout Being pregnant

Are you pregnant and experiencing a rash in your physique? Pruritic urticarial papules and plaques of being pregnant (PUPPP), also called polymorphic eruption of being pregnant, is the most typical rash in pregnant girls.

The situation will also be known as PUPPS or PEP. It usually happens in a girl’s first being pregnant, in the course of the third trimester (with a median onset of 35 weeks), or to mothers-to-be who’re carrying multiples. Fortunately, PUPPP doesn’t often have an effect on subsequent pregnancies.

Look of PUPPP

The rash of PUPPP virtually at all times begins within the stretch marks (striae) of the stomach. It doesn’t contain the stomach button, which is how medical doctors are in a position to distinguish the signs from different widespread rashes of being pregnant.

The rash consists of small, pink, itchy bumps within the stretch marks that develop collectively to kind bigger ​wheals on the stomach. Typically the rash can embrace small vesicles (clear, fluid-filled bumps). Over a interval of a number of days, the rash can unfold over the thighs, buttocks, breasts, and arms.​

This situation is innocent to the mother-to-be and the infant, however it may be very annoying.

The rash is pruritic (an disagreeable sensation of the pores and skin that provides you the urge to scratch it), therefore its title. It lasts a median of 6 weeks and resolves by itself 1 to 2 weeks after supply. Essentially the most extreme itching usually lasts for not more than 1 week.


The reason for PUPPP is unknown. It’s not related to preeclampsia, autoimmune problems, hormonal abnormalities, or fetal abnormalities. Though increased ranges of the male fetal DNA may be present in pores and skin biopsies of the rash.

Pregnancies with elevated maternal weight are additionally related to PUPPP, inflicting some researchers to counsel that the fast stomach wall development and stretching damages connective tissue, inflicting an inflammatory response.


There are not any laboratory checks that detect PUPPP, so the analysis of PUPPP is scientific, that means it’s primarily based solely on the looks of the rash. Pores and skin biopsies aren’t usually carried out except there’s a query in regards to the analysis.

Therapy for PUPPP

The remedy of PUPPP is symptomatic. Because of this treatment is given to alleviate the rash and scale back itching, together with the next.

  • Excessive-strength steroid lotions: Ointments could also be prescribed to alleviate itching and stop the unfold of the rash.
  • Decrease-strength steroid lotions: As soon as the rash is beneath management, altering to a lower-strength steroid that is used much less often is advisable.
  • Oral antihistamines: Atarax, Benadryl, and Zyrtec are usually much less efficient for itching than steroids however could also be helpful at night time to assist with sleep.
  • Oral steroids: Usually averted throughout being pregnant, oral steroids could also be vital to regulate itching for very extreme circumstances. Your physician can also take into account inducing labor (if you’re near your supply date and the itching is excessive) as a substitute of beginning you on a dose of oral steroids.

A Phrase From Verywell

Maintain this in thoughts: Whereas it is irritating and uncomfortable, PUPPP does clear up inside a few weeks after supply. It additionally poses no long-term hurt to you or your child.

Verywell Household makes use of solely high-quality sources, together with peer-reviewed research, to assist the information inside our articles. Learn our editorial course of to study extra about how we fact-check and maintain our content material correct, dependable, and reliable.

Further Studying

  • Brzoa, Z., Kasperska-Zajac, A., Oleś, E., Rogala, B. (2007). Pruritic urticarial papules and plaques of being pregnant. J Midwifery Womens Well being, Jan-Feb, 52(1), 44-8.
  • Tunzi, M., Grey, G.R. (2007). Frequent Pores and skin Circumstances Throughout Being pregnant. Am Fam Doctor, Jan, 75, 2, 211-18. 

By Heather L. Brannon, MD

Heather L. Brannon, MD, is a household observe doctor in Mauldin, South Carolina. She has been in observe for over 20 years.

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