Skin problems in pregnancy

Author: Dr Amanda Oakley, Dermatologist, Hamilton, New Zealand, 2009. Updated September 2015.

Introduction

Hormonal changes in pregnancy may result in physiological alterations in the skin, hair and nails. For example:

Pregnancy may result in an increase in prevalence or severity of some common and uncommon skin problems. These include:

When prescribing for skin diseases, safety of medicines in pregnancy must be carefully considered.

Itchy rashes during pregnancy

Itching is relatively prevalent in pregnancy. Causes include scabies, atopic eczema, contact irritant dermatitis etc. Some specific conditions that arise in pregnancy follow.

Cholestatic pruritus

Intrahepatic cholestasis affects about 1% of pregnancies. It results in unexplained pruritus (itch) during the second and third tremesters, with raised blood levels of bile acids and/or liver enzymes. Intrahepatic cholestasis is associated with:[1]

Prurigo of pregnancy

Prurigo of pregnancy (papular dermatitis of pregnancy) presents as scattered itchy/scratched papules at any stage of pregnancy. It should be managed with emollients, and topical steroids may help individual papules.

Pruritic Urticated Papules and Plaques of Pregnancy

PUPPP is an acronym for Pruritic Urticated Papules and Plaques of Pregnancy, and is also known as polymorphous eruption of pregnancy. Features include:

Pemphigoid gestationis

Pemphigoid gestationis is a rare blistering disease due to circulating IgG autoantibodies similar to those found in bullous pemphigoid, targeting a basement membrane zone protein BPAG2 (BP180) within the hemidesmosome. Features include:

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