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Itchy skin in pregnancy

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Woman itching her back
Itching in pregnancy can drive you nuts but in most cases it isn't serious.

However, in about 1% of women, itching in the final trimester can be the sign of a serious liver condition known as obstetric cholestasis. We tell you all you need to know about itching in pregnancy, including crucial advice on when to consult your GP.

There's nothing worse than an itch for really getting under your skin. An itch may start as a minor niggle, but a persistent itch can very quickly wear you down by making you tired, restless and irritable. Even just trying to resist the urge to scratch can drive you crazy, while scratching can aggravate the problems by adding sore broken skin to the initial irritation.

Causes of itching in pregnancy

Itching is one of the more common problems faced by pregnant women and has a number of different causes.

1. A long stretch

As your baby grows and your body changes, your skin has to stretch in order to accommodate your expanding belly. Stretch marks are the visible sign of the strain your skin is under and itching is often another unwelcome side-effect, particularly during the final trimester.

2. Hormone hell

Itchy palms? Can't stop scratching the soles of your feet? That'll be those pesky pregnancy hormones again. On this occasion it’s the rise in oestrogen which is to blame. However, in rare occasions intense itching of the hands and feet can be a sign of a obstetric cholestasis - a serious pregnancy complication which requires careful monitoring. (see below).

3. Sweaty Betty

Sweat glands are needed to regulate the body's temperature and during pregnancy, particularly in the last trimester, these glands go into overdrive. Heavily pregnant women may find themselves dripping with sweat, especially during the hot summer months. This can, in turn, lead to heat rashes which can be very itchy.

4. A (not very pleasant) topic

Changes to the immune system can mean that some women who have never suffered from eczema develop it for the first time in pregnancy. Women who already suffer from atopic eczema may find it gets worse.

5. What's PUPP?

Pruritic Uticarial Papules and Plaques of Pregnancy is a bit of a mouthful, which is why the condition is commonly referred to as PUPPs for short. PUPPS is an extremely itchy red rash that develops in the third trimester and affects around 1 in 160 women in pregnancy. Fortunately the condition, while madly irritating, is harmless to both mother and baby.

Doctors aren't certain what causes it, but recent research suggests it could be to do with foetal cells entering the mother's blood circulation.

The red rash first appears in stretch marks around the belly button area. It then spreads over the thighs and sometimes to the buttocks, breasts and arms. The only good thing about it is that it never appears on the face - small mercies we know!

The rash can last up to 6 weeks but goes away of its own accord within a few days of giving birth. Thankfully the most severe itching normally lasts for no more than a week. Strangely it is more common in women carrying twins or multiples, or those carrying a boy.

If you do develop a rash that fits this description then seek your GP’s advice. You may be prescribed topical moisturising creams or aqueous/emollient ointments or, if you have a particularly nasty case, you may be prescribed topical corticosteroid creams to help give swift relief.

6. When itching in pregnancy is more serious

Obstetric Cholestasis (also referred to as Intrahepatic Cholestasis of Pregnancy) is a potentially serious liver disease peculiar to pregnancy. If undiagnosed and left unmanaged, the condition can result in premature delivery, foetal distress and in some cases stillbirth.

It is not clear what causes OC but it seems that some women have livers which aren’t able to cope with the rise in oestrogen and progesterone that accompany pregnancy. This inhibits the flow of bile acids which can build up in the blood.

Often the only symptom of OC is a persistent itch which gets worse over time. The itching may be mild, but can be so severe that the sufferer scratches themselves to the point where they bleed. It is often worse at night and typically begins on the arms, legs, hands and feet.

If you are suffering from itching during pregnancy with no rash, no obvious cause and no sign of relief, then talk to your midwife or GP. A simple blood test is all it takes to diagnose the condition and the good news is that active management will significantly reduce any associated risks to your unborn baby. For more information visit britishlivertrust.org.uk

Treatment for itching skin during pregnancy

1. Over-the-counter remedies

Ask your pharmacist to recommend over the counter topical ointments which you can apply. Not all are suitable in pregnancy so do check first.

2. Oatmeal baths

Avoid hot baths as these may make the skin dry and itchy. Try having a lukewarm oatmeal bath instead. You prepare one yourself by grinding ordinary supermarket oats into a fine powder which you can add to your bath water, or try the Aveeno skincare range which includes a number of oatmeal-based products and preparations designed to soothe and relieve itchiness.

3. Avoid perfumed soaps

Opt for gentle, fragrance-free moisturising soaps as perfumed products can increase the itchiness.

4. Wear natural fibres

If you find that you are sweating a lot then opt for cotton clothes as man-made fibres like polyester will trap moisture and are more likely to provoke prickly heat outbreaks.

5. Moisturise, moisturise, moisturise

Dryness is the major factor in causing itchiness, so always moisturise your skin when you are fresh from the bath. We love Palmer’s Cocoa Butter Formula Massage Lotion which is available in most leading supermarkets.

Continued below...


6. A recipe for relief

If the oatmeal doesn't work, try mixing half a cup of baking powder with half a cup of corn flour and adding it to your bath water.

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