Pupps rash is a chronic disease which affects women during pregnancy and results in a hive-like appearance of the skin. Medically, it is known as Pruritic Urticarial Papules and Plaques of Pregnancy or PUPPP and in the United Kingdom it is known as Polymorphic Eruption of Pregnancy or PEP.
Pupps rash gives intense feeling of itching and a lot of discomfort to the mother. But pupps rash does not give, a life threatening long term effect, either to the mother or to the child. Normally, pupps rash begins from the stomach and spreads to other parts of the body like chest, arms, legs, feet and neck.
Symptoms of pupps rash
Some of the symptoms of Pupps rash are given below:
- Pupps rash are of two types, viz. pupps rash, which form as papules or bumps, and the other type may result in many skin abnormalities like blisters, lesions, bumps etc. Normally, pupps rash gets cured in due course of time.
- Pupps rash normally appears as tiny solid bumps or elevations over the skin which are called papules. Even though the bumps tend to be extremely itchy, almost half of the women affected by pupps rash do not develop any other form of complication.
- Multiple forms of rashes may also develop in women with pupps rash and such polymorphic rashes include blisters which cause more redness on skin and lesions that are similar to the rashes when affected by the eczema.
- Though pupps rash first occurs on the abdomen, it does not affect the belly button, but spreads on to body parts such as breasts, under arms, legs and feet. The face remains unaffected by pupps rash
- Normally pregnancy results in skin distention or stretching of skin particularly on women carrying heavy babies, twins or triplets. Such stretched portions bear the first instances of pupps rash.
- The average lifespan of pupps rash is 6 weeks and it disappears automatically in a week or two after delivery. Pupps rash with severe itching may last for a week.
Causes and diagnosis of pupps rash
Pupps rash does not have any causative factors. It does not seem to have any link with hormonal imbalances, autoimmune disorders or abnormalities of fetus. But research studies have noted the following facts about pupps rash:
- Most of the Pupps rash cases have happened due to stretching or distention of skin. Therefore, women who are undergoing their first instance of pregnancy normally tend to get affected by pupps rash in the 3rd trimester.
- Moreover women pregnant with twins or triplets and with exceptionally large babies are more prone to get pupps rash than others, who have single babies that are of average weight and size.
- Some studies have shown that most of the women affected by pupps rash tend to deliver a male child. Biopsies of papules or the rash conclude that there is male fetal DNA present in them; thereby giving a hypothesis that a male fetal DNA acts as a factor in skin irritation.
- Pupps rash don’t do any harm either to the mother or to the child. There may have been cases of induced labor and hypertension in some women affected with pupps rash.
- There is no fixed test or diagnosis to determine the presence of pupps rash. The diagnosis is purely dependent on the appearance of pupps rash.
Treatment of pupps rash
Pupps rash during pregnancy can be treated as shown below:
- Mild cases of pupps rash can be treated by applying topical moisturizing creams or by using water based creams or other emollient.
- Moderate cases of pupps rash can be treated by applying class I or class II topical corticosteroid ointments or ointments
- Severe cases of pupps rash may warrant the intake of oral corticosteroids by the expectant mother. But such pills may have side effects which would be harmful to mother and fetus. Therefore, such drugs are prescribed by doctors only after weighing the alternatives and serious consultations with the expectant mother.
- To prevent the chronic and distressing stages of pupps rash, some women of 37 weeks pregnancy may undergo induced labor.
- In most cases, pupps rash vanishes after delivery. But in some cases where there is continued presence of pupps rash even after delivery of the child, then it may need further medication.
- The itching due to pupps rash can be reduced by oral antihistamine drugs, but such treatment is not as effective as the use of corticosteroids.
- For removing the itching, women can follow home remedies like avoiding bath in hot water, use of mild soap and use of light toweling for drying. Sometime they may go for warm oatmeal bath. As heat can increase the itching, women should avoid going out in sun and also wear only loose clothing made out of cotton and other such materials.