Itching is a common issue during pregnancy, affecting about 40 percent of pregnant women.
It can range from mild to severe, with no rash or with visible skin changes. While often harmless, it's important to understand the different causes and when to consult a doctor.
But should itching during pregnancy become a concern?
What are the common causes of itching in pregnancy?
Normal pregnancy changes: As your belly grows, your skin stretches, which can cause dryness and itching. This is normal.
Hormonal changes: Pregnancy hormones can make your skin more sensitive, leading to itching without a rash.
Pre-existing skin conditions: Conditions like eczema or psoriasis may flare up during pregnancy, causing additional itching.
Pregnancy-specific skin conditions: Certain pregnancy-related skin conditions, like rashes or bumps, can trigger itching. An example is intrahepatic cholestasis of pregnancy (ICP).
This liver condition causes intense itching, particularly on your palms and soles, often worsening at night. It can also lead to nausea or stomach discomfort.
What common pregnancy-related skin conditions exist?
There are various skin related conditions you are likely to experience. These include:
Atopic eruption of pregnancy: This normally occurs before the third trimester. It’s normally characterised by eczema-like rashes on the face, neck, chest, or arms, and red bumps on legs and arms. The good news is that it clears up after birth.
Polymorphic eruption of pregnancy: This happens during the last weeks of pregnancy or just after birth. It is accompanied by red, itchy bumps on the belly, often near stretch marks, which may spread.
Just know that they are harmless and resolves after birth.
Pemphigoid gestationis: This occurs during late pregnancy or after birth. Symptoms include itchy bumps and blisters near the belly button, which can spread. It is usually rare, not harmful to the baby but can lead to early delivery. It is advisable to seek medical advice to avoid complications.
Intrahepatic cholestasis of pregnancy (ICP): This occurs at later stages of pregnancy. It is usually accompanied by intense itching on palms and soles, worse at night, with no rash.
This can affect your baby and lead to complications such as stillbirth or breathing problems for the baby. So, consult a doctor early to manage the symptoms and reduce risks.
Pruritic urticarial papules and plaques of pregnancy: This is very common primarily in the third trimester. Symptoms include red, itchy bumps or hives, mostly on the belly. It is not harmful to the baby and usually resolves after birth.
Tips and remedies on managing itchiness during pregnancy
It is advisable to keep your skin cool with fans or cool showers to ease itching. Avoid hot water, as it can worsen itching. Use fragrance-free moisturisers or natural oils like coconut oil to keep your skin hydrated.
Wear loose, soft clothing. Choose breathable fabrics like cotton to avoid skin irritation. Drink plenty of water to keep your skin hydrated. If itching is severe, especially on your palms and soles, it could indicate a liver condition. Consult your doctor immediately. And lastly, opt for mild, hypoallergenic soaps that won’t irritate your skin.
What to avoid if itching pregnancy
Don’t scratch: Scratching can damage your skin and worsen itching.
Avoid hot showers: Hot water can dry out your skin and increase irritation.
Don’t use harsh chemicals: Avoid skincare products with strong perfumes or alcohol, as they can irritate your skin.
Don’t ignore severe itching: If you experience persistent itching, particularly with symptoms like jaundice (yellowing of skin or eyes), seek medical attention immediately.
Recommended skin care tips
Regular moisturising helps prevent dryness, which is a common cause of itching, use sunscreen and wear protective clothing to prevent sunburn.
Stress can worsen skin conditions, so consider relaxation techniques like prenatal yoga or deep breathing and remember, a healthy diet rich in vitamins (like Vitamin E) supports overall skin health.
Treatment options for itchy skin during pregnancy
For itching caused by liver conditions like ICP, your doctor may recommend Ursodeoxycholic Acid (UDCA) to lower bile acids and reduce itching.
Antihistamines may be prescribed to help with itching relief, but always consult your doctor first. Topical steroid creams can help alleviate itching, but use them only under your doctor’s guidance.
Aloe vera gel or other cooling products can help soothe irritated skin.
While itching is common during pregnancy, it’s important to stay informed and seek medical advice if symptoms worsen.
With the right care, most cases of pregnancy-related itching can be managed safely, ensuring both you and your baby stay comfortable and healthy during this special time.
Dr Okemo is a Consultant Obstetrician Gynaecologist at Aga Khan University Hospital, Nairobi
