Skin Rashes During Pregnancy

Pregnancy induces several hormonal changes in the body if the individual. Such hormonal change also leads to changes in the skin and which in turn develops in to rashes [1].

Development of rashes can indeed be annoying for the pregnant women and there are certain types of rashes that itch and cause discomfort. However, it needs to be understood that many of the skin rashes are normal during pregnancy and should not be thought of as skin disorders [2].

Normal skin changes during pregnancy

Due to the various hormonal changes, mechanical changes and shifts in blood flow that take place during pregnancy, the skin undergoes lot of changes. Though, it is also true that not every woman would experience the same kind of changes.

Skin changes during pregnancy vary from person to person. The most common skin change experienced by majority of women is stretch marks and pigmentation of the skin. In addition, there are various other changes experienced; these include [1]:

  • Darkening of the area around the nipple, inner thighs and genitals
  • Appearance of dark patches all over the face mainly on the areas of cheek bone and upper lip. These dark patches are known as chloasma or mask of pregnancy
  • Development of a dark line on the abdomen that runs down straight to the belly button region. This is known as linea nigra.
  • It has been estimated that about 90% of women have stretch marks (striae gravidarum). During pregnancy as your abdomen and breast grows in size, the skin of that area stretches causing appearance of pinkish or reddish streaks all over the abdomen
  • Darkening of existing moles
  • Existing acne can get worse and new ones can even appear
  • Varicose and spider veins can develop
  • Development of skin tags – these are basically small, loose skin growth that appears beneath the arms and breasts.
  • Skin can glow more than before as, the body produces about 50% more blood during pregnancy

Abnormal skin conditions in pregnancy

Certain skin changes are normal during pregnancy. However, there are various other types of skin conditions that can put the mother and baby in danger. Basically there are 3 types of abnormal skin conditions that can haunt pregnant women.

Hence, it is advised, that whenever these rashes or disorders first appear, you should seek medical advice at the earliest. The abnormal skin conditions are [2]:

  • Development of rashes that are specific dermatoses of pregnancy
  • Development of Non- specific skin rashes that can occur any time
  • Occurrence of itching without rash particularly after the first 3 months of pregnancy

Why do skin changes occur in pregnancy

The woman’s body undergoes lot of changes during pregnancy and the skin is no exception [3]. Skin changes during pregnancy occur due to –

  1. Hormonal changes – The increase in the level of estrogen and melanocyte stimulating hormone (MSH) in blood causes skin pigmentation.
  2. Mechanical changes
  3. Shifts in blood flow

Are the skin changes permanent or harmful?

The skin changes that occur during pregnancy usually fade away within few months after the baby is born. The changes are not harmful and do not have any harmful effects on the mother and her baby. However, it is advised that doctor should be consulted whenever pregnant women notice unusual changes such as [4]

  • Development of blisters
  • Rashes that itch
  • Inflammation of the skin
  • Skin irritation

If these changes persist for couple of days then doctor must be consulted.

Specific dermatoses of pregnancy

Specific dermatoses of pregnancy image photo picture

Specific dermatoses of pregnancy are basically rare group of skin diseases that affect only pregnant women [5]. The various skin diseases that develop during pregnancy include the following [6]:

  • Eczema in pregnancy that occurs in the early stages
  • PUPPP (Pruritic urticarial papules and plaques of pregnancy) that occurs in the later stages
  • Impetigo herpetiformis also occurs in the later stages of pregnancy
  • Gestational phemphigoid occurs during the last trimester of pregnancy
  • Intrahepatic cholestasis of pregnancy during the last stage of pregnancy
  • Prurigo gestationis occurs in the early stages
  • Pruritic folliculitis of pregnancy occurs in the early stages
  • Spangler’s papular dermatitis of pregnancy occurs in the later stages

PUPPP – Pruritic urticarial papules and plaques of pregnancy

PUPPP – Pruritic urticarial papules and plaques of pregnancy image photo picture

  • This is one of the most common skin conditions of pregnancy characterized by chronic hives like rash.
  • In this condition the rashes first appear in the abdominal area and then spreads to the legs, chest and underarms.
  • The rashes are more likely to appear in the third trimester and women carrying multiple fetuses are more prone to contract PUPPP [7, 8].
  • The rashes are harmless and in no way affects the mother or baby.

Herpes gestationis

Herpes gestationis image photo picture

  • This is a rare autoimmune blistering disease that only strikes pregnant women.
  • Herpes gestaniosis is also known as pemphigoid gestaniosis [9].
  • This skin disease has severe complications for the mother. The mother may experience death of the affected skin and may also damage her kidneys.
  • Infants may also be born with this rash; but it gets cleared up by itself within few weeks after birth.

Impetigo herpetiformis

Impetigo herpetiformis image picture photo

  • This is an acute, but rare condition affecting pregnant ladies [10].
  • This begins during the last trimester and is characterized by small groups of blisters that develop irregularly.
  • These blisters generally appear in the groins, upper arms, beneath the knees and elbows.
  • If not treated in time, it can cause placental insufficiency and electrolyte abnormalities [11].

Papular dermatitis of pregnancy

Papular dermatitis of pregnancy image photo picture

  • Papular dermatitis is characterized by itchy rash spread all over the body.
  • The rashes appear to be raised spots that resemble insect bites.
  • These rashes can strike pregnant women at any time during their pregnancy period.
  • High doses of corticosteroids are necessary to take control over the situation.
  • So far no complications have been noticed in the mother, but studies suggest that it can cause fetal wastage [12].

Purigo gestationis

Purigo gestationis image photo picture

  • This condition is characterized by red itchy red spots during pregnancy
  • This usually occurs in the trunks, limbs and the abdominal region [13].
  • The rash completely withers off within three weeks after child birth
  • Purigo gestationis causes no complications in the mother and child

Non-specific rashes during pregnancy

Non-specific rashes during pregnancy image photo picture

Non – specific rashes of pregnancy are defined as diffused skin rash that can occur due to certain allergic reactions, reactions to certain medications or drugs. It can also occur due to certain disease conditions such as connective – tissue disorders, and systemic infections of viral, bacterial, parasitic or fungal origin.

Such rashes can strike any person at any age; however in pregnant women these take different form. The consequences of such non-specific rashes can prove harmful to both the mother and baby [14].

Itching without rash during pregnancy

Itching without rash during pregnancy image photo picture

Mild itching is considered to be normal during pregnancy. This can occur due to increased blood supply during pregnancy. However, if the itching worsens and continues beyond the first trimester then it can be a warning signal for obstetric cholestasis of pregnancy. This is basically a liver disorder and occurs in about 1 in 100 pregnancies [15, 16].

This condition brings along several complications for the mother and her baby. It increases fetal still birth rate and hence constant monitoring during pregnancy will be required.

References:

  1. http://www.mayoclinic.com/health/skin-changes-during-pregnancy/MY01810
  2. http://www.netdoctor.co.uk/womenshealth/facts/skinrash_pregnancy.htm
  3. http://medicine.yale.edu/dermatology/Images/Chapter%2028%20Skin%20and%20Pregnancy_tcm101-36915.pdf
  4. http://www.babycenter.in/a222/skin-changes-during-pregnancy
  5. http://www.medscape.com/viewarticle/707663
  6. http://en.wikipedia.org/wiki/Dermatoses_of_pregnancy
  7. http://www.ncbi.nlm.nih.gov/pubmed/17207750
  8. http://emedicine.medscape.com/article/1123725-overview
  9. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780519/
  10. http://www.kfshrc.edu.sa/annals/Old/186/97-339.pdf
  11. http://www.edoj.org.eg/vol004/0401/004/01.htm
  12. http://www.ncbi.nlm.nih.gov/pubmed/7360447
  13. http://en.wikipedia.org/wiki/Prurigo_gestationis
  14. http://medind.nic.in/jac/t10/i3/jact10i3p220.pdf
  15. http://www.nhs.uk/conditions/pregnancy-and-baby/pages/itching-obstetric-cholestasis-pregnant.aspx
  16. http://www.babycenter.com/0_itchy-skin-during-pregnancy_9450.bc

Published on January 17th, 2018 by under Pregnancy.
Article was last reviewed on January 17th, 2018.

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