Itching In Pregnancy: Is It Normal, Causes And Treatments

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Itching during pregnancy is a common complaint, especially in the third trimester. Although most itching occurs due to skin irritations that may have been triggered by several factors, itching during pregnancy is mainly caused by internal changes.

In most cases, itching occurs due to skin expansion and hormonal changes during pregnancy. Adequate moisturization is the easiest way to find relief from this condition. However, when moisturization does not help and other symptoms accompany your itching, it is advisable to consult a doctor.

Read on to know the causes of itching during pregnancy, when you should see a doctor, and natural treatments to alleviate it.

How Much Itching Is Normal In Pregnancy?

Mild itching in pregnancy is common. It could be due to dry skin paired with stretch marks. Pruritic urticarial papules and plaques of pregnancy (PUPPP) is the common cause for itching during the third trimester.

Severe itching is not normal and is usually a sign of an underlying condition. For instance, itching could occur due to a liver disease called cholestasis. Itching due to cholestasis is rare since only one to two out of 1000 pregnant women develop cholestasis (1) (2).

What Causes Itching During Pregnancy?

An increased itching sensation during pregnancy could be due to any of the following reasons (3).

  1. Stretched skin: Pregnancy is accompanied by stretching in the belly and breasts. The oil glands near these sites may struggle to keep the expanded areas moisturized. This inefficiency could result in dryness, which may cause itchiness.
  1. Hormone-related dryness: A pregnant body undergoes multiple changes, especially hormonal. These changes could also contribute to the dryness and flakiness of the skin, leading to an itch.
  1. Perfumes or fabrics: During pregnancy, your body might revolt against certain fragrances and chemicals. Certain compounds and chemicals, including those found in fabrics, could cause skin irritation on skin contact.
  1. Pruritic urticarial papules and plaques of pregnancy (PUPPP): PUPPP is a mild, gestational skin inflammation that causes rashes in the belly region. This itchy rash during pregnancy usually develops during the third trimester and may last for a few days to weeks after delivery. PUPPP is the most common pregnancy rash among first-time mothers (4) (5).
  1. Prurigo: Prurigo is an idiopathic (unknown cause) lesion that causes intense itching spots. These dome-shaped papules mostly occur during the second or third trimester of pregnancy and may cause itchiness on the legs, arms, or abdomen (6).
  1. Cholestasis: Itching during pregnancy could sometimes be a symptom of a serious liver issue, such as cholestasis (intrahepatic cholestasis of pregnancy (ICP) or obstetric cholestasis). The pregnancy-related hormonal changes may affect liver functioning. In cholestasis, there is a decreased or hindered flow of the bile acids from the liver. Cholestasis may occur during the second or third trimester and needs to be monitored by a healthcare provider (7).

Are There Natural Treatments For Itching During Pregnancy?

Natural treatments are a safe way to treat itches during pregnancy. You could try the following treatments for relief.

  1. Prefer natural fibers: Synthetic fibers may be rough on the skin during pregnancy and hinder heat release, causing heat-related rashes. Thus, wear light, breathable, and natural fabrics, such as cotton, which are less irritating to the skin (8).
  1. Try oatmeal and yogurt DIYs: Since dryness leads to itchy skin, you could try a yogurt or an oatmeal bath. These are easily available and have active moisturizing ingredients. As they are also devoid of strong fragrances, they could provide relief to your skin.
  1. Try moisturizing skin treatments: Fragrance-free and soothing lotions with vitamin E and oils of jojoba, olive, or coconut could be your go-to supplies. You could also try to moisturize often with gentle creams on dry and itchy rashes.
  1. Apply some calamine lotion: Calamine is a cooling agent for the skin. For better results, you could also cool the calamine lotion in the fridge before applying it.
  1. Stay hydrated: Drink water regularly to keep yourself hydrated. You could drink healthy soups, coconut water, or any other electrolyte prescribed by your healthcare provider.
  1. Avoid habits that dry out your skin: Hot water baths may inflame your skin and evaporate moisture in it. You could instead opt for warm water baths. Turning on humidifiers and fans in a room is also a better option as they lock the moisture in the room to soothe dry skin.

Even during times of severe itching in pregnancy, do not take any medicine without consulting a doctor first.

When Should You See A Doctor?

Itching in pregnancy is normal as long as it is due to stretching. However, if you notice the following symptoms, it is an implication to seek medical intervention (1).

1. Symptoms related to cholestasis

Pruritus of pregnancy (itching) is the main symptom of cholestasis. Palms and soles are the most commonly itchy zones, with increased intensity at night. Below are some other signs of cholestasis (1) (2).

  • Dark-colored urine
  • Pain in the lower belly
  • Fatigue
  • Anorexia
  • Jaundice (yellow pigmentation of the skin, well-observed in eyes)
  • Pale-colored stools

2. Symptoms related to PUPPP

This could cause rashes around the stretch marks. You may also observe small bumps and blisters near the rash. If the itching has become unbearable and is accompanied by blisters, it is recommended to refer to a doctor soon (4).

Can Itchiness Harm The Baby?

The general itch caused by stretching and dry skin will not affect your baby. Itching due to PUPPP and prurigo does not affect the fetus. Nevertheless, it is always better to keep your obstetrician informed about the itching sensation.

Absorption of vitamin K could decrease during cholestasis; hence there may be issues with blood clotting. This deficiency poses an increased threat of hemorrhages. Unattended cholestasis may result in premature birth or stillbirth (1). Therefore, if you develop itching with symptoms of cholestasis, consult a doctor as soon as possible.

Itching during pregnancy due to stretched skin is common and doesn’t last long as it usually subsides after the delivery. Keep your doctor informed at all times to prevent any symptoms from turning severe.

Key Pointers

  • Mild itching during pregnancy is common and arises from stretching of skin or inflammation, hormonal dryness, and certain fabrics.
  • You can manage the condition by resorting to soft fabrics such as cotton, frequent moisturizing, and staying hydrated.
  • If the itching is severe, accompanied by dark-colored urine, tiredness, or a rash, it can indicate an underlying health issue that demands medical intervention.

References:

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Dr. Ng Kai Lyn

(MMed (O&G), MRCOG)
Dr. Ng Kai Lyn is a Singapore-based obstetrician and gynecologist, specializing in urogynecology, minimally invasive surgery, and clinical interest in fertility. She has vast experience managing and treating benign gynecological conditions, including uterine fibroids, ovarian cysts, endometrial polyps, and endometriosis. She is also fellowship trained in urogynecology. She manages pelvic organ prolapse, pelvic floor reconstructive surgery, overactive bladder, urinary incontinence,... more

Sindusha MS

Sindusha is a clinical nutritionist with over two years of experience in diverse fields of nutrition. She did her Masters in Food Science and Nutrition and has qualified UGC-NET. She interned as a quality control analyst and as a dietitian during her graduation. She was a part of several community nutrition projects and a phytochemical-based nutrition study during the same... more

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