What is PUPPP and how is it dealt with?

While you are pregnant, your body's chemistry ebbs and flows, mostly working for the benefit of your health and the health of your baby.  One of the less beneficial side-effects of pregnancy can be skin changes, such as PUPPP.

PUPPP stands for Pruritic Urticarial Papules and Plaques of Pregnancy.  It is a common rash that most often appears in the first pregnancy during the 3rd trimester.  Typically, PUPPP does not affect pregnancies after the first.  PUPPP typically begins in the stretch mark area of the abdomen.  It does not involve the belly button.  The rash consists of small red swollen spots inside the stretch mark that grow together to form larger spots over the abdomen.  The rash can spread to the thighs, buttocks, breasts and arms. 

The cause of PUPPP is not known.  Statistics show that 70% of women with PUPPP give birth to boys, so there is some theory that suggests that the male fetal DNA acts as a skin irritant.

The diagnosis of PUPPP is based solely on the appearance of the rash.  There are no laboratory tests necessary to detect PUPPP. Skin biopsies are not generally performed unless there is a question about the diagnosis.

PUPPP cannot be cured, but the symptoms can be dealt with.  High strength steroid creams or ointments used up to 5 to 6 times a day usually relieve the itching and prevent the spread of the rash.  Once the rash is under control, changing to a lower strength steroid used less frequently is advisable.  For severe cases, daily oral steroids may be necessary to control itching. Oral antihistamines are generally less effective for itching than steroids, but may be useful at night to help with sleep.  PUPPP will disappear once the baby is delivered.

Print Article

Send to a friend