Do you find yourself waking up at night to scratch more times than you do to hit the bathroom?
Our bodies go through many changes when we’re expecting — some more unexpected than others. We expand, our hair gets thicker, and yes, often our skin gets itchier.
What is all that itchy and dry pregnancy skin about? Does it mean something specific when certain body parts itch? Can it be a sign of a more serious condition?
Most importantly — what can you do to get some relief finally?
Decoding Where You’re Itchy
So, you’ve heard of your belly itching during pregnancy — but have you ever heard of itchy underarms or eyes? Believe it or not, it can happen! Feeling itchy some places during pregnancy is completely normal, while feeling it in others can be cause for alarm.
It is also important to pay attention to the severity of itching. Although mild itching is something expected and common in pregnancy if it gets too severe to bare that could be something that you and your doctor need to investigate further.
Editor's Note:Dr. Njoud Jweihan, MD
One way to understand why you’re itching is to look at the specific areas where the urge to scratch is strongest.
An itchy belly might be the least surprising itch during pregnancy — after all, it’s the part of us experiencing the most visible change. Finding your belly is itchy during this time is completely normal depending on the severity.
Not only do the high levels of estrogen in your body make you itch, increased blood supply to the skin is another culprit of the itching that most pregnant women experience. Your belly is also growing and expanding to accommodate your new baby. As that happens, your skin will lose elasticity and moisture, possibly causing it to become dry and itchy (1).
Itchy breasts are not only common; they might be one of the first symptoms of pregnancy. This is due to hormone level changes that occur after ovulation and continue to develop as pregnancy progresses.
As you go through your pregnancy, tissue growth which can lead to dryness, and increased blood flow to the breasts can also cause them to itch or even hurt.
Itchy eyes during pregnancy might be something you never considered, but the good news is it’s completely normal. Dry Eye Syndrome is a real condition that occurs when the hormonal changes in your body cause your eyes to produce fewer tears than they once did. The extra water retention that occurs during pregnancy can also spread to the eyes and cause a general feeling of skin tightness and itchiness.
This leaves your eyes feeling dry and itchy, and can even cause you to experience moments of blurred vision.
While this can be annoying, especially if you are pregnant in the summer and want to wear sleeveless tops, experiencing itchy underarms during pregnancy is completely normal.
Hormonal changes during pregnancy can trigger skin irritation. Pregnant women are also more prone to yeast infections, which can occur in your underarms and cause swelling and itching (2).
5. Hands and Feet
Itchy hands and feet during pregnancy can not only be annoying, but they may also be dangerous. If your itching is mild and occurs during the early to mid-stages of your pregnancy, chances are it’s safe and healthy.
If the itching mostly includes the palms and soles, becomes more intense, especially at night time, or comes on suddenly in the third trimester, it could be obstetric cholestasis, a much more serious condition.
When Itching May Be Serious
As you’ve now read, most pregnancy itching is entirely normal and not cause for concern.
However, there are times when itching can be a symptom of larger issues and might require a doctor’s supervision to manage.
1. Obstetric Cholestasis
Obstetric Cholestasis is a condition that occurs in the late stages of pregnancy, usually the third trimester. It occurs when your liver stops functioning properly due to increased levels of hormones that it cannot handle and doesn’t release bile like it should.
While the causes are not precisely known, it’s thought that a pregnant woman’s rising progesterone and estrogen levels overwork the liver. These hormones are at their highest levels during the third trimester, when cholestasis often occurs. This causes the levels of bile in the blood to increase and get deposited under the skin which is thought to cause the severe itch that most women experience.
Other symptoms of obstetric cholestasis include:
- Jaundice, or yellowing of the skin.
- Darkened urine.
- Pale-colored bowel movements.
- Loss of appetite.
- Nausea or vomiting.
- Pain in the upper right quadrant, with no signs of gallstones.
- Absence of rash.
If you experience severe itching in your hands and feet,
Severe itching in obstetric cholestasis can also occur anywhere on the body, it’s important to contact your doctor right away. Cholestasis is a serious condition that can result in fetal distress, preterm labor, and even stillbirth. It is thought that the effect on the baby is due to the high bile salts in the blood make the uterus more sensitive to the hormone oxytocin, which is responsible for uterine contractions.
Editor's Note:Dr. Njoud Jweihan, MD
If your doctor determines you have obstetric cholestasis, they will monitor your liver enzymes carefully throughout the remainder of your pregnancy. Obstetric cholestasis can also affect your absorption of vitamin K, the vitamin responsible for blood clotting, and your doctor might offer you a vitamin K supplement. If the condition gets too serious, they might determine an early induction is necessary for your baby’s safety (3).
PUPPP, also known as pruritic urticarial papules and plaques of pregnancy, is a condition that occurs in roughly 1 in 150 pregnancies (4). It’s a rash that normally begins on the belly, in or around stretch marks, and spreads to other areas such as the back, legs, buttocks, and arms within a few days, the face is usually spared. It also usually occurs later in pregnancy or even after delivery.
No one knows exactly what causes PUPPP, but there are several theories.
Some researchers believe it’s due to skin stretching and rapid weight gain. Others think it’s caused by fetal cells migrating to different parts of your body, including your skin cells (5). A third theory says an overworked organ system causes it.
PUPPP can occur in anyone, but is more common in:
- First-time mothers.
- Moms carrying multiples.
- Women who are Caucasian.
- Moms who are pregnant with boys.
- Moms experiencing high blood pressure.
The good news is that PUPPP is not dangerous to you or your baby. The bad news — it can be pretty annoying.
Prurigo is the name for a group of hard itchy lumps that affects about 1 in every 300 moms. It usually occurs in the second or third trimester, but has been seen in the early months of pregnancy as well. The lumps start off looking like small insect bites on the abdomen and the outside of the joints such as elbows and knees (6). The papules will increase in number with scratching and as the days go on.
Studies show that prurigo occurs more often in women who have a history of eczema and asthma. This condition is harmless to both you and your baby, and should disappear shortly after delivery. Some women find it takes a few weeks to vanish.
Talk To Your Doctor
4. Pemphigoid Gestationis
Previously known as herpes gestationis, however, it does not relate to the herpes virus. Pemphigoid gestationis is a rare condition characterized by an itchy rash that eventually develops into blisters (7). This condition is an autoimmune disease, meaning your body’s immune system is fighting against its own tissue.
This condition is actually an autoimmune disease, meaning your body’s immune system is fighting against its own tissue. It has been thought that some parts of the placenta enter the mom’s bloodstream and travel to the skin which causes formation of antibodies against the skin. There is also a correlation between pemphigoid gestationis and other autoimmune conditions that affect the thyroid and the blood.
Symptoms of Pemphigoid gestationis:
- Rash that often starts around the umbilical area or center of the abdomen.
- Can occur on the buttocks, back, arms, and legs.
- Usually spares the face, mouth, and genital areas.
- Blisters develop 1-2 weeks after the rash appears.
Pemphigoid gestationis is not fatal to your or your baby, but may cause:
- Babies to be born prematurely.
- Babies to have a low birth weight.
- Transient blistering on babies.
- Susceptibility to other autoimmune disorders in mothers.
Doctors might prescribe antihistamines, immunosuppressants, or even intravenous immunoglobulin to help get the condition under control. In most cases, although you might experience a flare of the rash just before giving birth, this condition remedies itself within days of delivery.
5. Impetigo Herpetiformis
This is a very rare skin condition and has been reported in fewer than 100 women (8).
The condition presents itself similarly to pustular psoriasis, although most women with it do not have a history of psoriasis in their families.
Impetigo herpetiformis usually occurs in the third trimester of pregnancy, and will go away once the baby is born. The rash starts as pustules that form on the edges of a red patch of skin, typically on the inner thigh or groin, and usually does not cause severe itching.
The rash may spread to the torso, back, legs, and arms, but normally does not reach the hands, feet, or face. In extreme cases, the rash may extend to the mucous membranes of the mouth and nail beds.
Women with impetigo herpetiformis will also experience symptoms such as:
If you think you might be suffering from this condition, it’s important to see your doctor right away. Early detection and treatment are important, because the disease can increase your risk of both maternal and fetal morbidity. It also important to diagnose this condition since it can recur in future pregnancies.
Mothers with this disease are also at risk for placental insufficiency, meaning the placenta is unable to give your baby the amount of nutrients and oxygen it needs to grow and thrive.
Prednisone is the typical medication used to treat impetigo herpetiformis, with the dosage decreasing slowly as the symptoms fade. If you have this condition, you will need to be closely monitored by your doctor to ensure both you and your baby’s safety.
6. Yeast Infection
Who would have thought the joys of pregnancy would also mean being more susceptible to every woman’s arch-nemesis, the yeast infection?
Higher levels of estrogen can make your vagina produce more glycogen, and affect the PH balance of the vagina, creating the perfect environment for yeast to grow. Your underarms and the area under your breasts can also be a moist place where yeast can thrive (9).
Some signs of a yeast infection are:
- Itchiness or pain in the infected area.
- Discoloration or darkening of the underarm.
- A foul or musky odor.
- White discharge coming from the area resembling cottage cheese.
- Burning when you urinate.
If you think you could have a yeast infection, make sure to keep the area in question clean and dry. You can also try taking probiotics to balance out your body’s healthy bacteria. Cleaning underarms with apple cider vinegar may help kill the yeast.
It’s important to talk to your doctor if you suspect you have a yeast infection since the symptoms are similar to the symptoms of sexually transmitted diseases. They can recommend an antifungal cream to give you some relief in 10-14 days, and run any necessary tests — yeast infections may be a sign of gestational diabetes since the increased sugar levels in the blood give the yeast nutrients to grow.
Fortunately, most itchy skin in pregnancy, in my experience, is directly related to the skin itself, namely dryness and stretching. There are things you can do to improve the hydration status (and thus the itching) of the skin.
Editor's Note:Dr. Njoud Jweihan, MD
Solutions For Dry Pregnancy Skin
In most cases, itchy and dry skin during pregnancy is completely normal — that doesn’t mean you have to suffer until your little one is born.
There are several things you can do at home to try and relieve some of the itch and discomfort:
- Stay Hydrated: By drinking at least eight glasses of water a day, you help replace some of the moisture skin loses while stretching during pregnancy.
- Avoid Scratching: Scratching might feel great in the moment, but in the end, it can cause damage. By breaking the skin and causing it to work harder to heal, you can make your dry and itchy skin worse. Scratching can also lead to infections which are even harder to treat.
- Moisturize: Sweet almond oil, Vitamin E, cocoa butter, and shea butter can nourish your skin, while helping to replace some of the moisture it loses during pregnancy.
- Avoid Hot Baths: Hot water can dry out your skin even more, making the itch worse. Instead, try to take a lukewarm bath or shower.
- Stay Away From Chemicals and Fragrances: Your skin is often more sensitive during pregnancy. If you find yourself itching after using your favorite perfume, try unscented and nature-based bath and cosmetic products until your baby is born.
- Wear Loose Clothing: Tight clothing can irritate your skin as it rubs up against it throughout the day. Choose soft and loose clothing made out of natural fibers to help you feel more comfortable.
- Try A Cold Compress: A cold compress will slow the transition of nerve signals to your brain, helping to relieve the itching sensation that can occur from either dry skin or a rash during pregnancy. Lay a washrag or towel on the affected area and put the cold compress on top. Make sure to limit the amount of time you keep it on — if left too long, it can restrict blood flow. A good rule to follow is if your skin goes numb, it’s time to take the compress off.
A Warning On Antihistamines
Antihistamines are often considered safe during pregnancy, and might be tempting if nothing seems to be helping relieve the itchy sensation of dry skin or rashes. It is especially important to be careful during the first trimester. Before you go to the drugstore, it’s always best to consult your doctor.
They will consider your medical history, and advise you about the antihistamines safest for you.
Many women don’t anticipate excess scratching or rashes to go with their pregnancy glow — that doesn’t mean it doesn’t happen. Dry and itchy skin is common in pregnancy, and plenty of women experience it.
Lucky for us, there are many ways to alleviate the symptoms and resume preparing for the arrival of your new baby in scratch-free bliss. Ensuring you drink enough water, keeping your skin moisturized, and wearing loose, comfortable clothing are all simple cures for the itch.
Always remember: if you experience excess itching or rashes of any kind, and other associated symptoms such as fever, fatigue, nausea and vomiting, it’s key to contact your doctor for assistance.