Itching in pregnancy: symptoms, causes and treatments
Juliet Blank
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Every pregnancy comes with a bunch of weird and wonderful symptoms, and for most mums-to-be itchy skin – including an itchy bump – will be one of them. Find out what causes itching during pregnancy and how you can treat it.
If you're being driven mad by itching during pregnancy, don't panic. Dry and itchy skin is very common when you're pregnant, particularly on your growing stomach.
Mild itching is usually nothing to worry about. However, if your itching is severe, it could be a sign of something more serious (particularly if it mainly affects your hands and feet).
Here are some of the common causes of itchy skin in pregnancy, treatments for itching and when to see the doctor.
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What causes itching in pregnancy?
There are a number of reasons why you could have itchy skin when you're pregnant, the most common causes are:
- Pregnancy hormones – hormone changes during pregnancy can cause extra skin sensitivity and itching. You may find your eyes become dry and itchy, too.
- Stretching skin – during the second trimester and third trimester, as your bump gets bigger and bigger, your skin will stretch but your oil glands won't be able to meet their normal moisture requirement. This can cause itching, usually on your stomach and legs.
- Environmental factors – central heating, hot baths, washing powders and perfumed products can all make your skin feel itchy.
- Eczema – if you have eczema, pregnancy hormones could affect it. Many women find their eczema gets worse when pregnant, but around 25% find it clears up completely. You may also get eczema for the first time during pregnancy.
While most itching in pregnancy is mild and isn't harmful to you or your baby, in some cases it could be a sign of a more serious condition. Particularly if you notice it more in the evenings or at night.
When should I be worried about itching during pregnancy?
Severe itching in pregnancy should never be ignored. Talk to your midwife or GP about severe itching or any new skin problems as it could be a sign of a condition that needs medical treatment such as:
- Intrahepatic cholestasis of pregnancy (ICP)
- Polymorphic eruption of pregnancy (PEP)
What is intrahepatic cholestasis of pregnancy (ICP)?
Intrahepatic cholestasis of pregnancy (ICP) is a potentially serious liver problem that can develop in pregnancy and cause severe itching. Previously known as obstetric cholestasis, studies have linked ICP to premature birth and stillbirth.
According to the British Liver Trust, every year one in 140 pregnant women develop ICP – a build-up of bile in the body due to decreased liver function.
ICP is more common in women of south Asian origin and can run in families. It usually occurs when you're around 30 weeks pregnant but can develop as early as 8 weeks.
Symptoms of ICP
- severe itching that's typically worse in your arms, legs, hands and feet
- itching which is usually worse at night and can it make it difficult to sleep
- no visible rash
- dark wee
- pale poo
- some people may have jaundice – a yellowing of the skin and eyes
Treatment for ICP
While there's no cure for ICP, it usually goes away after your baby has been born.
If you're diagnosed with ICP, you will be monitored and have regular liver function tests and measurements of your bile acid levels. Your doctor will also discuss treatment options, which could include medication to relieve the itching and protect your baby.
Your doctor will only recommend medicine that is safe to take in pregnancy.
The NHS says pregnant women with ICP are often advised to give birth in hospital under a consultant-led maternity team. In some cases, your medical team may recommend inducing your pregnancy to minimise risk to your baby. This could be anytime from 35 weeks.
What is polymorphic eruption of pregnancy (PEP)?
Polymorphic eruption of pregnancy (PEP) is a relatively common skin disorder. It's sometimes known as pruritic urticarial papules and plaques in pregnancy (PUPPP).
PEP causes an itchy, bumpy rash that usually starts in stretch marks on your abdomen. While it's extremely itchy, it's not harmful to your baby's health.
PEP is most common among first-time mums and those carrying multiples. It's also more likely to affect caucasian women and those having a baby boy.
Some studies suggest PEP is linked to rapid weight gain.
Symptoms of PEP
- Usually begins in the third trimester.
- A hive-like rash that typically starts in stretch marks on your stomach. You may also have itchy, flaky patches.
- The rash can spread to your arms, bottom and thighs but doesn't usually go above the breasts.
Treatments for PEP
PEP usually goes away after your baby has been born, but your doctor may prescribe treatments including topical steroid creams, antihistamines and, in severe cases, oral steroids.
How to soothe itching in pregnancy
If you’ve seen your midwife or doctor about your itching and been reassured that there’s nothing more serious going on, these simple measures should help reduce the itch:
- wearing loose-fitting clothes in natural, breathable fibres
- using simple, fragrance-free moisturisers – we like Aveeno Skin Relief Moisturising Lotion for very dry skin. See more details at Boots.
- avoiding long, hot baths or showers
- avoiding heavily scented body washes or perfumes
- using non-bio or ‘sensitive’ washing powders and detergents
- when the itching is bad, take a cool bath or apply some unscented lotion
- you could try a belly mask – a bit like a face mask but for your pregnant belly – said to soothe itching and inflammation as well as helping to prevent stretch marks.
It's best to avoid overly hot water anyway while you're pregnant, as raising your body temperature isn't good for your baby. As a rule of thumb, if your skin turns bright pink, the water's probably too hot.
Always return to your midwife or doctor for more advice if the itching worsens or is accompanied by a new or unusual rash.
What about vaginal itching in pregnancy?
As well as itchy skin in pregnancy, you might notice you're more itchy down below, too.
‘We all have millions of normal, healthy micro-organisms that live harmlessly in our vagina, but pregnancy can alter the pH balance down there, making thrush (yeast infections) more common,’ says NHS midwife Leah Hazard.
‘This is also more likely if you’ve been taking antibiotics for something like a urinary tract infection.
'If you experience itching or tenderness in or around your vagina or vulva, or you notice any unusual-looking or foul-smelling discharge, don’t be embarrassed – just pop along to your GP or midwife, who will be happy to do a simple swab test and prescribe some treatment.’
What to Expect When You're Expecting by Heidi Murkoff is a must-read book for all expectant parents. See more details here at Amazon.
You can also buy it here at Waterstones.
Are you suffering from itchy skin in pregnancy? Chat about other pregnancy conditions and side effects on our forum thread below …
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