What’s PUPPP?

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PUPPP is a pregnancy rash that causes itchy, red, hive-like bumps, usually starting on the abdomen and spreading to other parts of the body. It poses no threat to the mother or baby, but can be uncomfortable. The cause is unknown, but it is more common in first pregnancies and those carrying twins. Treatment should be monitored by a doctor and may include topical steroid creams, antihistamines, and home remedies such as baking soda or oatmeal baths.

PUPPP is an acronym for pruritic urticarial papules and plaques of pregnancy, also known as pregnancy rash or polymorphic eruption of pregnancy. PUPPP is a rash that occurs in a small percentage of pregnant women. It is usually very itchy and causes multiple red, raised, hive-like bumps. It usually starts on the abdomen, then can spread to other parts of the body and most often starts in the third trimester of pregnancy.

The rash that develops with PUPPP is extremely itchy, in fact the word pruritic in the name refers to itching. It consists of many small, slightly swollen, red lumps and is usually first noticed on stretch marks, if any. From there the rash spreads rapidly to the rest of the abdomen, but does not develop on the navel. As it spreads, larger raised red patches that look like hives may develop. After a few days, it frequently spreads to other areas of the body, such as the chest, arms, buttocks, and thighs. However, it doesn’t affect the face.

Having PUPPP poses no threat to the mother or the baby, but it can make the mother very uncomfortable. When it does occur, the first symptoms are commonly noticed during the third trimester, on average during the 35th week, and last for the rest of the pregnancy. The itching is usually quite intense, especially during the first week. The rash and itching usually go away within the second week after delivery, but in rare cases they can last longer or even start after delivery.

There is no clear answer to what causes PUPPP, although there are several theories. It appears to affect women in their first pregnancy and those carrying twins, more often than the rest of pregnant women. One theory of the cause is that it is genetics on the father’s side. Another theory is that fetal cells invade the mother’s skin and cause the rash. If a woman suffers from PUPPP during one of her pregnancies, she is not as likely to experience it again.

Care should be taken when treating PUPPP symptoms, consult a doctor. Oral steroids should not be used due to potential harm to the baby. Topical steroid creams or ointments can be used in carefully monitored small doses and may provide relief. Antihistamines are generally considered safe and can be used if advised by a doctor. Some home remedies that may bring some comfort include baking soda or oatmeal baths, aloe vera gel, or cold compresses.




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