Itchy skin in pregnancy and postpartum is a common complaint. Sometimes itching in pregnancy is caused by “PUPPS Rash” and having PUPPS rash postpartum can happen after the birth of your baby. It can be a huge inconvenience when you are dealing with a newborn and lack of sleep. There are remedies that can help. This article explains what Pupps rash is, why you may continue to have the rash after delivery and what you can do to ease your discomfort.

PUPPS Rash Postpartum: What Is PUPPS Rash?

Also known as polymorphic eruption of pregnancy (PEP), PUPPS (Pruritic Urticarial Papules and Plaques of Pregnancy) can be very uncommon and only affects around 1% pregnancies. It doesn’t hurt the mother of the baby. However, it can cause quite a bit of discomfort for mom.

The rash is small bumps that erupt near the stretch marks sometime in the third trimester. Some cases may appear earlier and cover more than just the abdomen. In normal circumstances, the rash goes away just after delivery. A few of the cases may last as long as two weeks after the baby is born.

What Does It Look Like?

PUPPS rash postpartum tends to look like hives. Here are the symptoms:

• Rash consisting of bumps and redness. May spread to arms, thighs, buttocks, and breasts.
• Itching that can be severe for around a week. Itch clears before the rash.
• Stretch marks with rash around them.
• Fatigue due to lack of sleep from itching at night.

Causes of PUPPS Rash

PUPPS rash is often caused by abdominal stretching. It is also believed to be a possible allergy to a substance associated with the stretch marks that appear near the end of pregnancy. Here are some of the findings:

• The rash tends to appear simultaneously with the stretch marks in the last trimester of pregnancy.
• The first place the rash is seen is right around your belly button.
• PUPPS is seen more often in first time mothers.
• PUPPS is associated with larger weight gains in pregnancy, bigger babies, or twins.

Since the rash can spread and look like hives, it is also thought the rash may be an allergic reaction to the baby’s cells in the mother’s blood or a reaction to a chemical only seen in pregnancy.

What Causes PUPPS Rash Postpartum?

Researchers are still looking into the exact causes of PUPPS rash so until they find those, they won’t exactly know why the rash continues after the baby is born. One theory is that if the rash is caused by an allergic reaction to fetal cells in the mother’s blood, those cells may continue to circulate for a short time after delivery causing the rash to continue.

Risk Factors

PUPPS does not seem to be caused by pregnancy complications like preeclampsia, gestational diabetes, hypertension in pregnancy, or abnormalities in the baby. The condition does tend to be more common in women carrying male babies. One thought is that the male DNA causes a reaction in the mother. However, it does occur in pregnancies with a female fetus.

The one main school of thought is that when the abdomen stretches, it causes inflammation in the body and the inflammatory chemicals may be heightened because of the pregnancy.

A few of the risk factors associated with PUPPS are:

• Being overweight at the start of pregnancy
• Family history of PUPPS rash
• Rh-Positive mothers

Remedies for PUPPS Rash

There are treatments available to help relieve the symptoms of PUPPS rash postpartum and while you are still pregnant. They include:

Medical Treatments

If you develop a rash during pregnancy, talk to your OB/GYN about it. There could be other causes and it does need to be evaluated first. If your doctor determines you have PUPPS rash, the usual treatments include:

• Oral Antihistamines
• Corticosteroids, Oral
• Corticosteroids, Topical
• Moisturizers
• Coal Tar Soap

Home Remedies

The following home remedies have been found helpful in taking care of PUPPS rash postpartum at home:

• Nettle or Dandelion Tea. Drink two cups daily of the organic brand.
• Flaxseed Oil. Take two tablespoons in a cup of milk.
• Chickweed Gel. Apply 3 to 4 times daily to the affected area.
• Pine Tar Soap. Use with each shower with warm water, not hot. Works in 2 to 5 days.
• Olive Oil. Do not dry off after your shower or bath, but apply olive oil to your wet skin and then pat dry.
• Coconut Oil. Apply to the rash twice daily.
• Banana Peel. Rub a banana peel to the rash a few times a day.
• Baking Soda. Make a baking soda and water paste and apply it to the rash.
• Corn Starch. Make a paste and apply to rash areas to help relieve itching.

Experiences of PUPPS Rash Sufferers

“PUPPS is like being in hell. I had my baby 3 weeks ago and started getting the rash on my belly, knees, and breasts around one-week postpartum. My OB called a dermatologist and they diagnosed me with PUPPS rash postpartum and told me to take Zyrtec. It isn’t working at all. I had hoped after the birth of my baby all of these pregnancy symptoms would clear up. Apparently I was wrong. Since the Zyrtec isn’t working, they called me in a prescription steroid cream. I need the itching to go away and FAST! I feel like I want to dig all of my skin off.” ----Cindy

“My PUPPS rash came on when I was 37 weeks pregnant and I am now 3 weeks postpartum and still have the rash. Taking Claritin worked for me and pine tar soap in a warm shower. I tried Benadryl and it doesn’t do anything for the itching. I wore 100% cotton clothes and found Arm and Hammer cooling lotion to be very helpful. It went away in about a week.”----Karen

“I had postpartum PUPPS that began low on my legs and ankles and moved up. My abdomen started to itch the morning after my baby was born and at my one-week postpartum visit my doctor told me I had PUPPS.

Zyrtec didn’t really work for me and my doctor gave me oral steroids. It did help after about 10 days. The itch was horrible and I never want to itch that bad again. The rash is still there but the itching is gone. My doctor says it could take a few weeks for the rash to completely clear up.” ----Mary