What does early pregnancy rash look like?

Reviewed by Brunilda Nazario, MD on September 14, 2020

Along with the obvious changes that your body goes through during pregnancy, the surge in hormones also affects your skin. Most of the skin conditions seen in pregnancy will disappear after you have your baby. There are three categories of skin conditions during pregnancy:

  • Hormone-related
  • Preexisting
  • Pregnancy-specific
  • Hyperpigmentation. This condition is a darkening of the skin and is caused by an increase in melanin, the substance in the body that is responsible for color (pigment). Pregnancy causes more melanin in your body.
  • Melasma (also known as chloasma). Melasma is a form of hyperpigmentation. It causes tan or brown patches, usually on the face. This condition is so common among pregnant people that it's called "the mask of pregnancy."
  • Pruritic urticarial papules and plaques of pregnancy (PUPPP). This is an outbreak of pale red bumps on the skin. These lesions can cause itching or may burn or sting. They can range in size from a pencil eraser to a dinner plate. When they form together in a large area, they are called plaques. In pregnancy, these lesions can appear on the abdomen, legs, arms, and buttocks.
  • Stretch marks. Skin that’s been stretched by pregnancy or weight gain, or shrunk by extreme weight loss, bears a type of scarring called stretch marks, or striae. Stretch marks usually start off reddish or purplish in color, then turn glossy and streaked in silver or white.
  • Skin tags. A skin tag is a small flap of tissue that hangs off your skin by a connecting stalk. Skin tags are benign, meaning they are not cancer. You’ll usually find them on your neck, chest, back, under your breasts, and in your groin. They’re common in pregnant people and usually painless unless something rubs against them.
  • Acne, psoriasis, atopic dermatitis. All of these conditions can worsen with pregnancy. They should improve after the birth of the baby.
  • Varicose veins. Hormone changes during pregnancy can cause these twisted, enlarged veins mainly found in your legs.
  • Prurigo of pregnancy. These are scattered itchy bumps that can happen at any stage of pregnancy.
  • Pemphigoid gestationis.Blisters appear on your belly and could spread to other areas. This condition may boost your odds of complications, including preterm birth.
  • Intrahepatic cholestasis. This liver condition causes itching, but no rash, on the palms of your hands and soles of your feet. It can lead to preterm birth. If you have it, contact your doctor.

As noted, most of these skin conditions will clear up on their own after the baby is born. If they don’t go away, or if you want to do something about them during pregnancy, there are treatments available. Don't use any medication or treatment while you are pregnant without talking to your doctor.

  • Melasma. You can use certain prescription creams (such as hydroquinone) and some over-the-counter skin care products to treat melasma. But talk to a dermatologist for a proper diagnosis before you choose to treat it yourself. If you have melasma, try to limit your time in sunlight, especially between the hours of 10 a.m. and 2 p.m. Use a sunscreen with an SPF of at least 30 when outside.
  • PUPPP. Your doctor may prescribe an antihistamine or topical corticosteroids. For relief, you should wash with lukewarm (not hot) water, apply cool compresses or wet cloths to the affected areas, and wear loose, lightweight clothing. Don’t use soap on involved skin, since it will cause more dryness and itching.
  • Stretch marks. Wait until after your baby is born before seeking treatment for stretch marks. There isn’t a proven treatment, but sometimes laser or prescription creams can help.
  • Skin tags. Your doctor can remove skin tags by cutting them off with a scalpel or scissors, or with electrosurgery (burning them with an electric current).
  • Prurigo of pregnancy. You can manage this condition with moisturizers and topical steroids.
  • Intrahepatic cholestasis. Some treatment options include medications to stop your itch and reduce bile. Cold baths and ice water can also help.
  • Pemphigoid gestationis. Your doctor will prescribe topical or oral corticosteroids for this condition.
  • Pruritic folliculitis. You can relieve your symptoms with benzoyl peroxide, moisturizer with menthol, steroid cream or ointment that you apply to your skin, and oral antihistamines.
  • Pustular psoriasis of pregnancy (PPP). This life-threatening condition is hard to treat. In mild cases, doctors use a low dose of corticosteroids. Serious cases will need a higher dose, which can harm your baby.

There are a few natural ways to relieve itchy skin when you’re pregnant:

  • Apply a scent-free lotion or moisturizer.
  • Wear loose clothing that’s less likely to irritate your skin.
  • Wear clothes made of natural fibers like cotton.
  • Take a cool bath.
  • Put ice on your skin.
  • Take an oatmeal bath once or twice a week.
  • Avoid hot baths or showers, which can dry your skin out.
  • Try not to go out in the heat of the day.

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There are a number of changes you may see in your skin, hair, and nails during pregnancy. Some occur in response to shifts in hormone levels or certain triggers. Others aren’t as easily explained.

Rashes can appear anywhere on the body and may look or feel different depending in the cause. Some rashes are benign, meaning they don’t pose any threat to you or your baby. Others may be a symptom of an underlying condition that requires medical attention to keep you and baby safe.

Noting the symptoms you experience is important for identification and treatment. The good news is that there are often things you can do at home to help soothe your skin and itch. And many rashes go away on their own after you deliver your baby.

Pruritic urticarial papules and plaques of pregnancy (PUPPP) is a rash that typically develops in the third trimester. Around 1 out of 130 to 300 people develop PUPPP. It may first appear as itchy red patches on the stomach, especially near stretch marks, and may spread to the arms, legs, and buttocks.

Treatments for PUPPP include topical corticosteroids, oral antihistamines, and oral prednisone. PUPPP is more common with first pregnancies or those with multiples and tends to go away after delivery. It doesn’t affect your baby.

Prurigo of pregnancy can happen in the first, second, or third trimesters. Approximately 1 out of 300 people may experience this rash, and it can last for weeks to months after delivery. You may see itchy or crusty bumps on the arms, legs, or abdomen.

Treatment for prurigo of pregnancy involves topical steroids and oral antihistamines. Moisturizers may also help. While the rash should go away soon after delivery, some people may continue to have symptoms. The condition may also show up in future pregnancies.

Intrahepatic cholestasis of pregnancy is most commonly seen in the third trimester. It’s a sign of liver disease caused by hormones. An estimated 1 out of every 146 to 1,293 people may experience cholestasis during pregnancy.

While there isn’t necessarily a rash, itching can be quite severe over the entire body, but particularly on the palms of the hands and soles of the feet. You may even notice yellowing of the skin and eyes and have trouble sleeping due to itching.

While this condition usually resolves after delivery, it’s important to see a doctor for treatment during pregnancy. It may put you at risk for preterm labor. It can also put your baby at risk for stillbirth or lung issues from breathing in meconium.

To treat cholestasis, your doctor may prescribe a medication called ursodiol to help lower the bile level in your blood. Your doctor will also likely schedule extra appointments to monitor your baby, such as nonstress tests and biophysical profile, and possibly suggest early induction in certain cases.

Also referred to as pemphigoid gestationis, herpes gestationis is a rare autoimmune skin disorder that affects 1 out of 50,000 people in the second or third trimesters.

The hive-like rash may come on suddenly and appear first on the trunk and tummy. It can spread within a few days to weeks as the bumps turn to blisters or large raised plaques. Find pictures of the condition here.

Your doctor may prescribe topical or oral corticosteroids to treat herpes gestationis. Otherwise, it tends to go away on its own after you have your baby.

Talk to your doctor about what’s best for you, as it can lead to low birth weight or early delivery of your baby. Like prurigo, it may come back in future pregnancies.

Pruritic folliculitis begins as lesions on the torso and may spread to other parts of the body. The lesions contain pus, so they may resemble acne. This rare condition appears in the latter two-thirds of pregnancy and usually lasts between two and three weeks. It doesn’t impact your growing baby.

The exact cause of pruritic folliculitis is unknown, and it generally resolves after delivery. Treatments include ultraviolet B light therapy, topical corticosteroids, or benzoyl peroxide.

Pustular psoriasis, specifically impetigo herpetiformis, generally occurs in the second half of pregnancy. The rash can develop on any part of the body and may be very red, inflamed, and crusty. Other possible symptoms include:

  • nausea and vomiting
  • diarrhea
  • fever and chills
  • lymph node issues

Treatment involves corticosteroids, such as prednisone, and antibiotics if lesions become infected. While impetigo generally goes away after delivery without much reported risk to baby, at least one study links this rare condition to stillbirth.

Hives are raised bumps that appear alone or in clusters of red spots or patches. They can appear anywhere on the body and are itchy. You may even feel like they’re burning or stinging.

Hives may appear suddenly and go away just as fast or within a few days to six weeks. They’re caused by histamine in the body in response to things like emotional stress, hormone changes, or infections. Sometimes they may be a sign of allergic reaction to food, insect bites, pollen, or other triggers.

It’s important to rule out allergic reaction with hives, particularly if you have other symptoms of anaphylaxis, such as:

  • a rapid pulse
  • swollen tongue
  • tingling in your hands, feet, or scalp
  • difficulty breathing

Treatment may involve taking antihistamines, corticosteroids, or taking medications to help with inflammation. However, if you’re also having signs of anaphylaxis, get to an emergency room immediately.

Prickly heat or heat rash can develop anywhere on the body, usually due to excessive sweating. Because pregnancy can increase your body temperature, you may be more prone to heat rash during this time.

Along with an itchy or prickly feeling, you may see small spots, redness, and even swelling. Identify heat rash with the help of these pictures. This type of rash generally clears within a few days after it starts and doesn’t pose a threat to your baby.

Heat rash doesn’t necessarily require specific treatment. You may try antihistamines or calamine lotion. What also helps is staying cool and avoiding activities that produce sweating.

Over-the-counter medications called antihistamines can help with cases of hives, herpes gestationis, and other conditions that come about from a rise of histamine. Recent studies haven’t linked use of antihistamines with birth defects.

Speak with your doctor about these options before taking them on your own:

  • Cetirizine (Zyrtec), fexofenadine (Allegra), and loratadine (Claritin) are non-drowsy and better to take during the day.
  • Benadryl is better taken at night to help with itching and sleep.

Lather pine tar soap

Popular blogger and pregnancy expert Mama Natural explains that pine tar soap is a tried and true home remedy for PUPPP. Pine tar soap has a strong odor, but its antiseptic quality makes it a popular choice to help with various skin conditions, including psoriasis.

Consider using the soap while bathing with lukewarm water up to four times daily on affected areas. Some people report that this method relieves itching within a few hours.

Try an oatmeal bath

To further soothe itchy skin, try taking an oatmeal bath. Simply pour 1 cup of rolled oats into the center of a piece of cheesecloth and secure with a rubber band. Place it in a tub of warm water and then squeeze to release the milky, oat-infused water.

Oats help to moisturize the skin. Soak yourself in the tub for around 20 minutes for the best results.

Stay cool

For conditions like heat rash, it’s important to cool off, preventing sweat and overheating. These tips may help:

  • Wear loose clothing made from natural fibers, such as cotton.
  • Keep bedding lightweight and breathable.
  • Take showers and baths with cool water versus warm.
  • Stay hydrated by drinking water and other non-caffeinated fluids.

Moisturize

Itchy skin impacts some 20 percent of people in pregnancy. The most common cause is dry skin. Keeping skin hydrated — particularly sensitive areas, like around stretch marks — is key. Choose fragrance-free formulas and apply liberally after bathing or showering.

Check out these 10 best moisturizers for dry skin.

Cetaphil Moisturizing Cream and Eucerin Advanced Repair are highly rated and recommended by dermatologists.

You may even want to keep your moisturizer in the refrigerator for added cooling relief.

Tell your doctor if you’re experiencing a rash or any new symptoms during your pregnancy. In many cases, symptoms will respond well to home treatment and the condition itself will resolve after you give birth to your child.

That said, other symptoms — intense itching, yellowing of the skin, pain, or fever — are warning signs of conditions that require medical attention.

It’s a good idea to contact your doctor whenever you have concerns about your health or your baby’s health.

At your appointment, your doctor will likely examine your rash and ask questions about how it started, how it’s spread, and how long you’ve been experiencing issues. They’ll also ask about any other symptoms you’re experiencing to help determine the root cause.

You may have additional tests depending on the rash. For example, a blood test can check for bile levels or infection. Allergy tests — skin or blood — may help with identifying rashes caused by triggers, like hives. You may even have a skin biopsy so your doctor can evaluate the rash under a microscope.

Some conditions, like cholestasis, may have a genetic component or be related to previous liver disease or being pregnant with multiples. Make sure to mention anything about your personal or family medical history that might help with identification, even if it doesn’t seem significant.

Skin rashes aren’t considered an early pregnancy symptom. In fact, many rashes don’t appear until later pregnancy.

Instead, look for symptoms like increased urination, breast tenderness, nausea or vomiting, fatigue, and missing your regular menstrual period. Check out this list of 15 early pregnancy symptoms as well.

Hormone shifts can cause a variety of changes, however, so this doesn’t mean a new rash isn’t related to possible pregnancy. If you suspect you might be pregnant, consider taking a home pregnancy test or visiting your doctor for a blood test to confirm.

Not sure if your rash is something to worry about? Call your doctor. Most common rashes during pregnancy will go away on their own after your baby is born.

You can find relief with home treatments or see your doctor for pregnancy-safe oral and topical medications. In rare cases, you may need additional testing and monitoring or early induction to keep you and your baby safe.

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