Everything you need to know about PUPPP, the mother of all pregnancy rashes

Posted in Pregnancy Health.

Pruritic urticarial papules and plaques of pregnancy (PUPPP) rash is an itchy, uncomfortable rash that appears during the late stages of pregnancy (and keeps many a pregnant lady up at night!)

What is PUPPP rash?

PUPPP rash generally appears in the third trimester, developing in the stretch marks on a pregnant woman’s belly. It can also appear on the legs, buttocks or arms.

What causes the rash?

It’s not known what triggers the PUPPP rash but it’s thought that it may be sparked by the stretching of a woman’s skin during pregnancy. Some experts think that foetal cells state a hostile invasion of a mother’s skin during pregnancy, causing the rash. Others suggest that PUPPP may be passed down via the father’s side of the family.

The jury is basically still out.

Risk factors for PUPPP rash include: being Caucasian, first pregnancy, blood type (RH-positive may be higher risk), being pregnant with a boy, high blood pressure, rapid weight gain, obesity, family history of PUPPP or having a multiple pregnancy.

What does the rash look like?

PUPPP usually starts on the belly – amidst stretch marks – and spreads to other parts of the body (arms, legs and/or bottom) within a few days.

It begins as a collection of small, pink pimple-resembling spots that look similar to hives. These spots or splotches can join up, over time. They then form large red plaque-like areas. Sometimes blisters form around the rash.

The rash appears as small, pink pimple-like spots that appear in the stretch marks. They closely resemble hives. Eventually, the rash may start to come together and form large, red, plaque-like areas. Blisters can sometimes form around the rash.

How is it diagnosed?

Your GP can diagnose a PUPPP rash by examining your skin. Your doctor may also take some blood or a skin biopsy to be sure that your rash is not related to another infection. If you do have a rash or itchiness during pregnancy get it checked by your doctor as soon as possible.

What are they symptoms of PUPPP rash?

The PUPPP rash is uncomfortable, but it tends to be extra itchy at night, preventing a pregnant woman from getting a decent night’s sleep.

How common is it?

PUPPP rash occurs in approximately 1 in every 150 pregnancies.

Is the rash dangerous?

The rash is not dangerous and should not cause any complications for you or your baby.

How is PUPPP rash treated?

The ultimate “cure” for a PUPPP rash is delivering your baby. Usually after you give birth, the PUPPP rash will go away within four to six weeks.

Your doctor can advise you on moisturisers, bath preparations, steroid creams and antihistamines that will help to alleviate the discomfort of PUPPP.

Other things that may minimise discomfort include:

  • Avoiding hot showers or hot baths in favour of cool baths
  • Apply cool, wet compresses to the rash
  • Wear natural fibres, ideally light cotton clothing
  • Avoid going out during the hottest times of day, if possible.

Will this happen in future pregnancies?

If you’ve suffered from PUPPP rash there’s a slight chance that you could have a milder PUPPP rash recurrence if you become pregnant again.


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