Pruritic urticarial papules and plaques of pregnancy or PUPPP is the prevalent form of niggling skin ailment during pregnancy. Classically, the onset of PUPPP during the third trimester translates to the development of reddish, scratchy bumps on the abdominal region found in close proximity to stretch marks or striae.    PUPPP generally decreases in intensity in the initial few weeks following child birth. PUPPP has no effect on the health of the newborn and has no long-standing detrimental outcome on the mother.

Who is more prone to PUPPP?

PUPPP is a widespread occurrence among pregnant women with a recurrence rate of one among every two hundred pregnant women.

PUPPP Causes

puppps rashWith reasons still blurred, it is believed that the surge in hormonal levels, skin distending or stretching and varied reactions related to the immune system are contributors to this skin condition. Figures reveal that seventy percent of women getting PUPPP deliver boys; hence there could be some conjecture that indicates that the male fetal DNA could be acting as a skin aggravator.

PUPPP generally start appearing in the third trimester and quite recurrently among first-time expectant mothers and among women who are anticipating more than one baby. PUPPP generally does not appear in women during their second or further pregnancies.

PUPPP Signs and Symptoms:

The foremost signs are reddish, scratchy bumps found close to the stretch marks spreading eventually to the other areas of the body, generally the chest, arms, legs and buttocks. It is atypical for the rash to be noted on the facial region, the palms of the hands or soles of the feet. Many of these single bumps could grow larger in size, forming raised, reddish areas resembling hives. Blister formations inundated with liquid might additionally be observed. Though the appearance of the rash could be different and vary over time, majority of the women are aggravated by the intense scratching sensation that is mostly associated with this condition. PUPPP generally subsides in nearly seven days following child birth but could vanish from a week prior to childbirth to nearly six weeks after delivery.

Self-Tending Parameters

Thick-density moisturising topical applications on the aggravated spot all through the day for averting skin drying and allaying itchiness. An over-the-counter topically applied steroid like hydrocortisone (concentration 0.5 -1%) or antihistamine like diphenhydramine, Benadryl is deemed harmless for pregnant women and could relieve scratching, though it could lead to drowsiness. Loratadine (Claritin) and cetirizine (Zyrtec) are other kinds of antihistamines which have less sedative effects and could be beneficial for the entire day.

When Medical Assistance must be sought

The widely prevalent line of treatment being offered by the doctor would be steroid cream (prescription or over-the-counter) to be topically applied. Only in acute situations, oral steroids are needed for controlling scratching. On rare occasions, in case the doctor is doubtful about the finding of PUPPP, a skin biopsy might be conducted for confirming the diagnosis.

The doctor might issue a prescription for a topically applied corticosteroid and in rare situations, oral corticosteroids might be needed.

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