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Understand the common causes of itchy skin in pregnancy, and if it means you're having a boy or a girl.
Itchy legs, belly, breasts or palms of your hands are all very normal in pregnancy, especially in the third trimester. Unfortunately, it's one of the many discomforts, like indigestion or jumpy legs which are often associated with pregnancy. "Itchy skin in pregnancy is common due to hormonal changes. For most women itching is mild and limited to certain areas. As pregnancy progresses it can occur where the skin is being stretched, such as the tummy," says Dr Katie Morris (opens in new tab), reader in maternal-fetal medicine at the University of Birmingham and researcher at women's health research charity Wellbeing of Women.
Itchy legs in early pregnancy may start as a minor niggle, but a persistent itch can wear you down and make you tired, restless and irritable. Itching can stop you from sleeping, and unconscious scratching can aggravate the problem even further with sore, broken skin. However, in about 1 per cent of cases, itching in the final trimester can be a sign of a serious liver condition, obstetric cholestasis (opens in new tab) or Intrahepatic Cholestasis of Pregnancy (ICP). This is a serious pregnancy complication, which requires careful monitoring. It's therefore worth paying attention to symptoms and contacting your midwife or doctor if you have a rash as well as severe itching.
If you've had itchy skin in pregnancy before, you might be wondering if you'll have it again. Not necessarily. According to research published in the Annals of Dermatology medical journal (opens in new tab), women who have had PUPPP rash or itchy skin before are not more likely to have it again.
Do itchy legs during pregnancy mean I'm having a boy?
Not necessarily. It's an enduring pregnancy myth that women with itchy palms or itchy breasts will have a boy. The internet is awash with claims that 60-70 percent of women with itchy skin will have a baby boy. However there is not robust medical evidence to support this.
Does itching during pregnancy mean I'm having twins? Yes, this could be true. Itchy skin is more common in women carrying two or more babies. Some women believe that itching in early pregnancy is a sign of twins. According to ICP Care (opens in new tab), which supports women with the condition, multiple pregnancies also appear to have a higher risk of developing ICP.
Will I get hives in early pregnancy with twins? No, not necessarily. Hives is the general name for a mild, raised skin rash which is usually an allergic reaction to food, allergens, insect bites or chemicals. Whilst women with multiple pregnancies are more likely to get a rash or itchy skin, that is not the same thing as hives or dermatitis (opens in new tab).
5 things that cause itchy skin in pregnancy
1. Skin stretching over the bump: As your baby grows and your body changes, your skin has to stretch to accommodate your expanding belly. Stretch marks are the visible sign of the strain your skin is under and itching is often another unwelcome side effect, particularly during the final trimester. You may also get itchy ankles, feet or hands which can be caused by dry skin.
2. Itchy pregnancy hormones: A rise in oestrogen creates an itchy feeling as it moves around your body, which explains why so many women suffer from itchy palms and feet.
3. Sweating: Sweat glands are needed to regulate the body's temperature and during pregnancy, particularly in the last trimester, these glands go into overdrive. Heavily pregnant women may feel sweatier than normal, especially during the hot summer months. This can, in turn, lead to heat rashes which can be very itchy.
4. Pregnancy eczema: Changes to the immune system can mean that some women who have never suffered from eczema develop it for the first time in pregnancy. Women who already suffer from atopic eczema may find it gets worse.
5. PUPPP rash: Pruritic Urticarial Papules and Plaques of Pregnancy is a bit of a mouthful, which is why the condition is commonly referred to as PUPPPs for short. PUPPPs is an extremely itchy red rash that develops in the third trimester. According to research published in the Journal of American Academy of Dermatitis (opens in new tab), PUPPs affects about 20 per cent of women. Fortunately, the condition, while madly irritating, is harmless to both mother and baby.
Doctors aren't certain what causes PUPPPs, but recent research suggests it could be as result of hormonal changes or foetal cells entering the mother's blood circulation. It could also be caused by skin stretching, especially over the bump area. The red rash first appears in stretch marks around the belly button area. It then spreads over the thighs and sometimes to the buttocks, breasts and arms. It would not normally result in an itchy vagina (opens in new tab) or an itchy bum (opens in new tab), which could be from other health issues. The rash can last up to six weeks but goes away of its own accord within a few days of giving birth. Thankfully the most severe itching normally lasts for no more than a week.
If you do develop a rash that fits this description then seek your GP’s advice. You may be prescribed topical moisturising creams or aqueous/emollient ointments. If you have a particularly severe case, you may be prescribed topical corticosteroid creams to give swift relief.
What is Obstetric Cholestasis or 'ICP'?
Obstetric Cholestasis (opens in new tab) (also referred to as Intrahepatic Cholestasis of Pregnancy or ICP) is a potentially serious liver disease that's particular to pregnancy. Often the only symptom of ICP is a persistent itch which gets worse over time. If undiagnosed and left unmanaged, the condition can result in premature delivery, foetal distress and in some cases stillbirth
The itching may be mild, but can be so severe that the sufferer scratches themselves to the point where they bleed. It is often worse at night and typically begins on the arms, legs, hands and feet.
"There are certain conditions that occur in pregnancy that women should be aware of," says Dr Katie Morris, researcher at women's health research charity Wellbeing of Women. "The most common condition is intrahepatic cholestasis of pregnancy (ICP). This is a liver condition that affects 1 in 140 women in pregnancy usually in the last trimester of the pregnancy. Women with ICP have no rash and often notice that the itching is worse at night and more noticeable on the hands and feet, but can be all over the body."
It is not clear what causes ICP but it seems that some women's livers do not respond well to the rise in oestrogen and progesterone that accompany pregnancy. This inhibits the flow of bile acids which can build up in the blood.
If you are suffering from itching during pregnancy with no rash, no obvious cause and no sign of relief, then talk to your midwife or GP. A simple blood test is all it takes to diagnose the condition. The good news is that there is no risk to your baby, and active management will significantly reduce any discomfort.
Is PUPPPs or ICP rash contagious in pregnancy? No, the rash is not contagious to your partner or other children. However, the rash may continue to spread across your body if it continues to get worse.
8 ways to stop itchy skin in pregnancy
Try one of these simple remedies to stop itching during pregnancy:
1. Moisturise, moisturise, moisturise: Dryness is the major factor in causing itchiness. Always moisturise your skin after a bath and try rubbing a specialist pregnancy oil over your bump and breasts as they grow. It's a relaxing ritual and will help prevent itchy skin too. We love My Expert Midwife's Fantastic Skin Elastic (opens in new tab) serum with geranium, lavender and vitamin E to soothe and keep the skin supple. It's a midwife-developed, mum-approved massage serum that offers relief for tight, dry, or irritated skin anywhere on your body and helps to reduce the appearance of stretch marks and scars too.
2. Over-the-counter remedies: Ask your pharmacist to recommend over the counter topical ointments which you can apply. Not all are suitable in pregnancy so do check with your midwife first.
3. Oatmeal baths: Avoid hot baths as these may dry the skin dry further. Try a cool or lukewarm oatmeal bath instead. Aveeno do readymade oatmeal bath packs, or grind one cup of oats into a fine powder in a food processor and add to your bathwater.
4. Avoid perfumed soaps: Opt for gentle, hypoallergenic, fragrance-free soaps because perfumed products can increase itchiness. Skin experts and the National Eczema Association recommend Cetaphil moisturisers, as they heal, hydrate and nourish the skin.
5. Wear natural fibres: If you find that you are sweating a lot during pregnancy, then wear looser cotton clothes. Man-made fibres like polyester will trap moisture and are more likely to provoke prickly heat outbreaks.
6. Avoid spicy food and caffeine: "Some women find that avoiding spicy food and caffeine also helps," says Dr Katie Morris, researcher at women's health research charity Wellbeing of Women. "For women whose itching is mild, some simple measures may help."
7. Soak your feet: "Soak your feet and lower legs in cool water to help reduce swelling and itchiness," advises Lesley Gilchrist, Registered Midwife and Founder of My Expert Midwife (opens in new tab). "But remember to moisturise afterwards to prevent your skin from drying out."
8. Massage feet and legs: "Find a willing partner to gently massage itchy legs to encourage the blood flow to the surface of the skin," says Lesely. "This will also enable better circulation around the body."
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