What is PUPPP?

PUPPP- Pruritic Urticarial Papules and Plaques of Pregnancy

Pruritic– Itch; a tingling or faintly burning skin sensation that prompts a person to rub or scratch. T20 p.1800

Urticarial– Pert. to urticaria- Multiple swollen raised areas on the skin that are intensely itchy and last up to 24 hrs; they may appear primarily on the chest, back, extremities, face, or scalp. Syn. Hives T20 p.2279

Papule– A small bump or pimple, typically larger than a grain of salt but smaller than a peppercorn, that rises above the surface of the neighboring skin. T20 p. 1585

Plaque– A patch on the skin or on a mucous surface. T20 p.1683

PEP- Polymorphic Eruption of Pregnancy

Polymorphic– Occurring in more than one form. T20 p. 1727

Eruption– The appearance of a lesion such as redness or spotting on the skin of a mucous membrane. T20 p. 735

PUPPP is an itchy rash that appears on pregnant women normally in the last month of pregnancy. It starts on the abdomen and spreads to the back, breasts, neck, buttocks, arms and legs. Symptoms normally last between 5-6 weeks but the intense itching normally lasts about a week. Mothers who are most likely to develop this rash are first time moms, carrying twins, or expecting boys. Up to 1% of pregnant women are affected. Although PUPPP is uncomfortable it is not known to cause harm to the fetus. In very rare cases the newborn may have a rash.

Currently there is no way to test for PUPPP and it is unknown why women are affected. Some theories are that the mothers are developing a resistance to fetal cells. One study found male DNA from biopsies of the lesions. Some believe that it is a hormonal reaction associated with pregnancy. Others believe it is caused by an inflammatory response to rapidly stretching skin.

Prescription Steroid creams, oral steroids and antihistamines may provide some relief. Some women have found that dandelion root and nettle tea reduces symptoms, possibly by cleansing the liver. Applying apple cider vinegar, coconut oil, and using Pinetarsol or Grandpa’s Pine Tar Oil soap may reduce itching. Avoiding heat, cool showers and ice packs may also reduce discomfort. On hot days wearing light cotton clothing may help. Women should be drinking lots of water and reducing sugar intake.


Tabers 20




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