Pregnancy can cause all sorts of symptoms. You may have heard of, or experienced, some of the more common symptoms such as nausea, sickness, heartburn, or fatigue. However, itching can also be an uncomfortable symptom that occurs. 

Ranging from mild to intense itching, it can happen for several reasons. If you wonder what causes itching during pregnancy, when itching is a concern, and what to do about it, then read on to find out more. 

What causes itching during pregnancy?

Mild itching is actually pretty common in pregnancy. It tends to happen for a few reasons:

• Raised levels of certain chemicals in the blood, such as hormones, can cause mild itching
• Hormone changes can also lead to skin dryness which in turn can lead to itching. Your skin can also become more sensitive to scented skin products due to hormonal changes
• When your bump grows in the later stages of pregnancy, your tummy's skin is stretched and may feel itchy
• Pregnancy-related skin conditions such as pruritic urticarial papules and plaques of pregnancy (PUPPP) or prurigo

However, when itching becomes more intense, it can signify a more serious liver problem called obstetric cholestasis (OC), also called intrahepatic cholestasis of pregnancy (ICP). So, let's take a look at this and the skin conditions that can cause itching in pregnancy in more detail. 

Signs of obstetric cholestasis (OC)

OC is a liver condition where a buildup of bile acids in the blood causes feelings of itchiness. It most commonly occurs at around 30 weeks of pregnancy. However, it can present as early as eight weeks in some women. 

As you may have guessed, the main symptom is itching. It is often very intense, but in most cases, there is no rash. Itching tends to be more noticeable on the hands and feet, but some women can experience it all over the body. Usually, the itching gets worse at night. 

As it is a liver condition, you may also notice other symptoms alongside the itching, such as:

• Lack of appetite and/or nausea
• Dark urine
• Pale/light poo
• Jaundice (yellowing of the skin and whites of the eyes)

OC can be serious, and some studies have linked OC to a higher chance of premature birth or stillbirth. Therefore, if you are worried that you may have signs of OC, it is essential to seek medical advice and support.

Signs of Pruritic urticarial papules and plaques of pregnancy (PUPPP)

PUPPP is a type of rash that appears during the later stages of pregnancy and extends from stretch marks. The rash starts as small, red, raised pimple-like dots. However, it can develop into plaques (patches of raised skin lesions) and blisters. 

PUPPP rashes tend to first appear on the stomach, particularly around stretch marks - but some women get the rash even if they don't have stretch marks.

This type of rash is intensely itchy, especially at night. It usually lasts for four to six weeks towards the end of pregnancy. It then disappears within a few days or weeks after delivery. 

PUPPP isn't dangerous, and your doctor will be able to diagnose it through a skin examination.

Signs of Prurigo

Prurigo is intensely itchy spots and bumps that appear on the arms, legs, or abdomen. The spots are often grouped together and may crust over. 

Prurigo is not dangerous and occurs in approximately 1 in 300 to 1 in 450 pregnancies. It most commonly appears in the 2nd or 3rd trimester, but women have reported it happening in all stages of pregnancy.

It's usually treated with topical steroids or oral antihistamines and clears up after the baby is born. 

What can you do to help with itching during pregnancy?

There are several ways you can help relieve pregnancy itching if you are finding it challenging to get comfortable:

• Avoid scratching
• Take an oatmeal bath 
• Avoid heavily scented skin products and change perfumes or detergents if necessary
• Wear loose clothing made from natural fabrics to help your skin breathe and stay cool 
• Use cold, wet compresses on areas of intense itching
• Use a moisturizer to help with dry skin
• Increase your water intake and stay hydrated to help prevent dry skin
• Try to keep the room cool with air conditioning or a fan
• Some people find aloe vera gel, or calamine lotion can help relieve itching

When to see your doctor or OBGYN:

Itching can be mild and harmless, but it can be a sign of OC in some cases. If your itching is:

• Distressing or relentless
• Worse at night
• Worse on the palms of your hands and soles of your feet
• Progressively getting worse

Then it is best to give your doctor a call. It's always safer to seek help early so that you can get the medical support you need.

At Colorado Obstetrics & Women's Health, we are dedicated to providing you with the highest quality OBGYN care. Our expert team of clinicians are compassionate, friendly and want to make your experience as comfortable as possible. If you are looking for OBGYN care, don't hesitate to get in touch with us by calling (719) 634-8800. 

We look forward to supporting you with all your women's health needs.