PUPPS rash – Pictures, Causes, Treatment, Diagnosis


Pruritic Urticarial Papules and Plaques of Pregnancy rash or PUPPS rash is a skin condition that develops during pregnancy. Pregnant mothers expecting a baby for the first time are the ones mostly affected by this skin problem. Usually, the PUPPS rash appears on the 7th to 9th month of pregnancy or the third trimester of pregnancy. This rash starts around the stretch marks in the abdomen area.  And then red and hive-like rashes will begin to grow on the area until they become a big rash covering the whole abdomen. The rash can also form into small blisters. In addition, the PUPPS rash can spread to other parts of the body such as the breasts, arms, and legs. The good thing about PUPPS rash is that though it could be very uncomfortable, it does not harm the pregnancy.  So the baby and the mother are completely safe.

 Causes of PUPPS rash 

The etiology of PUPPS rash is not yet known but there had been different theoretical studies done to discover the cause for this type of rash. One theory suspects that the male fetus has something to do with the appearance of the rash as most cases of PUPPS rash occur in pregnancies with male babies. Scientists believe that the PUPPS rash may be due to the mother’s reaction to the male fetal DNA which may have been considered by the mother’s immune system as a skin irritant.

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Another conjecture involves the expansion of the abdominal walls because of the growing fetus. As the abdomen stretches, the connective tissues of the abdominal walls get damaged resulting to inflammation or the formation of the PUPPS rash.

Some studies would also show that being pregnant for the first time can induce the appearance of PUPPS rash, but there is no strong evidence to prove this. Having a two or more babies in one pregnancy (multiple pregnancies) may contribute to the appearance of this rash since the abdomen becomes extremely distended to accommodate the babies inside the womb of the mother. Certain conditions, like hypertension, are also suspected to be the cause of PUPPS rash.

 PUPPS rash treatment 

PUPPS rash lasts for about 6 to 7 weeks and may disappear 1 to 2 weeks after the delivery of the baby. Since the condition would resolve by itself then the treatments for PUPPS rash focus on managing and controlling the symptoms suffered by the mother.

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Since one of the major problems for the pregnant mothers having PUPPS rash is itching, then treatment to relieve the itch is given. Steroid ointments and creams are prescribed to stop the inflammatory reaction of PUPPS rash thus relieving the itch felt by the pregnant mother. These medications also prevent the further spread of the rash to other parts of the body. They are usually administered 5 to 6 times per day depending on the severity of the rash.  But if the rash is not treated with creams and ointments, oral steroids are given to address the itching. Before taking the oral steroids, it is important to consult your physician about it since oral steroids can harm the pregnancy. Antihistamine medications, such as Benadryl, may also help to control the itching especially during night time.

In PUPPS rash where itching and skin irritation may arise, there are alternative ways to make the pregnant mother feel better.

  • Avoid sun exposure because the heat may induce itching and can inflame the area with rash. Use sun protective devices such as umbrella, jacket, long sleeves, long pants and sunscreen lotion with SPF 30 and above.
  • Apply cold compress on the area to sooth and lessen itching.
  • When taking a bath, use lukewarm water. The pregnant mother may also try to have an oatmeal or baking soda bath because these materials have been proven to relieve itching.
  • Use clothes that are made from soft cotton to avoid skin irritation.

PUPPS Rash diagnosis 

Once the PUPPS rash comes out, the physician may order a skin biopsy to confirm the rash. The skin biopsy is the only test that can differentiate PUPPS rash from the other pregnancy related rashes. A skin biopsy will diagnose the presence of PUPPS rash correctly.

How is PUPPS rash prevented? 

Unfortunately, there are no preventive measures that can be done to thwart the appearance of the PUPPS rash. This skin condition appears spontaneously without making any prior manifestations or indicators to warn you of its impending occurrence.

Most cases of PUPPS rash can be very difficult during pregnancy since the irritation of the skin can cause major discomfort and inconvenience to the pregnant mother.  It may even hinder the pregnant woman from doing her day-to-day activities. It is best to consult the doctor once PUPPS rash appears.

Pupps Rash Pictures

Check out pictures of Pupps rash to see how the rash looks during pregnancy

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