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What-is-PUPPs

What Is PUPPS?

PUPPS (Pruritic Urticarial Papules and Plaques of Pregnancy), also known as PEP (Polymorphic Eruption of Pregnancy) is a fairly common skin condition seen in pregnancy.

As if those pregnancy hormones haven’t wreaked enough havoc with your skin and sleep along comes PUPPS to keep things interesting (but aren’t you LOVING that glossy thick pregnancy hair?).

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PUPPS is short for pruritic urticarial papules and plaques of pregnancy. It’s also known as PUPPP. In the UK, it’s known as polymorphic eruption of pregnancy, or PEP.

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PUPPS affects about 1 in 160 women (it’s more common if you’re pregnant with multiples). Women with darker skin are less likely to develop this common skin condition. PUPPS is an itchy skin rash that seems to start in the stretch marks of the abdomen and spreads.  It often shows up in the 3rd trimester (right when your bump skin is at its most uncomfortable). Depending on the severity it can be mildly uncomfortable to very distressing especially in warmer weather.  The skin on your bump can already feel quite tight and itchy in the 3rd trimester so adding PUPPS into the mix can test even the calmest mum to be.  Thankfully it hasn’t been shown to have any long-term impact for mum and baby but ongoing disrupted sleep in pregnancy isn’t good for either of you! 

Causes of PUPPS

 It’s not entirely known why some mums are affected by PUPPS – various theories suggest it’s caused by pregnancy hormones, even the sex of your baby may increase your chances of developing this annoying condition. Mums carrying baby boys seem to develop this condition more than mums of baby girls (but don’t decide on your nursery colour based on a PUPPS diagnosis). 

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How is PUPPS Diagnosed?

There is no clinical test to diagnose PUPPS but any itching in pregnancy should be investigated as a more serious condition (Obstetric Cholestasis) that can manifest itself with a severe itch all over the body especially on the palms of your hands and soles of your feet.  

What Can I Do For The Itch?

The constant itch can be very stressful and many women who experience PUPPS it’s a case of trying lots of different options and find what works for you.

Here’s a couple of suggestions:

  • Cool, wet compresses (place a fan by the bed too to blow over you at night or stand in front of it after applying cool lotion from the fridge).
  • Keep the room cool
  • Light cotton clothing
  • Bread soda baths
  • Calamine lotion
  • Oatmeal baths
  • Even thinking about an itch makes us want to scratch but we can also help the brain turn down that sensation. Hypnosis Mp3s can also be used alongside all of these options especially it includes imagery that includes being in cool water or feeling a cool breeze. Your brain can’t tell the difference between what you’re really experiencing (a cool refreshing shower that soothes the itch…or an imaginary one!).
  • Homeopathy remedies

Your care provider may also recommend antihistamines, steroids and antibiotics if the skin becomes broken from scratching.

Have you experienced PUPPS? We would love to hear from you. Let us know in the comments how you dealt with it.


About the Author

I’m Tracy Donegan, registered midwife and mum to 2 gorgeous boys. I’ve been working in Irish maternity services since 2005 and really enjoy helping Irish families have the best experiences possible. You may be familiar with my books – The Irish Better Birth Book and The Irish Caesarean and VBAC Guide, as well as the very popular GentleBirth Positive Birth app.

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