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Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP Rash)

Itchy rashes during pregnancy can be caused by a number of conditions, but if it’s your first pregnancy and you are carrying a boy, there’s a high possibility you have a condition called pruritic urticarial papules and plaques of pregnancy (PUPPP) – also known as polymorphic eruption of pregnancy.

Roughly 1 out of every 150 pregnant women will develop the PUPPP rash. That’s roughly 1 percent, but it is the most common pregnancy rash in pregnant women. Fortunately, it does not harm your unborn baby in any way, but it is incredibly uncomfortable and annoying to you.

What is the PUPPP Rash?

The PUPPP rash is an incredibly itchy, red, and bumpy rash that starts on your abdomen, near your belly button. If you have stretch marks, it will start in and around them. The rash can spread to your thighs and other areas of your body – including your butt, breasts, arms, and legs. It’s usually most common in first-time pregnant women and those carrying twins or multiples. (It usually does not occur in subsequent pregnancies.)

Sometimes, the itchiness can be so intense but it usually does not affect your neck, face, or hands and feet. Sometimes, it is just itchy, red bumps on your skin. For some unlucky women, the PUPPP rash can look like a hive-like rash.

PUPPP Rash Pictures 

The below photos were sent to me by my best friend, who experienced pruritic urticarial papules and plaques of pregnancy (PUPPP Rash) during her first pregnancy. She was (like a majority of pregnant women with this common pregnancy rash) carrying a little baby boy.

PUPPP Rash on Thigh PUPPP Pregnancy Rash on Stomach pruritic urticarial papules and plaques of pregnancy (PUPPP) skin rash on stomach

When Does the PUPPP Rash Start and End?

For most women, this itchy pregnancy rash starts in the second or third trimester. (In a majority of cases, it affects more women in their third trimester but it can occur earlier). This PUPPP rash can last up to 6 weeks, and it usually goes away within 2 weeks after you have your baby.

Causes of the PUPPP Skin Rash in Pregnancy

Researchers do not know what causes the PUPPP skin rash. Fortunately, it is not associated with any pregnancy complications – like fetal abnormalities, preeclampsia, or any hormonal disorders. There is also no evidence that the PUPPP pregnancy rash is caused by increased hormonal levels (which causes all the other symptoms that you experience in pregnancy).

Some studies suggest that the rapid growth of the abdominal wall during pregnancy can damage connective tissue and cause your body to have an inflammatory response – i.e. the itchiness and red skin rash.

One recently study found that male fetal DNA in the skin biopsies of the PUPPP rash, leading some researchers to believe that male DNA acts as a skin irritant. THis study is definitely interesting, since 70% of women who have PUPPP in pregnancy are pregnant with baby boys.

Another theory suggests that PUPPP is genetic, passed through your father’s side.

PUPPP Rash Treatment 

Because there are many conditions that can cause pregnancy skin rashes – including prurigo of pregnancy, intrahepatic cholestasis of pregnancy, mpetigo herpetiformis, and eczema – you need to go to see your OB/GYN or healthcare provider for an accurate diagnosis of rash.

If you do have the PUPPP rash, your doctor will probably prescribe steroid creams and ointments to help relieve your itchiness and prevent the rash from spreading.

But if you are not comfortable using steroid creams, you may want to use a more natural remedy – such as Grandpa Pine Tar Soap.

My best friend bathed with Grandpa Pine Tar Soap with amazing results. Her PUPPP rash disappeared within one week after using this soap every day, and it never came back for the length of her pregnancy.

Grandpa Pine Tar Soap is made with pine tar oil – a natural moisturizer with antiseptic properties – created in a closed kiln process. It’s a natural soap but it does have a strong smell but it has great reviews from anyone who has tried it. Available on Amazon, GNC, and a few other health stores. I do recommend it to help reduce your PUPPP discomfort.

Taking an oatmeal bath and applying cold compresses may also help. Using aloe vera gel after you shower or bathe may also alleviate your discomfort and itchiness.

About the author: DP Nguyen is founder and editor of Hip Chick’s Guide to PMS, Pregnancy and Babies. She’s an expert pregnancy and women’s health blogger. She is NOT a medical doctor and does NOT offer medical advice. Connect with her on Google+, Twitter and Facebook.

{ 6 comments… add one }
  • Amanda September 24, 2016, 3:32 pm

    So, I went out and purchased the pupp cleanse (www.pupppcleanse.com). So far so good. I definitely feel MUCH better. The itching is almost completely gone. I have been on it now for 4 days. I will update the post in a few more days.

  • Nancy September 4, 2016, 6:18 pm

    I did not have the PUPPs rash during my pregnancy. My PUPPs rash appeared 6 days after birth of my fourth child. It is also my second boy. I have tried; Sarna lotion, all hydrocortisone creams and gels,itch ointments galore, grandpas pine soap daily for two weeks, oat meal soaks, aloe gel, allergy medicines 3 times a day (all kinds), cold showers, cold baths, have stay away from all calcium foods and drinks, and have not eat or drank any citrus. The only thing that has given me at least 30 minutes of itchiness freedom has been ; taking a cold shower with a medium bristled brush and exfoliating every inch of my body (except privates, feet bottoms, and hand palms. Its the only place it hasnt touched) and immediately massaging first cold pressed olive oil all over and then immediately using menthol Sarna lotion on top. The rash has covered my entire body. In some spots the rash bumps are piled so thick it has begun tearing my skin and creating stretch marks, the top of my feet and down my shins. Its not only gross looking but painfully non stop itching. I also have deep blue bruises all over because the itching is that unbearable. There has to be something ,someone has discovered to relieve this!!!

  • Keisha September 1, 2016, 10:27 pm

    I am currently 37 weeks almost 38 and I am pregnant with a girl. The itching is so irritating. It started from my belly and moved to my butt, then down to my thighs (side & back). It is a horrible feeling. It is weird to me because I have 3 sisters and none of them went through this, but I did. Everything I’ve tried so far hasn’t worked not even a cold compress. Hopefully after I have my daughter the rash and the itching will immediately go away because I can not take it anymore. With 2 weeks left I am trying my best to be patient but it is very hard.

  • Krystie August 24, 2016, 12:44 am

    I had the PUPPS rash with my third pregnancy, and I was pregnant with a girl. Never had the rash with my first two pregnancies and they were both boys. Either way it was horrible, and I am beyond thankful it didn’t last as long as other’s have stated.
    My PUPPS rash appeared the last month of my pregnancy. And actually started towards the inside of my right thigh, and spread up to the middle of my right breast and progressed to the left side of my body, eventually it was on my hands and arms, but not as dense as my abdomen. For me it last about 3 weeks. It was pretty scary for me, because I had no idea what it was at first, and I was extremely nervous about this crazy rash covering my body so close to my due date! As you all could imagine, I’m sure. Not sure why these things happen, but thankful it wasn’t anything serious, and my daughter and I were both healthy.

  • Carley June 10, 2016, 6:26 pm

    I just bought the book, the puppp cleanse (www.pupppcleanse.com). It lists all of the products you have listed above and a list of foods to avoid as well as things you should do like take cools baths and avoid dairy products. I have been following the instructions and purchased the supplements suggested and in two days I feel MUCH better. The itching has completely stopped, but I still have bumps.

  • Amber February 22, 2013, 10:57 pm

    I had the PUPPS rash pretty severly during my pregnancy. I was pregnant with a girl. It also took a good 2 YEARS after giving birth to go away, however, was mild after pregnancy. It would come and go with my cycles.

    This rash is hell, and I would not wish it on my worst enemy! There were nights where I was in tears from the itching. The worst were my hands and feet.

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