Hives, medically known as urticaria, are a common skin reaction characterized by itchy, raised welts that can appear on any part of the body. These welts can vary in size, change shape, and often cause intense itching or a burning sensation. While hives frequently result from allergic reactions, they can also stem from various other triggers.
Experiencing hives during pregnancy is possible, even for those who have not had them before. About one in five pregnant individuals experience some skin changes, and while hives are less common than some other issues, they do occur. Though often harmless, hives can sometimes indicate underlying conditions that require attention.
This article explores the reasons why hives may appear during pregnancy, including common triggers and specific pregnancy-related skin conditions. It also provides guidance on how to find relief and when it is important to seek medical advice.
Common Triggers for Hives in Pregnancy
Hormonal shifts during pregnancy, particularly in estrogen and progesterone levels, can influence skin sensitivity and immune responses, potentially leading to hives. These internal changes can make the body react differently to substances it previously tolerated.
Allergies are a frequent cause of hives. Food allergies, medication allergies, or environmental allergens such as pollen, dust mites, and pet dander can all provoke a hive outbreak. Contact allergens, found in soaps, detergents, or lotions, might also trigger skin reactions.
Stress, a common experience during pregnancy, can also contribute to the development or worsening of hives. Emotional and physical stress can influence the body’s inflammatory responses. Physical stimuli like heat, sweating, or friction from tight clothing can also induce hives. Dryness and stretching of the skin, common as the belly grows, can further increase susceptibility to these irritations.
Pregnancy-Specific Skin Conditions Causing Hives
Certain skin conditions are unique to or significantly associated with pregnancy and can manifest with hive-like symptoms.
Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP), also known as Polymorphic Eruption of Pregnancy, is a common condition that typically appears in the late third trimester. It presents as intensely itchy, red bumps and patches that often begin on the abdomen, particularly within stretch marks, before spreading to other areas like the arms and legs. PUPPP is generally harmless to both the pregnant individual and the baby and usually resolves shortly after delivery.
Intrahepatic Cholestasis of Pregnancy (ICP) primarily causes severe itching, especially on the palms and soles, often worsening at night. While not always classic hives, intense itching can lead to hive-like lesions or irritation from scratching. ICP involves impaired bile flow and requires medical attention due to potential risks to the baby.
Prurigo of Pregnancy is characterized by the appearance of intensely itchy, small bumps. These bumps often emerge on the extensor surfaces of the limbs, such as the elbows and knees, and can also appear on the trunk. Unlike PUPPP, Prurigo of Pregnancy can occur at any stage of pregnancy.
Relief and When to Contact Your Doctor
For immediate relief from hives during pregnancy, several home remedies can help manage symptoms. Applying cool compresses to affected areas or taking lukewarm oatmeal baths can soothe irritated skin. Wearing loose-fitting clothing made from breathable fabrics can also reduce friction and heat, which might exacerbate hives. Regularly moisturizing the skin helps alleviate dryness, which can contribute to itchiness.
Over-the-counter antihistamines, such as loratadine or cetirizine, are generally considered safe for use during pregnancy to alleviate itching. Always consult a doctor before taking any medication for appropriate dosage and suitability. Avoid older, first-generation antihistamines that cause sedation, as these are not recommended during pregnancy.
Seek medical advice if hives are widespread, severe, or accompanied by other concerning symptoms. Immediate medical attention is needed for:
- Difficulty breathing
- Swelling of the face, lips, or tongue
- Abdominal pain alongside hives
Intense itching, especially on palms and soles worsening at night, warrants investigation for conditions like Intrahepatic Cholestasis of Pregnancy. Consult a healthcare provider if hives do not respond to home remedies or over-the-counter options, or if there is any concern about the baby’s well-being.