Pregnancy often brings about numerous bodily changes, including shifts in skin health. Eczema, also known as atopic dermatitis, is a common skin condition that can either appear for the first time or experience flare-ups during pregnancy. Understanding how pregnancy impacts eczema and effective management strategies can help individuals navigate this experience.
Pregnancy and Eczema Development
Hormonal changes, particularly fluctuating estrogen and progesterone, contribute to the onset or worsening of eczema during pregnancy. The body’s immune response shifts from Th1-dominant to Th2-dominant immunity, a change that helps protect the growing fetus. This shift can make pregnant individuals more sensitive to allergens, potentially leading to or exacerbating eczema.
Approximately 20% to 40% of pregnant individuals develop eczema without prior history. For those with pre-existing eczema, more than 50% may see their symptoms worsen, while about 25% might experience improvement. New onset eczema during pregnancy is often referred to as atopic eruption of pregnancy (AEP), and it typically manifests in the first or second trimester.
Identifying Eczema Symptoms
Eczema symptoms during pregnancy are similar to those experienced outside of pregnancy. Common signs include dry, itchy skin, inflamed red patches, and sometimes small bumps or blisters. These skin changes frequently appear in areas such as the folds of the elbows and knees, on the neck, and on the face. On lighter skin tones, patches may appear red, while on darker skin, they might look ashen, gray, or have a brown or purple hue.
It is important to distinguish eczema from other rashes that can occur during pregnancy. Conditions like polymorphic eruption of pregnancy (PUPPP) or pruritic gravidarum present differently. PUPPP often starts in stretch marks on the abdomen during the third trimester, while eczema can appear earlier and in various locations. Consulting a healthcare provider can help ensure an accurate diagnosis and appropriate management.
Managing Eczema Safely
Managing eczema during pregnancy focuses on alleviating symptoms while prioritizing the well-being of both the pregnant individual and the baby. A foundational approach involves consistent, gentle skincare. This includes using fragrance-free, hypoallergenic moisturizers frequently, especially after bathing, to maintain skin hydration and support the skin barrier. Avoiding prolonged hot showers and identifying and minimizing exposure to personal triggers like harsh soaps or certain fabrics can also help prevent flare-ups.
For topical treatments, emollients are a primary recommendation. Mild to moderate topical corticosteroids are generally considered safe for short-term use during pregnancy to reduce inflammation and itching. If these options are insufficient, a healthcare provider might consider other treatments like phototherapy (UVB light therapy), which is also typically considered safe. Oral medications are usually reserved for severe cases and are prescribed under close medical supervision due to potential considerations for pregnancy.
Eczema’s Effect on the Baby
A common concern among pregnant individuals is whether their eczema will affect the baby. Maternal eczema itself does not directly harm the fetus or lead to complications such as miscarriage or premature birth. However, a genetic predisposition to eczema exists. If one parent has eczema, the child has an increased chance of developing the condition, with the risk rising if both parents are affected. This is an inherited tendency rather than a direct transmission of the condition during pregnancy itself.
When to Consult a Doctor
Consult a doctor for any new skin rash that appears during pregnancy. Also consult a provider if existing eczema symptoms worsen despite home care measures, or if intense itching disrupts sleep or daily activities. Signs of infection, such as pus, increased redness, or fever, require immediate medical attention. A healthcare provider can accurately diagnose, differentiate eczema from other skin conditions, and recommend safe, personalized treatment options during pregnancy. This ensures comfort and appropriate care.