Itching during pregnancy: What's normal, what's not

Is it normal to have itching during pregnancy?

Yes, mild itching in pregnancy is normal in most cases. It's also common – up to 20% of women have itchy skin during pregnancy.

You may feel especially itchy around your belly and breasts as your skin stretches to accommodate their growth. (And yes, that includes itchy nipples, which are also common during pregnancy.) Dry skin and hormonal changes may contribute to extra itchiness. In the winter, indoor heating can exacerbate itching.

Itchy skin conditions such as eczema can worsen during pregnancy, though some expecting moms find that their eczema improves. Many women with psoriasis report less-severe symptoms during pregnancy, while some find that their psoriasis gets worse.

If you have a new itchy rash during pregnancy or you're experiencing severe itching on your palms or the soles of your feet, reach out to your healthcare provider – these are sometimes symptoms of more serious conditions that require medical care (see below).

Ways to prevent itching during pregnancy

You may not be able to prevent itchy skin entirely, but these tips might minimize itching in pregnancy:

• Take lukewarm showers and baths. Hot water can dry out your skin and make the itching worse. (It's best to avoid super-hot baths when you're pregnant anyway.) Limit your baths and showers to less than 10 minutes if possible, and use mild, fragrance-free soap. Rinse well, and gently towel yourself dry.
• Stay as cool as possible. Try to avoid being outside for extended periods in the heat of the day because heat (and overheating) can make itching worse.
• Wear comfy clothing. Loose cotton clothing keeps your skin from getting irritated.
• Moisturize. Slather on fragrance-free lotion or cream after you take a shower or bath. Consider keeping lotion in the fridge so moisturizing your skin also feels cooling. 
• Lower your stress. Take steps to reduce stress and anxiety while you're pregnant. It may not seem connected, but these can actually make itching worse.
• Stay hydrated. Drink plenty of water throughout the day. Here's how much water to drink while pregnant.
• Use a humidifier. Keeping the air moist and cool may help keep your skin from drying out.

How to relieve itchy skin during pregnancy

Do your best not to scratch – it can irritate your skin further and increase the risk of skin infections. If you're itchy or scratching because of dry, stretched skin, these simple measures can give you some relief:

• Apply cold. Put an ice pack or a cool, wet washcloth on itchy areas for five to ten minutes, or until the itch fades.
• Moisturize. Lotions and creams that are free of fragrances are best. Pure aloe vera gel applied directly to itchy areas may also provide some temporary relief.
• Take an occasional warm oatmeal bath. You can buy commercially prepared oatmeal bath powder in drugstores or online.
• Apply medicines before moisturizing. Talk to your healthcare provider about topical, anti-itch medications that are available over-the-counter, including calamine lotion. While most of these medicines are safe during pregnancy, it's best to review them with your doctor or midwife first. If your provider prescribes you a topical medication for itching during pregnancy, apply it as instructed and then moisturize your whole body, even the areas of skin you've just treated with medication.

When to call your doctor about itching during pregnancy

Although an itchy rash during pregnancy is usually harmless, it can be a symptom of something more serious. Some conditions that cause itchy skin can affect your baby's well-being and require special monitoring or treatment.

Call your provider if you:

• Develop a new rash during pregnancy
• Have a skin condition that's getting worse
• Feel very itchy, especially on your hands and feet, even if you don't have a rash

Your provider will want to do a physical exam and potentially order some blood tests so they can diagnose any potential problems, recommend appropriate treatment, and refer you to a dermatologist if necessary.

Possibilities include:

Cholestasis of pregnancy is a condition that happens when bile starts building up in the liver. Severe itching usually starts in the palms of the hands and the soles of the feet, most often in the third trimester. Cholestasis happens in about 1 to 2 of 1,000 pregnancies and is more common in Latina women. It usually goes away shortly after birth.

Atopic eruption of pregnancy (AEP). AEP includes several conditions: eczema, pruritic folliculitis, and prurigo of pregnancy. It can cause very itchy skin, usually on the arms, legs, or torso. If you have eczema you may have scaly patches, flaky skin, or small bumps. Pruritic folliculitis appears as tiny, pimple-like bumps. Prurigo of pregnancy causes tiny, itchy bumps that look like little bug bites and increase in number each day. AEP isn't dangerous, it can be treated with medication, and it usually goes away soon after birth.

Pemphigoid gestationis. This is a serious but very rare autoimmune condition. It often begins as an intensely itchy rash that turns into blisters. It usually appears on the abdomen, but may also show up on your arms and legs. Pemphigoid gestationis doesn't usually affect a fetus, but it may take weeks or even months to go away after delivery.

PUPPP rash. If you develop small and itchy raised spots that look like pimples around your belly – especially in the third trimester – they may be pruritic urticarial papules and plaques of pregnancy (commonly known as a PUPPP rash). This is a rare pregnancy skin condition that doesn't lead to complications but can cause severe itching.

Read more:

Pregnancy acne

Skin darkening during pregnancy  

Hair and nail changes during pregnancy

Pregnancy symptoms you should never ignore