PUPPP or PEP rash, can I beg to be induced at 38 weeks (currently 36+3)?

[LDNmummy]

Really need some advice as I am almost scratching my skin off and haven't slept properly in days!

I have been formally diagnosed with PUPPP or PEP as it is referred to now, and it is all over my body. Last night and this morning was so bad my DH made me an oatmeal bath (which made it worse), I tried Tea Tree Oil cream (which didn't work), I have taken Piriton (also didn't work), and various other methods to try and soothe the stinging itch I have from my shoulders to the tops of my feet. Nothing works and I actually cried in a burning itch induced delirium this morning while my poor DH tried to stop me scratching myself to bits. I know it sounds dramatic but it really is that bad.

I have had this rash for the past few weeks and it has spread and gotten so bad in the last few days that I had to go to hospital on Friday to check it wasn't something to do with my liver. That was given the all clear and although I already knew what it was, the docs confirmed it and said I would have to wait it out.

Since then it has just erupted into a whole new level of horribleness and I have been housebound for two days!

Does anyone know if I can beg to be induced early so it will go away? I searched and found only one other thread from 2009 about this, so am hoping for a more updated idea as to what I can do as it seems to be something even doctors don't know too much about. Only post birth will it go away and I am desperate as I don't think I can hold on for almost another month.

Sorry for long post, just fed up

That sounds awful,I had something similar in the first trimester just on my arm so you must be so uncomfortable.From memory (I'm a GP on mat leave) I'm sure I had a patient like this who was induced at 37-38 weeks for that reason.The midwives were very helpful in getting her in.Since term is considered to be 37 weeks plus I would have thought it would be safe to induce you now without risk to your baby.Go to your GP on Monday and get them to ring the obstetric reg on call, if you came to see me I know I would definitely do that.Your condition sounds unbearable,it will only improve after delivery so there is probably a very good case for induction.If they still refuse, topical steroid cream will help (GP can prescribe).

Sorry, misread your post about exactly how far on you are, 36+2 may be a bit early but nearer 38 weeks I'm sure they would consider it

Have you tried steroid cream? I had PUPP so feel your pain, but the steroid creams sorted it in a week.

Oh god yes, it really is bloody awful, and usually not understood by GPs / HVs.

I had it from 15 weeks and spent a few horrendous weeks before someone suggested dandelion tincture and it completely went in a week. Something to do with cleansing the liver, apparently. However, it does have quite a high level of Vit A, which is advised against (although I can't remember why )

I too suffered in the 1st trimester and feel for you. But I also had my DS1 at 36 weeks and he was so tiny and this led to one problem after another (years and years of little things). If you can wait it out and use the steriod cream, I would.

You need an urgent referal to a skin specialist, or go private, for £200 or so you could see a consultant and get started on treatment.

Poor you xx

Thank you downpipe. I actually have an appointment with my midwife on Monday and I am planning to speak to her about it then. I really want to stick it out as this is my first child.and I would prefer a spontaneous labour but I think it will be too stressful to wait now.

Was wondering if anyone knows if I could still use a birthing pool if I am induced or will it have to be the labour unit? I know my hospital says you can use the birthing unit as long as you reach 37 weeks with a straightforward pregnancy but not sure if this would change that.

wipe I have read that it is possible to use the steroids cream but so far it has not been offered as a treatment option. I will have to ask about it on Monday too.

I don't think so as you would need to be monitored. Induction first time round isn't ideal......I would focus on getting the PEP sorted

I do not know about being induced early but I just wanted to say I feel your pain! Pupp is the most horrendous thing to have. I tried everything in an attempt to feel better but had no real relief until after the birth.

Im glad to say one year on it is a distant memory and something that was overcome

Do not scratch!!

You want to try some peppermint oil or emolient. Best thing to take away the itch.

I got this at 34 weeks and was in agony. Someone recommended pine tar soap in the shower 4 times a day and it was like a wonder drug! It immediately eased it and the rash was fully gone in 2 weeks. I could only find it online but def worth a go.. Good luck and I really feel for you - it's the most unbearable thing ever when heavily pregnant.

Had it too, bloody nightmare, moderate strength steroid cream and aqueous cream helped a bit - aqueous cream available over the counter I think. You really don't want to be induced if possible as you're more likely to experience a "cascade of interventions" ultimately culminating in a c-section and trust me, they're worse than PUPPP. It will stop as soon as you go into labour.

You might also want to try Kamillosan chamomile ointment, also available over the counter. The chamomile might soothe the itch and it'll be good for after baby comes for sore nipples (it's edible so you don't have to wash it off to breastfeed) and nappy rash.

Thank you, thank you, thank you for all the help and suggestions everyone.

I will be trying every remedy listed (not kidding) this week but will still talk to my midwife about my options in case it doesn't ease up.

Tanso I honestly cannot wait till I can just think of this as a past experience NEVER to be repeated.

Worse than hideous! Nothing can describe the itching. It's beyond relentless.

I had in both first and second pregnancies. In the first from 38 weeks and second it had just started a little in my stretch marks about 4 days before DS came along.

Second time it vanished instantly. First time it took over 2 weeks after birth to go (sorry adding to you misery). That said I had a traumatic first birth and lovely second one. Perhaps that is why it hung around the first time.

First time it was a whole body thing and
I got steroid cream which helped a little. I found aqueous cream with drops of tea tree oil after a shower could make the itch vanish for hours at a time. nice and cooling.

No magic answers but in all likely hood it will vanish after birth immediately and worst case disappear over a week or so.

Despite the nasty look of the rash it vanished almost over night and no scarring or marks despite furious itching.

So sorry for you!!

Hi LDNMummy,

I was diagnosed, just last week as having PEP at my latest dermatology appointment. I am only 17 weeks and don't know how I'm going to suffer this for the next 23 weeks. Here are a few things that 'help' me somewhat, E45 Itch Relief cream, cool baths and showers, I also bought soap on the internet its called Granpas Pine Tar soap (I read about it online) I also take piriton every evening (I was told to do this by the dermatologist even though it has no effect on me)
Apart from that I don't sleep as such, an hour here or there if I'm lucky so you have my deepest sympathies, I can't imagine how awful it must be when you are so far along.
I hope they really take you seriously and consider earlier induction because the pain of that is soul destroying. I'll watch this thread to see how things work out for you

i had this too and found balneum plus cream helpful - try and get it on prescription though as it cost me £20! Agree with poster who said you need a referal to dermatology though. I sympathise, its horrible.

LDN - i know what you're going thru! I had PUPPPs...just recently, started around 28/29 weeks, in a cpl of stretch marks and then spread into a rash around my lower belly. I itched and itched and drove myself mad...luckily my husband is a GP too, so had a bit more sympathy and understanding.
I went to my own GP (who actually specialises in Dermatology) and asked for some steroid cream (Elocon) and he also prescribed me a moisturizer (Double Base) and Piriton. I used the steroid cream twice a day, relunctantly, but it helped and within a week, was only using it in the evenings (which i found the were the itchiest time of day!).

Since the last 2 weeks, I've stopped the steroid, and using the double base only...it's still a touchy itchy now and then, but the rash has cleard up completely (still got the stretch marks though)...im 33 weeks now, and hopefully the worst of it is over.

i also read somewhere that citrus fruits could aggravate the rash, so i stopped eating clementines for a cpl of weeks too...not sure if that was just a coincidence...but im sure ur willing to try anything right now!

hope that helps and i'd really recommend getting some double base, i lathered it all over myself, and it luckily didnt spread more.

Oh it's awful, I feel for you it honestly does disappear like magic when you have the baby though! I thought I'd be scarred for life this time last year and a week after having DD you'd never have known there were any marks. The Pine tar soap did help, but you have to really lather it up and then let it dry onto your skin for a few mins before washing off. Not pretty, but if it gets you some scratch-free sleep...

I can really empathise too and hope by the time I write this post you have had your baby and the PUPPS?PEP has resolved. I had it at 36 weeks and started on my tummy and rapidly spread all over my body. I was initially prescribed steroid creams which didn't do anything. The only way i could stop itching was to put ice packs on the area's which itched. I was exhausted as couldn't sleep and after many trips to the doctors and then 3 trips to the maternity unit a lovely consultant agreed to induce me at 38 weeks as both my husband and I were exhausted and I don't know how I would have coped for another few weeks. The PUPPS did re occur after our baby was born for another 10days after it initially settled which was pretty tough so back to the ice packs and menthol aqueous was good as well then.
Awful at the time but once you have your baby it's a distant memory, just really hope I don't get it next time

I am currently experiencing the above at 38 weeks.

I went to the GP, labour ward and A&E and no one seemed to know what it is. I haven’t been officially diagnosed, but I have done this myself.

calling the GP today, may be futile as my section is booked for next Thursday. I am also going to ask if I can move my section forwards, before I shred myself to death.

I have been given aquaderm, antihistamines and camomile lotion. I have ordered Grandpa’s pine tar soap via Amazon and I am currently sitting my dressing gown on in bed, feeling very sorry for myself. Baby baby is totally fine and loving life!

I read that PUPPP is more common with boys and increased weight gain and I have both. the rash started in my stomach and is now all over my body, including my butt, which is joyful! Not. I am praying that upon delivery, I will be fine.

Omg, this is me now. I’m miserable after 4 almost sleepless nights (and days) with diabolical itch. How did it pan out for you after delivery? I’m 39 weeks, 2 weeks til my induction date.

This is me now! Driving me nuts! 36 weeks and nothing is helping! Not even steroids

You have my sympathy!
it’s not the same but I had morphine after my crash c section under GA. And I had a reaction to the morphine and scratching my face off. I was crying and sobbing and scratching, I couldn’t bear it. I felt crazy