Help! What is this itchy pregnancy rash? (Pics)

[Silentreader]

Sorry for the lengthy post but I'm a desperate 15 weeks pregnant lady, please can anyone shed any light on what this rash could be? The thought of having to live with this for another 25 weeks terrifies me..

Around two weeks ago I developed a dry, itchy rash in my left armpit which spread to my right armpit and the creases of my elbows. I visited the pharmacy as the itchiness was keeping me up at night and the pharmacist suggested Canestan 1% as he thought it could be a fungal infection. I stopped using any skincare with fragrance and only use aveeno wash and moisturise with aveeno/epiderm.

I was able to get a telephone appointment and the Dr suggested an OTC hydrocortisone cream (Daktacort) which I started to apply twice a day.

The rash started to spread but the spot formation became almost like chicken pox everywhere else instead of the initial dry large patch of psoriasis looking rash. In desperation I visited my GP who was flummoxed and prescribed Eumovate steroid plus told me to continue with Canestan and also gave me some menthol aqueous cream for the itchiness.
I have only been using this medicine for the past 3 days but my rash has significantly worsened and is now EVERYWHERE.

The itching is absolute torture and I am waking up in the night and having to get in the bath for some sort of relief.
I add a sock with porridge oats to my bath which helps the itch temporarily but I'm currently having atleast three baths a day which is becoming quite challenging with work and a 3 yr old!

It doesn't appear to be PUPPS as I am not far enough in my pregnancy and it is not particularly bad on my stomach/stretch marks.
The maternity triage will not see me until I am 16 weeks but when I spoke to them they are not concerned about intrahepatic cholestasis due to rash and as I have not experienced itching on my hands and feet. I have not had any blood tests however.
I have whittled it down to perhaps Atopic eruption of pregnancy (AEP) or perhaps pityriasis rosea although the 'host' rash was not on my stomach/back and I don't have a Christmas tree formation on my back so who knows...

Has anyone had any experience of this and can tell me I don't have to live like this for the rest of my pregnancy :(

Could it be hives? Does the rash move about, come and go, or is it fairly fixed and getting scabby? Hives are more on the surface and move about but are incredibly itchy.

Otherwise it could be pityreas rosea with the herald patch being in your armpit rather than torso. Though I had it about 5 years ago and it wasn't itchy at all, and spots were very much confined to my torso. But first Dr looked flummoxed and prescribed me fungal cream which was useless, 2nd Dr immediately identified it as pityreas rosea and said it would go on its own in a few weeks, which it did. So maybe try seeing a different Dr.

Other options could be scabies? It might be completely unrelated to your pregnancy. Have you recently had any viral illness like covid or flu, this makes you more susceptible to bacterial and fungal infections, as does being pregnant which dampens your immune system.

Are you taking any anti-histamine to help with the itchiness? I took zyrtec throughout my pregnancy for rhinitis.

Polymorphic light eruption? I had it in my last pregnancy. It was awful. It went when I gave birth though.

Sorry, not 'light', just polymorphic eruption!

Pregnancy can throw up all sorts of skin issues. I developed contact dermatitis during my 1st pregnancy - basically allergic to pretty much all skin care/make up - needed a referral to dermatology to diagnose & see what I could be treated with while pregnant. Like this it started in one area but spread across whole body & itchng was like torture!

@YearoftheRabbit23 Thanks for the reply, this is really helpful.

After a bath the rash is definitely less prominent but always visible, if I have had a mad scratching session it's very inflamed and hives looking though. No scabs just feels bumpy and spotty to the touch, it's not dry anywhere but my armpit either.

I did think that about covid but not had any symptoms other than that horrible cold everyone seemed to have about 2 months ago.

The Dr told me he didn't think piriton would help and was reluctant for me to take it for some reason.. I already feel nervous about being covered top to toe in steroid cream but I'm getting so desperate now that I have to try something. I will have a chat to the Dr about Zyrtec.

I have asked for a referral to a dermatologist so hopefully will get a second opinion, it's just a case of how long that will take..

Get them to do blood tests.

www.nhs.uk/pregnancy/related-conditions/complications/itching-and-intrahepatic-cholestasis/

In the meantime- fexofenidine. It saved my sanity.

@Pinkbananas01 did they prescribe anything that helped? I feel like I'm going slowly mad.

@Silentreader you can get ceterizine hydrochloride (zyrtec) over the counter so you could see if it gives any relief before seeing a GP. As a chronic hives sufferer I know how unbearable the itchiness can be!

You have all my sympathy! I’m 10 weeks along and developed a similar rash as soon as I feel pregnant which day by day would get worse. Exactly like you, the itch at night was unbearable and it got to the point that I haven’t sleep over a few hours a night in the last month.
I have a history of eczema (atopic dermatitis) but I’ve never been this bad in my life, as of last week around 70% of my body was covered in rash and I was dreading the rest of pregnancy.
The first time I went to my GP they were so useless I cried. I went back in desperation last week and the doctor finally prescribed me something that’s almost entirely got rid of the rash, I honestly could cry with relief!

For me I’m using Betnovate twice a day and Epaderm (an emollient cream) once a day all over before bed, and touch ups in the day. I’m also taking an anti-histamine at night to help with night itches. The Betnovate took around a week to really take the edge off, but after a week my skin is almost clear and the itching has gone.
As someone that’s had eczema before you have to be really careful what you put on your skin, a menthol cream would break me out in minutes! Aveeno (the dark blue one) works well for me, but others can make my itching worse. It sounds like you’ve stripped back any skin products to minimal, also check your washing laundry with non-bio or even special detergent for sensitive skin. Try not to over bath (can disrupt the skin barrier) and use ice packs to try and dampen the itch instead.
Ive also used mometasone furate in the past which works in days, so don’t let the GP fob you off, if treatment isn’t working insist of something new to try, it’s impossible to live like this!!

I’ve also got a referral to dermatology - but to be honest I’ve been down this route before and while it’s been quicker to get treatment (I’ve also used fexofenidine really successfully) to clear up big flares, a lot of the time I’ve just cycled through steroids under their watch.

Before the itch started to clear I was looking into UVB treatment which is safe in pregnancy, so this may be worth flagging. It’s expensive and inconvenient so it’s likely that you might have to increase steroid potency first.

Thank you all so much for your advice and experiences. After the worst night ever last night I caved and went to a&e.. Dr has diagnosed pityriasis rosea and told me to continue with Eumovate and have piriton 4x a day so hopefully there is light at the end of the tunnel and it will only be with me for a few more months.
Thank you all for your words of wisdom

@Silentreader I’m so glad you have a treatment plan and we’re taken seriously!
How are you doing now a few days on? I really hope it’s working for you!
I’ve managed to clear around 80% of my rash but can’t quite seem to resolve the last 20% which is slightly annoying, but on the plus side I’m sleeping which is amazing!

Hi,

I don't have the answers but I'm in exactly the same boat. Mine started at 24 weeks and I'm now 28 weeks and in itching hell! it started on my thighs, moved to my bump, now is really bad on my boobs, armpits, chest and back, as well as my arms. It moves around and when one area calms down another starts up. I can't sleep from the itching and cover myself in creams etc and take piriton but nothing works.

The GP thinks PUPPP, I'm not convinced, and the hospital have taken bloods to check for OC which were fine (thankfully) which they're repeating Monday because I'm still suffering. The thought of having this for the next 3 months is getting me so down, and I'm so exhausted from waking up itching!

If anyone finds any treatments please let me know, I'll try anything! Hydrocoitisone from the GP does nothing, as does Aproderm emollient. I get 20 mins relief when I take an oat bath but thats about it.

I feel your pain and we're in it together x

@Lid88 Im so sorry you’re in the same boat! Honestly when this started for me, there was so little online about it, that I thought that it was only me!
I think you need to push the GP / hospital for stronger steroids. In my years of experience with eczema, hydrocortisone is so weak, it’s never had any positive effect on my skin. Only mometasone has worked for me (pre-pregnancy) and now Betnovate whilst pregnant. Even the OP was given eumovate, which is much stronger than hydrocortisone.
My rash hasn’t gone 100% but it’s healing enough that my legs, belly, arms are clear with just residual rash on my shoulders and chest to go. I’m also able to sleep most importantly!

Thanks, I’ll make another appointment and push to try something stronger! They talked about prescribing Eumovate then looked and it said not suitable for pregnancy so didn’t! So frustrating!

Urgh it drives me nuts when GPs give out incorrect information. My first GP did the same until I called back in tears after a month of no sleep and had a different GP who was much more switched on.

Eumovate is a moderately potent steroid that is safe in pregnancy. From the NHS website: www.nhs.uk/medicines/clobetasone/pregnancy-breastfeeding-and-fertility-while-using-clobetasone/

I can’t tell you how much research I’ve done on this as I’m on a slightly stronger steroid and wanted to be sure of the risks, especially as I’m still in my first trimester.

@CityKity I'm so sorry I didn't get any notifications of these messages! Have they diagnosed your rash as anything? Or saying it's still atopic dermatitis?

So a few days on and it's worse than ever- see pic..it's like that everywhere. I've been in the bath at 2am most mornings clawing my skin off. The blood blisters all over my thighs are just awful.

So sorry to hear you are struggling too@Lid88. I could have written your post. I am still using the Eumovate,
(I was hesitant about steroids but this was prescribed by my GP plus recommended by the GP at a&e so maybe push your Dr?Although to be honest I haven't noticed it has made any difference at all for me) I have been told I can use it twice a day but the sticky tacky feeling it leaves on my skin seems to be making the itching worse so stick with once in the morning and then try and keep myself distracted. I don't know if the piriton is helping but I am still taking it 4x a day and liberally applying Eurax for the itching. This is an OTC anti itch cream which is not recommended in pregnancy but I absolutely would not be able to function without it and when researching it I couldn't find any reports of it causing issues.
I am also living in the bath with a sock filled with oats.

My only tip would be to file your nails as short as possible so that if you do scratch you are not causing too much damage.

Things I have tried that haven't worked so far so hopefully can save you some pain and money!-

• Head and shoulders diluted in bath water (meant to help Pityriasis Rosea) seemed to flare things up more.
• Calamine Lotion- way too drying
• Menthol Aqueous cream
• Pine Tar Soap - highly recommended for PUPPs on forums but did nothing for me.

I am going to a dermatologist tomorrow for a third opinion as I can't see how people can live like this. I know it sounds dramatic but it is absolutely all consuming.
I will update the thread tomorrow with any recommendations. If not I'm tempted to try phototherapy like @CityKity suggested.

Keep strong ladies xx

@Silentreader I reckon we both have the same rash because I too have wasted a tonne of money on pine tar soap (reading on puppp forums like you!) which makes me sting and sore, menthol talc (works for about 2 mins then itching) and emollients that like you said seems to leave that tacky sticky feeling that I also think irritates me even more! Mine also looks the same as yours. I’m absolutely exhausted from
the night time showers and baths and I am finding myself losing my rag with my DD (2.5) because I’m so tired I have zero patience at the moment. Work is the worst because wearing any form of clothes just irritates it more.

I’m very intrigued to what your Dermatologist says, I got told a referral round her is around a 52 week wait…. Not really helpful is it lol.

Thanks for replying x

@Lid88 It's a relief to know there is someone else going through it.
Yeah I'm exactly the same with my 3 year old, my fuse is so short because of the exhaustion and because I just want to lie spread eagled on the bed and not be touched!
We are in the process of moving house so I don't think the stress of that whilst pregnant helps.

Thankfully I was able to go private through work otherwise the NHS wait times here are the same.
I will let you know how I get on. Hope tonight is slightly more comfortable for you xx

@Silentreader thanks for the update, it’s nice to not feel so alone with this odd pregnancy triggered symptom!

I’m so sorry it’s getting worse and not improving. I sympathise so much with how you’re feeling, it’s impossible to live like this when all you’re thinking about is itching, especially at night.
Agree about keeping nails short, I also put socks over my hands at it’s worse to try and stop the worse of the itching at night. Head and shoulders also worsened my skin. I’ve been living in oat baths too, but am going to try Aveeno baby bubbles in this evenings bath and will report back.

Also totally with you on the tackiness of some cream making itchiness worse. It’s like as soon as I put ointment or emollient on my skin my skin is so sticky and dust that sticks to my skin makes me even itchier, it’s such a catch 22.
Im still waiting for my referral for the dermatologist, I let it go after seeing improvement last week, but I’m still struggling so need to chase that up again.

Maybe I’ll be brave a post a picture later, but my rash is different to yours in that all those dots that you have have all merged into one giant rash on my back / front / legs. Due to my history of eczema the GP still suspects pregnancy induced flare of atopic dermatitis - according to my research 1/2 eczema suffers report worsened of symptoms during pregnancy with 1/4 showing improvement. Why couldn’t I have been in that 1/4!

Good luck tomorrow and keep us posted to what the derm says! I really hope you can get a solution soon, the lack of sleep is really torture! xx

Has anyone tried Eurax anti itch cream? I’ve heard lots of people swear by it not pregnant but the packet says not to be used in pregnancy, I wonder if this is because it’s not been tested or if there’s a genuine reason - I would really like to try it!

Please mention the itchy rash to your midwives. I had crazy itching during my pregnancy, it was torturous, it could be obstetric colestatis which they can check for with blood tests but it can be dangerous if left untreated (not trying to scare anyone). But better to be safe than sorry. Good luck 😊

@tillyrainbow Thank you, I had the bloods taken for OC last Monday - all clear and have a repeat on Monday coming :)

@CityKity That's a good idea with the socks, I will have to do that tonight as I woke myself up scratching one patch last night and then like a domino effect all the non itchy areas started itching again! Argh!
Are you still going to persevere with the Betnovate? I'm guessing that's another steroid cream?
Hopefully the dermatologist can give us all the answers tomorrow.. I would quite like to 'glow' at some point during this pregnancy haha xx

@Lid88 yes that's the one I am using, the one without hydrocortisone in. It definitely helps take the edge off. I think with most medicines they cannot say something is categorically safe unless tests have been carried out on pregnant women. I did find a thread somewhere where a pharmacist said it would be fine but it comes down to personal decision at the end of the day.
Alternatively there is an E45 anti itch cream which I believe is safe in pregnancy.

@tillyrainbow Thank you. I will mention it at my next appointment although the midwife at triage didn't seemed concerned as I don't have itching on hands and feet.