I developed this rash in week 25 of my first pregnancy. I don't know if there is a connection, but this was 3 weeks after catching Covid. It felt like a form of torture - 'an itch' doesn't explain it well enough at all. It felt like my skin was in spasm and I'd be rooted to the spot until it passed. There were moments when all I could do was cry. I spent a lot of time trawling through forums and websites trying to get tips from people who had managed to resolve this. I didn't get any useful information from health professionals (being told it would clear up when I gave birth was not helpful). Thankfully, I was able to resolve this in around 6 weeks by changing my diet and routines, so wanted to share this in case it will help you if you are suffering. I read in multiple sources that dietary changes would take 2 weeks to have effect, so I recommend you persevere with any changes for at least this long. I was in a state of desperation, so I you have my full sympathies!
Obvious disclaimer - I am not a doctor. Every 'tip' that was recommended I did research in to. I decided not to follow some tips as I thought they weren't safe (more on that below). Please do the same for yourself. I was later diagnosed with gestational diabetes too so I did have to alter my diet again later on, though not very significantly.
My rash started as itching on my bump. I didn't have any stretch marks, as I'd read it tends to start within these. I developed bright red lumpy hives that spread by a couple of inches daily up to my collarbones, around my back, all over my arms and even between my legs. The worst areas were my bump, arms and whichever bit was the newest bit to start itching.
DIET
From online searches, what I noticed was that the dietary changes people had found helpful were all things that are good for your liver. As this rash disproportionately affects women having boys, I wondered if this is something to do with hormones and liver function (as I said, I'm no doctor!). I had already cut down on my sugar intake massively in the first trimester as I hoped this would mean I wouldn't get gestational diabetes (now I know that would never have worked, but it was beneficial to have done so already!).
My starting point was a lady called Ally Boothroyd who was able to clear up her rash. Some things I decided not to follow from her - she recommended Hibiscus tea and says it is safe, however I quickly found evidence saying it is not safe to drink in pregnancy. She also had an extremely high sugar intake, which I think is not sensible and would have been damaging for my baby as I didn't know I had gestational diabetes at that time. Also she drank vast quantities of black cherry juice daily. I couldn't get hold of this in the UK and again, I think a balanced diet is a healthier approach, so I didn't want large amounts of any one thing. I didn't try her yoga techniques as I haven't done yoga before and the dietary changes and skincare routine took all my focus.
I looked online for foods that are good for your liver and made sure every meal and snack included at least one of these:
Avocados
Turmeric
Zinc (this is in pregnacare supplements)
Garlic
Sprouts
Celery
Red skinned apples
Walnuts
Coffee (I kept to decaf)
I also had lots of water, lots of veg (up to 8 portions a day, raw or cooked) and made sure I only had wholemeal / wholewheat carbohydrates in small amounts. I had a lot of dairy products (cheese, milk and yogurt) and got protein through milk, eggs and nuts. I avoided sugar. If I needed a chocolate fix I mixed unsweetened cocoa powder in plain yogurt.
As I couldn't get black cherry juice, I tried to get hold of black cherries. The best I could do was a bag of frozen dark sweet cherries. I had a few each night with plain yogurt and the huge benefit of these was greatly improved quality of sleep. I was still waking every few hours, but when I woke I felt refreshed. Cherries have lots of melatonin in, so are great for sleep. This is something I will continue once my baby is born as it made everything easier to manage.
The other key successful change was warm lemon juice, first thing in the morning. I squeezed half a lemon in to warm water and drank this as soon as I got up. I'd wait 20mins or so before having breakfast. If you have gestational diabetes you will need to check that you can safely have this as citrus fruits can be too high in sugar for some. I have continued this daily as I notice I itch more the following day if I skip it. This is meant to be really good to kick start your liver at the beginning of the day.
I drank Dandelion Root tea (different to dandelion tea) but this is not recommended if you are taking medications for gestational diabetes. I was able to stay diet controlled for my diabetes.
TOPICAL TREATMENT
I found heat made the rash worse, so began washing regularly during the day with a flannel in cold water (in February, it was rough) and had daily showers as cool as I could cope with. In the worst moments I'd rub ice cubes on my skin. It seemed as though there was a layer of something building up on my skin during the day, because if I put another layer of cream on top, it would not do much, but if I washed my skin with cold water then re-applied cream/oil, I would be OK for about 4 hours (then repeat!). Pine Tar Soap worked really well for me. I bought one bar via eBay quite cheaply and it lasted the rest of the pregnancy. It lathers up well and smells faintly of bonfire smoke. Leaving the lather on for a few minutes was more soothing still. I tried Aveno oatmeal washes but didn't like the texture and it didn't relieve the itch. I had a little bag that I took everywhere with a flannel and some oil so that I could wash every four hours when I was out and about - I didn't need to use the soap for these extra washes, cold water was enough. This was day and night, but it meant I could still work and could get intervals of some sleep. After 3 - 4 weeks I only needed to wash once in the middle of the night.
As I'd bought some stretch mark creams and oils I just used these all over the rash. They are packed with good nutrients for your skin. Oils definitely gave longer lasting relief than creams. My favourite was Palmers Skin Therapy Oil. I found that creams or oils with Argan oil worked better for me (once I used handcream with Argan oil in a desperate moment and it worked well). I did try Aloe Vera gel, really expensive pure stuff, and it BURNED so much it took my skin a few days to recover from it. I did get a big bottle of cream from a pharmacy in Spain which I think was an equivalent to Aquaeous cream but this didn't help at all. I used Vaseline over my nipples to act as a barrier from contact with my bra.
Online advice I found was to wear loose cotton clothing. I couldn't do this - any light contact with my skin would trigger itching. Instead I wore tight vest tops that covered the rash and wore sleeveless tops. This way my arms could get cold air (as I said, February in the UK!) and itching wasn't triggered.
I was given conflicting advice about medications. I was told I'd need steroids to clear it up but wasn't allowed them in pregnancy. I did get prescribed antihistimines eventually, but by the time I'd been prescribed these the rash had resolved so I didn't need to take them..
I really hope this will be of some help to you if you are going through this. There isn't a quick fix (other than birth) but for me it was 6 weeks instead of potentially 15 weeks, which would have been torture.