PUPPP (Pruritic urticarial papules and plaques of pregnancy)

[Teki]

Yes, that title IS a mouthful!

OK, it took some research to finally realise WHAT I was suffering. PUPPP - is a condition where your stretchmarks on your tummy are extremely itchy and terribly bumpy, just above the pubic area, below the belly-button.

I am 36weeks pregnant with twins, and started suffering PUPPP about a week ago. I oil up after a shower; try to keep my bump-skin moisturised and wear loose fitting clothing, but I cant find any proper relief from the symptoms it causes, and its getting me down. Sometimes the skin 'stings' when applying cream or soothing skin gels.

I'd like to know if anyone else has been suffering this condition, and what advice they can give on relief of the horrible symptons. I have read that it will go once the babies are born, but you know, c'mon, thats a bit of a wait eh?

Also, if you've suffered this during pregnancy, are there any long term effects after? Because its rather unsightly and I am worried about the effect on my skin in this area....

Tx

bumping for you..

Hiya, thankfully no experience of this myself - sounds awful - but I'm sure I read a thread on it before.

Try typing in PUPPP in search Mumsnet Talk and some threads should come up which may contain helpful advice.

oooh! thank you ladies!
Tx

Hi, I have to reply to this one - I had this with DS and it was awful, so I really feel for you! Have you been given any prescription medication? I was referred to the dermatology unit at local hospital and eventually given some steroids, which helped a little but it was still horrid.

On the up side, this is apparently very rare (I was featured in a seminar and photographed for textbooks, they were so excited in dermatology - I think I cried!) and unlikely to recur in subsequent pregnancies (I was absolutely fine when pregnant with DD). Also it really does go when the baby (or babies!) arrive (symptoms eased nearly straight away, rash gone in about 24 hours). And I don't have any scarring or lasting skin damage at all, so please don't worry about that.

That probably doesn't make you feel any better right now, I recall endless sleepless nights in a summer heatwave and just feeling like a zombie! It's worth asking for stronger medication or some steroids if you don't already have them, they might help. In the meantime, try not to let it get you down too much and remember it will go when the babies arrive!

Best of luck, M x

Ooooh Teki, I really feel for you!

I had this too during my twin pregnancy and it started at about the same time. I had it in winter and that was awful enough...can't imagine in the summer heat...really sorry you're suffering.

Not much provided relief, I'm afraid. I remember walking around the house in the wee hours of november / december mornings with a wet tea-towel across my bump. That helped a bit. I just tried to keep myself distracted and cool...I do remember being driven to tears one day.

On the positive side; it disappeared immediately the babies were delivered.

BTW; the research I did on it suggests that it is more common when carrying boys - something about finding male DNA in the skin scrapings from the rash (???? Very vague memory of reading that while feverishly trying not to scratch!!). I did go on to deliver twin boys, though...

Just hang in there and know that it isn't forever. This too shall pass....

Ah ah! Found it!

"Cause of PUPPP
The cause of PUPPP is unknown. It is not associated with preeclampsia, autoimmune disorders, hormonal abnormalities, or fetal abnormalities. Some investigators suggest that the rapid abdominal wall distension damages connective tissue and causes an inflammatory response. One study has shown that male fetal DNA can be found in skin biopsies of the rash. Since 70% of women with PUPPP give birth to boys, a new hypothesis is that male fetal DNA acts as a skin irritant. "

I feel your pain. I also had this. Eventually after weeping in the admissions room of the maternity hospital a nice junior doctor took pity on my, found out exactly what it was, called a dermatolagist and I was given steroid cream (quite strong) and it cleared it up completely. Coal tar soap is also supposed to help, the cool tea towel is a good idea as well. It will pass! And I was also told it was related to having a boy, and indeed I had a boy!

Sympathies from me. I had this and it started at 21 weeks. I was told it would get better when I had the baby! I came out from seeing the dermatologist in tears. It spread everywhere from my neck down. However I didn't have to wait 19 weeks for relief. I went to see a dermatologist specialising in pregnancy skin conditions. He told me that PUPPP has a lifecycle of 6 weeks. 2 weeks spreading, 2 weeks at its worst and 2 weeks getting better which was exactly how it was. I was given Eumovate cream and was sent to the dermatology department for application of the cream twice a week then they made me a full body suit out of tubular bandages - very attractive!! It really stopped me from scratching though as I could rub the bandage but not scratch the skin. Also had some aqueous cream with menthol which felt nice and cool on the skin and lots of cool baths. I had a boy as well and no lasting issues with my skin.

Gosh, this thread brings back bad memories!

I got PUPPS last summer when my daughter was 2 weeks old - no gp could diagnose it and the itchng was unlike anything I have known before, def the worst part of pregnancy and labour together!

I eventually got a private app to see a dermatologist 3 weeks later (having tried steroid cream after steroid cream, anti histamine tabs which started to dry up my milk etc) and was prescribed oral steroids, which cleared the rotten thing up in about 5 days.

My rash was across my tummy, arms, legs, bum, hips and towards the end on my palms and feet also.

But it is an unusual condition (about 1% of all pregnancies are affected) and my dermatologist had never heard of a post partum case, such as mine.

I am now expecting again and praying it doesn't return. Must be very difficult in pregnancy to suffer as there is little you can take to improve it...Really hope you feel better soon and good luck with the exciting weeks ahead!

I developed this at 39 weeks pregnant, it was pretty horrific, I actually admitted myself to hospital because I was literally tearing my skin off. My GP had diagnosed it as a 'virus', although after doing a bit of Googling I realised that it was PUPPP. Even in the hospital only one midwife and one consultant had heard of it. I begged them to induce me, as after much research I knew my skin would clear up after my baby had been delivered (which it did, almost straight away.) The consultant was far from sympathetic, "I've seen a LOT worse" were her exact words. They gave me steroid cream which didn't help, and some liquid paraffin based cream and Piriton allergy tablets which made it SLIGHTLY more bearable and easier to sleep, and I found sitting by a fan after slathering on loads of cream really helped to cool it down. I went into labour a few days after, luckily, and it did pretty much dissapear overnight.

mine started at 23 weeks, ds2 is now 15 days old & not only has it not gone the rash & itching are still getting worse. Dermatologist has advised that the only thing that might help at this point (we've tried pretty much everything else) is high dose oral steroids which are not safe while breastfeeding - so I'm screwed really :(

I had this too - big baby, big fibroid (seems to be related to very fast stretching of the skin eliciting a sort of immune response, hence more common in twin pregs etc).

Two things got me through it; cold washcloths laid on the worst bits, and piriton - the old fashioned one, chlorpheniramine maleate - prescribed by the doctor, just taken at night to get a little sleep!

Good luck, mine actually disappeared before I had my DD, so there is hope!

I had this with my first pregnancy with DS1. It was horrific and spread to my arms and legs within days of it appearing. Eventually they induced me at 40+10 (instead of +12 so not much) as it was driving me nuts. I used calamine lotion and also after much googling found that rubbing the inside of a banana skin on the bumps seemed to calm them down! They did give me Piriton in the hospital but it didn't have much effect. As I was giving birth the rash literally started disappearing and within a week was gone everywhere except my boobs, but as I breastfed I think maybe it was his saliva continuing to irritate my skin Anyway, didn't have it when pg with DS2 nor this time around so far- 28 wks with DS3. Really feel for you it is awful. Hope you manage to find some relief from it soon.

I was not diagnosed with PUPP but had a different itching condition - obstetric cholestasis - although they sound very similar ito symptoms. I also had stretch marks and itchy skin below belly button. I don't know if any of this helps but I took anti histamines but they only helped a little.

I used aloe Vera gel as well as regular moisturiser all the time (like 10 times a day, alternating the two). That did help a little. Cool baths with almond oil. The doctor also prescribed me E45 cream with menthol which helped a little.

Good luck!

Oh OP I really feel for you. I had this for about 3 weeks before DS was born and it was really awful. Spread all over my stomach, legs and feet. The itching was so bad that I was seriously sleep deprived before DS even arrived.

I had steroid cream and antihistimenes (sp) prescribed and to be honest none of it provided any more than very temporary relief. Found calamine quite soothing though. Its true what others are saying, it really does disappear within a couple of days of having the baby, but I found it got progressively worse up to that point.

Does anyone know if it is true that you can only have it once? :)

I had this with my first pregnancy from 31 to 38 weeks - my consultant said it would likely 'burn itself out' before the birth, which it did. It was utterly horrific and anyone who suffers with this has my utmost sympathy. However, on the positive side - I am now pregnant with my 5th child and it has never reappeared again.

Baldricks - My itchy rash remained just on my boobs throughout the first 4 months of feeding - thought interesting you had this too. I always thought it was related.