A rash during pregnancy is a fairly common phenomenon. Of course, when it occurs, you need to inform your doctor about it, since it can be a symptom of an infectious disease. Nevertheless, most often we are talking about such a group of pathologies as dermatoses of pregnant women.
These are various skin pathologies, which are manifested by symptoms such as itching and rash (it can be papular, pustular, urticaria, and others). In any case, the doctor should prescribe additional studies - to begin with, at least a biochemical blood test and an immunogram.
Dermatoses and Infectious Diseases
A rash during pregnancy can be associated with diseases such as atopic dermatitis, cholestasis (also characteristic of the gestational period), polymorphic dermatosis, pefigoid (a type of herpes).
In this case, it happens that before pregnancy the woman was not bothered by allergies or other skin diseases. But most often, there was still a predisposition to them (approximately every fifth patient with atopic dermatosis showed signs of this pathology earlier).
In general, I diagnose pregnant dermatoses in about 3-5% of women, but it should be noted that with a mild illness, not every expectant mother goes to the doctor, so it’s quite difficult to establish the true scale.
A rash on the abdomen during pregnancy most often appears in those women who have a hereditary predisposition to such diseases, including autoimmune pathologies and allergic reactions. Fortunately, after childbirth, she quickly passes.
It happens that the rash indicates an infectious pathology like measles or rubella. In this case, additional symptoms characteristic of viral infections arise, by which you can understand the nature of the disease.
Causes of the rash
Although the emergence of such a pathology has not yet been fully studied, among doctors there is a prevailing opinion that the problem is associated with hormonal changes during pregnancy, as well as with the natural physiological changes that occur during this period, as certain sweat glands are activated. In addition, stretching the skin leads to itching.
Many people think that a rash is a sign of pregnancy. In fact, it does not occur in every woman.
The reasons that provoke it are as follows:
- Changes in immunity, which during pregnancy are aimed at preventing fetal rejection.
- Genetic predisposition. That is what determines the majority of autoimmune processes. Interestingly, in this case, allergic reactions are caused not so much by external stimuli as by the placental antigen.
- Damage to connective tissue. It often happens that a rash during pregnancy does not itch due to a classic allergic reaction, but because of an increase in the size of the abdomen and the associated stretching of the skin. Connective tissue fibers are damaged, fragments of elastin and collagen enter the bloodstream, and the body perceives them as allergens, hence the reactions in the form of a rash and itching.
In some cases, the rash and itching are not caused by allergic reactions, but by gestational cholestasis, that is, stagnation of bile, which can occur during pregnancy.
What diseases cause rashes and itching?
Although in some cases, a red rash during pregnancy is caused by an infectious disease. And then they are accompanied by signs of general intoxication. Basically, we are talking about skin pathologies.
Atopic dermatitis of pregnant women
It accounts for more than 50% of cases of rashes. They usually cause a rash during early pregnancy. Other types of skin diseases appear later, but atopic dermatitis can occur in the first trimester. It is caused by changes in immunity during pregnancy.
Practice shows that after childbirth in 80% of cases it passes and the woman is no longer bothered. Such reactions manifest as pruritus, eczema, and itchy folliculitis. They do not represent danger.
Polymorphic dermatosis of pregnant women
It is also a common pathology in the gestational period. Most often they encounter him in the third trimester. Provoking factors are multiple pregnancy and the presence of excess weight.
It is associated with the skin stretching mechanism described above. The rash may look different. Does not give birth complications.
Obstetric (intrahepatic) cholestasis
The disease develops in the last trimester, most often it is hereditary. It is associated with the irritating effect of bile acids.
It can lead to dangerous complications. For example, postpartum hemorrhage, since this disease disrupts the processes of coagulation.
Pemphigoid Pregnant
It is a fairly rare autoimmune pathology, when the placental antigen acts as an allergen. It is accompanied by itching and a rash in the form of vesicles. It usually goes away after birth, but a rash may occur in the baby.
Fortunately, this is a rarer disease compared to atopic dermatitis, because it causes complications such as placental insufficiency, premature birth, and more. And in the postpartum period, problems can begin - for example, postpartum thyroiditis develops. In addition, with menstruation or while taking hormonal drugs, there may be relapses of the disease.
All of these diseases require treatment, so you must consult a doctor.
Symptoms that accompany a rash
It should be noted that rashes can have different localization. For example, a rash on the hands during pregnancy is basically a manifestation of atopic dermatitis.
In this disease, red eczematous spots also appear on the face and neck, and on the hands they are localized mainly on the palms and flexion surfaces. Especially often it appears on primiparous women. With atopic dermatitis, a rash on the legs during pregnancy is also not uncommon. Including, it is localized under the knees and soles. But there are practically no rashes on the stomach.
With itchy folliculitis, the rash is similar to acne. It most often occurs on the shoulders and back, stomach, arms. Pimples are located near the hair follicles. They can be quite large - 2-4 mm in diameter.
With polymorphic dermatosis, the rash is itchy red papules. They mainly appear on the stomach, then spread to the hips and buttocks. Basically, a rash occurs over stretch marks. On the mucous membranes it does not happen. The skin near the navel and on the face also remains clean. Although individual spots have a diameter of 1-3 mm, they tend to merge into large spots.
It happens that there is a rash on the face during pregnancy. She talks about the presence of allergic reactions, can be accompanied not only by itching, but also by increased tearing, runny nose, and other symptoms.
With pemphigoid rash most often appears at 4-7 months. It is mainly localized on the skin around the navel, but can also occur on the chest or back. Rashes look like bubbles. If they are damaged, erosion appears in their place, and when the crust dries.
Intrahepatic cholestasis is characterized by yellowing of the skin and itching, which is especially acute on the palms and soles. The rash is usually secondary in this case. Very often, a woman combs her, because the itching is almost unbearable.
Diagnostics
In order to correctly diagnose, the doctor will prescribe an additional study. After all, he must exclude infections, microbial damage, other pathologies.
One of the most informative studies from this point of view is a biochemical blood test. It allows you to detect the presence of obstetric cholestasis, because with this disease in the blood, the level of bile acids rises significantly, approximately 20% of expectant mothers who have encountered a rash problem also increase the level of bilirubin.
And in the vast majority of cases, the analysis shows a significant increase in the activity of liver enzymes. In other diseases, manifested by a rash, the indicators in the biochemical analysis remain within normal limits.
To exclude microbial or fungal damage, an analysis is made of scraping or the contents of the rash bubbles on the microflora, as well as luminescent diagnostics. When diagnosing, it is very important to exclude scabies, seborrhea, bacterial folliculitis, hepatitis and a number of other diseases, since they require other methods of therapy.
For atopic dermatitis and herpes, an analysis is carried out such as determining the content of IgG4 antibodies (with herpes, the indicator increases) and IgE (this indicator reflects the course of an allergic reaction).
Finally, if a pemphigoid and polymorphic dermatosis are suspected, a histological examination of the skin biopsy is done.
Treatment of rashes: basic methods
Itching and rash during pregnancy should be treated comprehensively, including eliminating the cause of their appearance, depending on what such phenomena are associated with.
For example, antihistamines are used for atopic dermatitis and other types of allergies. They can affect the fetus, so they are prescribed with caution in the first trimester if the benefits to the mother outweigh the risk to the baby. In such cases, antihistamines of 2-3 generations are used - "Histafen", "Claritin", "Zirtek", "Cetirizine".
If the rash is accompanied by severe inflammation, then corticosteroids can be prescribed for all types of diseases, except for itching of pregnant women (i.e. atopic dermatitis, polymorphic dermatosis, pimpheoid). For example, it may be hydrocortisone or prednisone ointment.
There is no specific treatment for a pemphigoid, so most often the hormones described above are also used with it.
With obstetric cholestasis, preparations of ursodeoxycholic acid are prescribed. It improves the composition of bile, reduces the concentration of toxic types of bile acids in it, and promotes the outflow of tin. In this disease, hepatoprotectors are additionally prescribed to protect the liver, for example, Karsil, as well as cytostatics (Methotrexate). It is recommended to take the antihistamines and vitamins described above.
Finally, it is important to observe certain restrictions on food, to refuse spicy, fatty, salty foods in order to support the liver. Sometimes therapeutic massage or special physical education are prescribed.
Emo tapes
These are creams and lotions that are used in similar skin care diseases to restore damaged epidermis, moisturize and soften the skin, and promote the regeneration of intercellular lipid structures.
Most emollients have no contraindications for expectant mothers, but you need to carefully study their composition so that it does not include components that could cause allergic reactions.
The composition may include peach or olive oil, panthenol, other natural and synthetic ingredients to moisturize the skin.
Among the popular emollients is, for example, Bepanten cream, which is even recommended for the treatment of atopic dermatitis in infants.
Care
During pregnancy, it is important to take good care of your skin in order to exclude a rash caused by inadequate hygiene.
As such, there are no preventive measures against dermatoses. But doctors recommend abandoning synthetic underwear and clothing in favor of products made from natural fabrics, as well as excluding contact with various allergens: house dust, animal hair, and pollen from plants. To do this, it is recommended to regularly do wet cleaning and wash the window mesh, and during flowering, stay away from potential sources of problems.
It is very important to choose the right detergent so that it does not cause either atopic dermatitis or contact.
Conclusion
A rash during pregnancy can have various causes, therefore, at the first symptoms it is necessary to seek qualified help. Timely therapy will help to avoid negative effects on the woman and the unborn child.
It is also necessary to remember that the independent use of drugs is strictly prohibited without first consulting a doctor, as well as folk remedies. And you can not ignore such a state in any case.