Itching during pregnancy is a common problem encountered by women. Increase in the blood supply to the skin along with stretching of skin around the lower abdomen are the two primary reasons of itching during pregnancy.

 

Itching can also be cause by:

  • Eczema (formation of inflamed, itchy, red, and rough skin patches)
  • Scabies (itchy skin condition caused by mites)
  • Thrush (fungal infection around the vagina)

 

Mild itching is considered normal. However, a severe form of itching indicates a defect in the liver, called obstetric cholestasis (OC), which indicates there is a decreased amount of bile flow in the liver. In rare cases, women suffer from obstetric cholestasis.

At times, itching along with a rash may occur on the belly due to polymorphic eruption of pregnancy (PEP).  It is a common cause of itching with rashes during the third trimester of pregnancy. PEP does not affect the baby and subsides soon after the baby is born. It’s commonly seen in women with twin pregnancy.

 

Severe itching in pregnancy can be due to obstetric cholestasis (OC) or intrahepatic cholestasis of pregnancy (ICP).  OC is a disorder of the liver that occurs during pregnancy. The disorder is more risky for the baby then mother.  Under normal conditions, the bile flows from the liver to the stomach and helps in digestion of food. In OC, the bile salts instead of flowing to the stomach collect in the liver. This gathered bile clears up after the baby is born.

 

OC is a hereditary condition and is common in Asian women. Also, if a woman has had OC during the first pregnancy then the chances of developing it again during the later pregnancies are increased.

 

Itching on the palms and sole is the most common symptom of OC. It usually starts around 28th week of pregnancy.  Sometimes, if itching does not stop then it may cause a rash. Itching is more severe during the night.

 

Family history along with liver function tests (LFTs) are performed during pregnancy. In fact, LFTs are performed throughout the pregnancy from the time of diagnosis until the baby is born.

 

Managing itching during pregnancy

Mild itching can be managed easily by taking certain lifestyle measures such as:

  • Wearing loose clothes. Cotton clothes are preferred over synthetic clothes as cotton allows air to pass through them.
  • Avoiding baths with too hot water as it can aggravate the itching.
  • Using a soothing lotion or crème.
  • Using plain crèmes, soaps or lotions, as sometimes, itching can be caused by allergy due to some perfumed crème, lotion or soap.
  • Using body oils that are rich in linoleic acid, such as vegetable oil. Unlike olive or mustard oil, vegetable oil protects the skin barrier rather than making it more permeable.
  • Applying a cold pack can give an immediate relief.
  • Keeping the skin hydrated by drinking around 10 to 12 glasses of water reduces itching.

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Itching and rashes due to PEP can be managed by:

  • Applying steroid crèmes or lotion under the supervision of your doctor
  • Taking antihistamine medicines

 

The management of severe itching due to OC mainly includes:

  • Application of calamine lotion.
  • Taking medicines to reduce the bile juice in liver.
  • Taking vitamin K supplements, as OC can affect the absorption of Vitamin K.

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