Rash during pregnancy is a fairly common phenomenon. Of course, if it occurs, you need to inform the 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 that are manifested by symptoms such as itching and rash (it can be papular, pustular, urticaria and others) immunogram.
Dermatoses and infectious diseases
Rash during pregnancy may be associated with diseases such as atopic dermatitis, cholestasis (also characteristic of the gestational period), polymorphic dermatosis, pefigoid (a type of herpes).
At the same time, it happens that before pregnancy a woman was not bothered by allergies or other skin diseases. But most often, there was a predisposition to them (approximately every fifth patient with atopic dermatosis had signs of this pathology before).
In general, I diagnose dermatoses of pregnant women in about 3-5% of women, but it should be noted that with a mild course of the disease, not every expectant mother goes to the doctor, so it is quite difficult to establish the true scale.
A rash on the abdomen during pregnancy most often occurs in those women who have a hereditary predisposition to such diseases, including autoimmune pathologies and allergic reactions. Fortunately, after giving birth, it passes rather quickly.
It happens that a rash indicates infectious pathologies like measles or rubella. In this case, there are additional symptoms characteristic of viral infections, which can be used to understand the nature of the disease.
Causes of rashes
Although the issues of the occurrence of such a pathology have not yet been fully studied, among physicians the opinion prevails that the problem is associated with hormonal changes during pregnancy, as well as with the natural physiological changes occurring during this period, since certain sweat glands are activated. In addition, stretching the skin leads to itching.
Many believe that a rash is a sign of pregnancy. In fact, it does not occur in every woman.
The reasons that provoke her are as follows:
- Changes in immunity, which during pregnancy are aimed at preventing rejection of the fetus.
- Genetic predisposition. It is this that is responsible for most of the autoimmune processes. Interestingly, in this case, allergic reactions are not caused byas many external stimuli as placent antigen.
- Damage to connective tissue. It often happens that a rash during pregnancy itches not because of 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 reactions in the form of rash and itching.
In some cases, rashes and itching are caused not by allergic reactions, but by gestational cholestasis, that is, bile stasis that can occur during pregnancy.
What diseases cause rashes and itching?
Although in some cases, a red rash during pregnancy is caused by infectious diseases. And then they are accompanied by signs of general intoxication. Basically, after all, we are talking about skin pathologies.
Atopic dermatitis of pregnancy
It accounts for more than 50% of rash cases. They usually cause a rash during early pregnancy. Other types of skin diseases appear later, but atopic dermatitis can occur as early as the first trimester. Due to changes in immunity during pregnancy.
Practice shows that after childbirth in 80% of cases it disappears and the woman does not bother anymore. Such reactions are manifested as pruritus, eczema and itchy folliculitis. They pose no danger.
Polymorphic dermatosis of pregnant women
Also a common pathology ingestational period. Most often it is encountered in the third trimester. Provoking factors are multiple pregnancy and excess weight.
Associated with the mechanism of skin stretching 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.
May lead to dangerous complications. For example, postpartum hemorrhage, since this disease disrupts coagulation processes.
Pemphigoid pregnant
It is a fairly rare autoimmune pathology, when placental antigen acts as an allergen. It is accompanied by itching and a rash in the form of vesicles. It usually goes away after delivery, but the baby may develop a rash.
Fortunately, this is a rarer disease compared to atopic dermatitis, since it causes complications such as fetoplacental insufficiency, premature birth, and more. Yes, and in the postpartum period, problems can begin - for example, postpartum thyroiditis develops. In addition, during menstruation or while taking hormonal drugs, there may be relapses of the disease.
All of the listed diseases require treatment, so you should definitely consult a doctor.
Symptoms accompanying the rash
It should be noted thatrashes can have different localization. For example, a rash on the hands during pregnancy is mainly a manifestation of atopic dermatitis.
With 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 on the soles. But there are practically no rashes on the stomach.
When itchy folliculitis, the rash looks like acne. It most often occurs on the shoulders and back, abdomen, 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 abdomen, then spread to the thighs and buttocks. Basically, the rash occurs over stretch marks. It does not occur on mucous membranes. The skin near the navel and on the face also remains clean. Although individual spots are 1-3 mm in diameter, they tend to merge into large spots.
It happens that there is a rash on the face during pregnancy. She speaks of the presence of allergic reactions, may be accompanied not only by itching, but also by increased tearing, runny nose and other symptoms.
When 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. The 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.
Diagnosis
In order to correctly diagnose, the doctor will prescribe an additional study. After all, he must exclude infections, microbial damage, and other pathologies.
One of the most informative studies from this point of view is a biochemical blood test. It allows you to identify the presence of obstetric cholestasis, since this disease in the blood significantly increases the level of bile acids, in about 20% of expectant mothers who are faced with a problem with a rash, the level of bilirubin also increases.
And in the vast majority of cases, the analysis shows a significant increase in the activity of liver enzymes. For other diseases manifested by a rash, the indicators in the biochemical analysis remain within the normal range.
To exclude microbial or fungal infection, an analysis of scrapings or the contents of vesicles-rashes for microflora is done, and luminescent diagnostics is also carried out. 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 pemphigoid and polymorphic dermatosis are suspected, a histological examination of a 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 benefit to the mother outweighs the risk to the baby. In such cases, 2-3 generation antihistamines are used - Histafen, Claritin, Zirtek, Cetirizine.
If the rash is accompanied by severe inflammation, then for all types of diseases, except for itching of pregnant women (ie, atopic dermatitis, polymorphic dermatosis, pymphegoid), corticosteroids can be prescribed. For example, it can be an ointment based on hydrocortisone or prednisolone.
There is no specific treatment for pemphigoid, so the hormones described above are also most commonly used.
Ursodeoxycholic acid preparations are prescribed for obstetric cholestasis. 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, hepatoprotective drugs 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 in food, refuse spicy, fatty, s alty foods to support the liver. Sometimes therapeutic massage or special physical education is prescribed.
Emollients
These are creams and lotions that are used in such diseases for skin care 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.
May contain peach or olive oil, panthenol, and other natural and synthetic skin moisturizers.
Popular emollients include, for example, Bepanthen cream, which is even recommended for use in the treatment of atopic dermatitis in infants.
Care
During pregnancy, it is important to take good care of your skin to avoid rashes caused by poor 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, plant pollen. To do this, it is recommended to regularly do wet cleaning and wash the window mesh, and during the flowering periodstay away from potential sources of trouble.
It is very important to choose the right washing powder so that it does not cause either atopic dermatitis or contact.
Conclusion
Rash during pregnancy can have various causes, so at the first symptoms you need to seek qualified help. Timely therapy will help to avoid negative impact on the woman and the unborn child.
It is also necessary to remember that the independent use of drugs is strictly prohibited without prior consultation with the doctor, as well as folk remedies. And it is impossible to ignore such a state in any case.
