Itchy Rash on the Belly in Your Last Trimester? It Could Be PUPPP!

Itchy Rash on the Belly in Your Last Trimester? It Could Be PUPPP!

If you are in your third trimester and notice an intensely itchy rash on your belly, you should know about the condition that causes it

The third trimester prepares you for the life of a new mum. Your growing baby is snuggling inside you, and lets you know what he likes by jumping and kicking! As your belly grows bigger and your delivery date nears, you might notice some strange new pregnancy woes. One of these is a very itchy, very red rash on your belly. 

This rash is known as the polymorphic eruption of pregnancy, commonly referred to as PUPPP (Pruritic Urticarial Papules and Plaques of Pregnancy).

What is it exactly and why do you get it? Let’s learn more about polymorphic eruption of pregnancy treatment and causes in this article. I will also tell my own story towards the end of the article, so please read till the end. 

polymorphic eruption of pregnancy treatment

Is there any polymorphic eruption of pregnancy treatment? | Image source: file photo

What is PUPPP?

This polymorphic rash appears in different forms. It could be red dots, spots, or even patches. The cause of PUPPP is not exactly known, though there are a few theories about why it occurs. But before that, let’s see what this rash is all about and how frequent it is.

Facts about PUPPP

  1. It is not uncommon. PUPPP occurs in 1 in 160 pregnancies.
  2. It is intensely itchy.
  3. It starts around the umbilicus and spreads over the abdomen and may reach buttocks, thighs, arms, and legs.
  4. More common in the first pregnancy, it is almost never seen in subsequent pregnancies.
  5. It is also more common in a triplet (14%) and twin (2.9%) pregnancy. 
  6. In the rare event that it occurs in the subsequent pregnancies, it is in a much milder form.
  7. It is seen more often with a male foetus than a female foetus. 

What Causes Polymorphic Eruption of Pregnancy?

polymorphic eruption of pregnancy treatment

Source: Heykerriann at English Wikipedia [Public domain], via Wikimedia Commons

Polymorphic Eruption of Pregnancy, or PUPPP looks like a manifestation of an allergic reaction, so to say. However, the exact cause is not established. There are two main theories about what causes it. 

It occurs in the late third trimester when the baby is growing rapidly in size. The stretching of the tummy may cause a reaction to the skin, causing a rash. 

Meanwhile, the second theory is that a tiny amount of foetal cells enter the mother’s blood circulation and they might cause an allergic reaction.

In either case, sadly, nothing can be done to prevent it. 

Polymorphic Eruption of Pregnancy Treatment

Polymorphic eruption of pregnancy treatment is mostly symptomatic. The itch is horrible, so it can affect everything.

Luckily, emollients and topical steroidal creams are highly effective in controlling the rash. The rash is going to disappear almost immediately after delivery. And, it does not affect the baby. If it does, it is in a very mild form of rash that disappears within the first few weeks. 

You do not have to undergo a C-section, and you will not have any problems with breastfeeding. There is no need for any sort of special monitoring as well. 

Mums-To-Be, Please Read My Story Now

It was June 2016. My wife was pregnant with our son. One morning, while taking a bath, she noticed some sort of a rash on her tummy. She was almost 34 weeks pregnant. Both of us are doctors, but we were very very scared. Because, a) rashes in pregnancy are scary, and b) as doctors, we know a little too much! 

We got in touch with our obstetrician, who is a lovely lady working at the NUH. She then referred us to a dermatologist, who is, again, a very experienced doctor. We walked into his clinic and sat down with sufficient anxiety.

My wife was super itchy. Every minute was killing us. We knew that it was PUPPP in all probability, but we needed a confirmation. Both of us were praying, “Please God, let this not be something else.”


One look at it and he confirmed the diagnosis. He prescribed a lotion to apply to the belly, and it took away most of the itch. My wife was itchy most of the time, but the lotion helped a lot. In her own words, she would have given up anything just to make the itch go away! 

And then, our son was born, and the rash disappeared. We got busy exploring parenthood, and it was unlike anything we were prepared for! So, mums, I know what you are going through. I promise you, it will pass. Just see your doctor and get the rash checked.

Because soon, as the little one arrives, your life is going to change forever and polymorphic eruption of pregnancy treatment is not going to be on your mind anymore!



  1. British Association of Dermatology

Also read: Skin health tips for babies and mums: Useful advice from a medical expert


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Written by

Anay Bhalerao

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