Pruritic Urticarial Papules and Plaques of Pregnancy

What is PUPPs you may ask? The easiest, most basic explanation is a skin condition seen in pregnancy. 1% of pregnant women get this non-contagious skin rash which results in bumpy skin that constantly and intensely itches. Women develop small bumps and hives that starts on the abdomen and spreads to the thighs, butt, breasts, and arms.

Anyone that has been pregnant knows that it’s already uncomfortable to be pregnant and your stomach is already slightly itchy. Not to mention all the insecurities that come along with the changes you go through physically and mentally.

I have met a woman through one of my telegram groups who dealt with this and wanted to share her story with us. She felt it was something no one really talks about because it’s not serious or life-threatening but was still hard to go through.

You can follow her on either or both of her Instagram accounts:
@chelsea_partyof3
@alexandermichael2016

 

Here is her story:

My husband and I were very blessed when we decided to start our family – a month later and we had 4 positive sticks and couldn’t have been more excited. I was thrilled to start this journey of motherhood, beginning with pregnancy. I got to grow a human being, my own child; how amazing!

After all the firsts; appointment, blood test, ultrasound..etc. everything was moving along perfect and smooth. I had gained some weight fairly early on but expected that was the norm. I was working a full-time job that required me to be on my feet and walking around a lot of hours during the day. We also went hiking every weekend in the mountains and so I continued to stay in fairly good shape throughout the pregnancy.

Halfway through – the anxiousness of what we were going to have running through my mind before our ultrasound. I had a feeling all along it was going to be a boy, to the point I was already buying little blue things…and sure enough it was confirmed, I would be the mommy to a little boy.

28 weeks came and I was feeling great, I had quite a bit of energy, was still working and thinking I was doing so well because I hadn’t had a stretch mark yet. Maybe, I would be free and clear with all my walking and smoothies they wouldn’t catch up. Sure enough, I was really sore and started to get a mark just above my belly button. That’s ok, I thought, it’s normal and just a tiny one, right? Fast forward over the next 5 weeks and that tiny stretch mark, yep, you guessed it..was no longer a lone soldier. I now had a belly full of dark red bands running from the button and down to the seam of my pants. Little did I know, these were not only going to be a part of me forever, but also the home to a debilitating rash.

I was beginning to start the countdown to meeting my little Alex. 7 weeks to go, we have made it this far, not much longer to go and still feeling like a champ. Sure, I was wobbly and starting to have to go to the bathroom nonstop but I had this pregnancy conquered. I would snicker at the comments about being so hot and miserable, that the last month was going to just be horrible.

On Fridays, I only worked until noon, and on this one, it had been a sort of uncomfortable day. My stomach just felt warm and was starting to itch quite a bit. Not the usual just stretching of the skin, but something was really bothering me. When I got home, I realized that my stretch marks were starting to form some bumps all inside. I called my midwife and she advised me to go to the labor and delivery ER to have it checked out since they did not have any open appointments to see me in the afternoon. My husband was still at work and I figured it was no big deal, I would just run over and make sure everything was ok. I was naïve. I had to get into the super stylish gown, pee in a cup, and get situated on the bed. The nurse said she was going to put a wrap on my belly and monitor the baby for a while. This was an anguishing hour – the rash was full force itching and having the tight band where I wasn’t able to itch about drove me mad. The baby was okay, and I finally I asked if she would PLEASE remove that scratchy material from my stomach. As soon as she took it off, I went to town. Just scratched and scratched. Ahhhhh… that was better, for a minute at least. What was going on, do I have hives? Am I having an allergic reaction? After more waiting, and waiting (you know how the hospital is) and the itching just getting more intense. The nurse came to tell me I had Pruritic Urticarial Papules & Plaques of Pregnancy – Also known as PUPPPs.

What is PUPPPS, why do I have it, and will my baby be OKAY? Right away, tears start flowing down my face, I grab my phone to call my husband and of course google this thing that she tells me I have.

“Its ok Chelsea, take a deep breath..it’s completely safe for the baby and won’t harm him, you will just have some discomfort for a while” utters the nurse to try and comfort me. She sends me home with the advice to get some over the counter anti-itch cream, try not to scratch, and a “Good Luck”

Here’s the quick lowdown after researching this diagnosis. Well…. Not much. I could have gained to much weight early on in pregnancy, 70% of women that have gotten the rash carried a boy hypothesizing that the male DNA acts as a skin irritant. That doesn’t tell us much does it? Why am I still sitting here on the couch, with my husband placing raw potatoes over the rash to try and help ease me and not know what is causing all of this mayhem? I am miserable, out of my mind. Can’t sleep, can’t focus on work, trying to keep it together and I finally have a meltdown. I snap a picture of the rash and send it to my mom, OMG Chelsea… are you OK? What is that? In easy terms, it’s hives. Most everyone knows what hives are right, from an allergic reaction? I try SO hard to not scratch, keep running over and over in my mind it will go away, it’s just a simple itch focus on something else. every move I make my husband is making sure I am not scratching. So, when he’s sound asleep, I give it. AND IT FEELS AMAZING.  I’ve now scratched so hard its bleeding and bruised. I really can’t compare what this felt like to anything else, as I don’t remember the chicken pox I was really little, But I do imagine that it’s somewhat of a comparison.

A week has gone by, and during all of this, we have tried creams, more creams, baking soda, raw potatoes, and Grandpas pine tar soap from the natural store. The sales lady warned me the soap would smell like a campfire, and boy she was not kidding. After slathering my belly with it, I felt like I had just enjoyed a weekend in the mountains roasting marshmallows. It gave me some relief and took the burning sensation away, but that pesky itch was still there.

I went in for my 34-week appointment and my midwife was able to get me a prescription anti-itch that was safe to take, and also recommended some Benadryl because I was overly exhausted and needed to sleep. I am not one to take many drugs, but I was beginning to feel desperate, and I didn’t know if I would be able to mentally tackle the next 6 weeks. Put socks on your hands while you sleep, so if you itch there won’t be contact and more just rubbing. Ha! Like that is going to work when you feel like you have ants crawling all over your skin.

The rash had grown and was now keeping me awake even with the prescription. It didn’t help that I was giving into the itching and fueling the fire. I couldn’t help it though, it had taken over my mind. After work, I would come home and strip down to my underwear, slather up with some cream and sit in front of the fan. I was extremely uncomfortable at night, tossing and turning, taking cool baths at 2 am, watching endless shows on Netflix.

I was trying to work and just couldn’t keep it together, I would escape every chance I had to the bathroom and itch itch itch. We decided to take another trip to the Labor and Delivery ER. After using WebMD and Google, I, of course, had thought I was diagnosing myself with Cholestasis. This is a condition where your liver is not functioning properly, and the baby would have to be delivered right away if it was true. It had to explain all my symptoms though, surely it couldn’t just be this rash? They did tests and we had to wait for a few hours, while I laid there and scratched away, my midwife anxiously telling me that if I indeed had cholestasis, I would be having an emergency C-section that day. All my family was wondering what was going on, was Alex going to be born at 36 weeks, was everything okay? Good news, It wasn’t cholestasis and I learned my lesson to stop googling every symptom I was having. But why am I still such an itchy mess? Why do I have a rash all down my legs? Why are my feet so hot?

At this point, I’ve been to 4 different appointments specifically for this rash, and really nobody can tell us why it’s happening, but just that it will be over after he is born. I just have to make it a little bit longer. I was so frustrated and decided to try some western medicine and go to acupuncture. They know the sweet spots, surely she would stick a needle somewhere and would make it all go away? Normally, I am not good with needles at all, but when your desperate, all that fear is forgotten. After having a long conversation and explaining what I had been going through, she told me she didn’t really have a solution to the rash in specific, but she would try and do some variation of what helps some other skin conditions. Now, the room was very low lit, there was soft music playing. If anything, her ultimate goal was to get me to even just relax enough for an hour. I fell asleep! I couldn’t believe it! Whatever she did, made me feel so much better. I went back to work and throughout the rest of the day my feet were just sweating and sweating, I was actually sliding in my shoes. Gross, I know. But, that was the last of the heat in my feet.

Day in and Day out I went over the same routine of trying anything I can to get the itch under control and focus on anything but the rash. It was time for my 38th-week appointment. My midwife asked how I was doing, and with tears rolling down my face she said, “ok, it’s time to schedule an induction, this is getting out of hand and has been long enough” YES! THANK YOU!! Pleasssseeeeeee help me. I only had to wait 9 more days. I was SO excited to be knowing that Alex was coming soon, and the itch would soon be over, I was able to focus my mind away and be positive. I did complete 3 more rounds of acupuncture every day before he was born.

Multiple times I was told, and read on the internet, that this rash would disappear on its own after birth. It might take a few weeks, but certainly, it would go away. I was still itchy after the birth, but there were so many other things going on, the itching really just started to fade away. About 2 weeks after getting home and settled with Alex, I started to notice the itch was relieving, it was going away. Wahooooo, right? And then…..As I’m struggling with breastfeeding I am sitting on my rocking chair and notice bumps forming on my leg. Surely, this couldn’t be coming back? I’m not even pregnant anymore, why is this happening? I call my midwife, and she has NO answers, none, she’s completely baffled and tells me I’m the worst case she’s had in 20 years. Well great, I’m so glad I can make a history book.

I’ve now put a call into the dermatologist, I am going to go somewhere that specializes in skin. I take my dress off and she immediately knew what it was, but says, I thought it would go away. “let me get a book and lets read about this together” as she pulls one of her books off the case, and literally dusts it off. “blah blah blah, will subside within weeks of birth” Ok – I’ll get you a prescription cream and see if that helps. I think your best option is to just wait it out. I would consider stopping breastfeeding though because the hormonal surges could be a contributing factor. I headed home with a really heavy heart that day. Am I being selfish? Should I just endure this for the health and best for my baby boy? I just don’t think it’s healthy for him when I am the borderline mental case because my mind is on my hurting body all the time.

Let me just put a side note in there, that now its 4 weeks after birth, I’ve got the rash back but down my hips, and we are moving 1100 miles in 5 weeks. So; I am packing up our house, making arrangements for housing in Idaho, taking care of a newborn. Recipe for a disaster if you ask me.

I mentioned to my midwife at my 6 week check up about the breastfeeding correlation with hormones and the rash, and she agreed. It was too much for my body. I clearly was trying to fight something, and this wasn’t working out.

We moved 3 weeks later, taking 3 days to get to our destination. I was happy to be starting a new adventure, but still wondering why I was dealing with these skin issues. I decided to go to a 2nd dermatologist and get another opinion. I was in a whole new place, I was sure to find some answers here. No happy news there – just to keep putting some petroleum jelly on it and waiting it out, it would certainly go away eventually. EVENTUALLY? I’ve been dealing with this monster for 15 weeks but it would be over EVENTUALLY? I cried and cried the whole way home. I have stopped breastfeeding, I have taken drugs, spent a lot of money on useless creams, to be told by multiple people they don’t know much about it.

The good news is, eventually yes it did go away. It peaked at 9 weeks postpartum before starting to fade away for good. I wanted to share my story because I still don’t understand why there is not much research about this rash, and what can be done to help women struggling with it. It’s an age-old diagnosis, but not harsh enough to be specifically paid attention to. You are always hearing big stories about preeclampsia, diabetes, and other pregnancy illnesses, but I’ve never seen one on PUPPPS. Maybe to most people, it isn’t that big of a deal, or the cases aren’t very large. But to me, it was the worst case imaginable, and maybe if I would have more to reach out too for advice, or support, it would have made it easier to cope with. Here’s to strong women!

 

This photo is the snap she first sent to her mother:

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The second hospital visit when they tested for cholestasis and she was busted mid-scratch:

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Alex when he was born:

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This collage is when she was 8 weeks postpartum and it was still spreading:

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Hiking at 34 weeks at 9000 feet elevation:

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