Pregnancy can lead to many changes within the body hormonally, emotionally, physically, and more. Some of these changes may lead to different conditions that occur as a result of, or during, pregnancy. Skin conditions called dermatoses of pregnancy are a group of itchy or inflammatory skin disorders that can occur while a woman is pregnant. Most of these dermatoses resolve once the baby is born or slightly thereafter. Each dermatosis has its own specific characteristics, treatments, and risks. The most commonly discussed dermatoses of pregnancy are:
Atopic eruption of pregnancy (AEP)
Polymorphic eruption of pregnancy
Intrahepatic cholestasis of pregnancy1-4
This is not an exhaustive list of all skin-related conditions that can happen during or as a result of pregnancy. If you notice any new or worsening symptoms related to your skin while you are pregnant, contact your healthcare provider as soon as possible.
What is atopic eruption of pregnancy?
The term atopic eruption of pregnancy (AEP) represents a group of conditions including eczema or atopic dermatitis in pregnancy, pruritic folliculitis of pregnancy, and prurigo of pregnancy.5 AEP can happen throughout any or all trimesters of pregnancy, and is the most common of all dermatoses of pregnancy. Roughly one out of every five women with AEP will experience an exacerbation of already present atopic dermatitis, while the other 80% may be experiencing these skin changes for the first time in a long time (such as since childhood), or the first time ever.1,2
AEP is classified into two types, the E-type (associated with eczematous changes that mainly impact the face, neck, and extremities), and the P-type (papule lesions and prurigo nodules on the limbs, trunk, arms, and shins). The E-type affects roughly two-thirds of individuals with AEP and the P-type affects roughly one-third.1,2 A history of atopic conditions is thought to increase an individual’s risk of developing AEP.1,4 Diagnosis of AEP is generally made upon physical examination of the skin and after other conditions have been ruled out.2,4
What causes AEP?
The exact cause of AEP is unknown; however, it is thought to be related to changes in the immune system as a result of pregnancy. A woman’s immune response is typically weakened during pregnancy, and levels of specific immune system-related chemical messengers, called cytokines, are altered. These changes may be what leads to AEP, and why it generally resolves quickly after delivery.1-4
How is AEP treated?
AEP generally resolves on its own after a woman gives birth. The most common treatment options for AEP focus on reducing symptoms, such as itching, while the skin condition is present. Some of these treatment options include, but are not limited to:
As mentioned, AEP generally resolves quickly after childbirth, however, it may return during future pregnancies. There is no known harm to the mother or the fetus as a result of AEP, however, some experts have suggested that if a woman has AEP, her baby may be at a higher risk of developing atopic conditions once born.1-4 More research is needed to characterize this potential relationship.
Pomeranz MK. Dermatoses of Pregnancy. UpToDate. https://www.uptodate.com/contents/dermatoses-of-pregnancy. Published June 26, 2017. Accessed July 20, 2018.
Ambros-Rudolph CM. Dermatoses of pregnancy—Clues to diagnosis, fetal risk, and therapy. Ann Dermatol. Aug 2011; 23(3), 265-75. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3162253/. Accessed July 20, 2018.
Sachdeva S. The dermatoses of pregnancy. Indian J Dermatol. 2008; 53(3), 103-5. Avaulable from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2763729/. Accessed July 20, 2018.
Maharajan A, Aye C, Ratnavel R, Burova E. Skin eruptions specific to pregnancy: An overview. The Obstetrician & Gynaecologist. 2013; 15, 233-40. Available from: https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1111/tog.12051. Accessed July 20, 2018.
Roth MM, Cristodor P, Kroumpouzos G. Prurigo, pruritic folliculitis, and atopic eruption of pregnancy: Facts and controversies. Clinics in Dermatology. May-June 2016; 34(3), 392-400.