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Eczema During Pregnancy: Your Guide

Posted on January 03, 2022
Medically reviewed by
Kevin Berman, M.D., Ph.D.
Article written by
Anastasia Climan

Many people notice a link between their hormonal shifts and eczema flare-ups. Some find that their symptoms improve while they are pregnant, while others observe the opposite. Members of MyEczemaTeam have weighed in on the various ways pregnancy impacts their skin.

One member wrote, “I started with eczema when I hit puberty. It’s always worse when I’m on my period. The strange thing is, during my pregnancy and while expressing breast milk, my skin was completely clear! It wasn’t even dry! I was wondering if anyone else has had any links between hormones and a skin condition?”

Another member responded with her experience: “Mine was totally opposite! When I was pregnant, it was terrible. I didn’t nurse, but my eczema was still bad postpartum.”

It’s tough to predict how pregnancy will affect your eczema. Sometimes one person will have a very different experience with their first pregnancy than they do with subsequent pregnancies. If you’re expecting a child currently or recently gave birth, here’s what you should know about managing eczema.

How Does Pregnancy Affect Eczema?

Some people — with or without a history of eczema — develop a skin condition during pregnancy called atopic eruption of pregnancy. It usually happens during the first trimester, and shows up as an itchy rash on your breasts, neck, and/or skin near your elbows and knees. Scratching these rash areas may lead you to have an infection that requires antibiotic treatment.

Such skin itchiness is a common complaint of pregnant people, particularly those with eczema. Cholestasis — a natural buildup of bile in the liver that can happen during pregnancy — can contribute to itchier skin than usual. One way to avoid dryness (and thus keep symptoms under control) is by taking cool showers and regularly applying lotion.

Pregnancy is a time when it’s that much more important to stay on top of your eczema skin care routine. Because a person’s immune system is suppressed during pregnancy, people with eczema may be more susceptible to infections, such as those caused by the herpes simplex virus.

If you experience any signs of an infection or if your eczema symptoms worsen while you are pregnant, let your doctor know right away. If your eczema treatment is delayed and its condition worsens, you may be at higher risk of serious complications.

Possible complications stemming from untreated eczema during a pregnancy can include:

  • Fetal infection
  • Preterm labor
  • Death (of parent or fetus)

Eczema Medication During Pregnancy

Your dermatologist will evaluate the best course of treatment that will be safe for your pregnancy and relieve your eczema symptoms. Your doctor will consider several factors, including how far along you are in pregnancy, the severity of your condition, and your risk of pregnancy complications.

Topical steroids are considered safe for pregnancy in small doses and for a limited amount of time. (Using them sparingly on areas that expand during pregnancy can also lower your likelihood of stretch marks, because steroid creams can thin your skin.) Talk to your gynecologist or dermatologist about topical steroids during pregnancy.

Low doses of oral steroids for a short period of time may also be appropriate. If your eczema responds to ultraviolet light treatment, this is another viable, low-risk option while you are pregnant.

Eczema medications that are off-limits during pregnancy include methotrexate, psoralens plus UVA (PUVA), and Toctino (alitretinoin). If you’re planning to become pregnant, talk to your doctor about discontinuing methotrexate at least three months before conception.

Natural Eczema Treatments Aren’t Necessarily Better During Pregnancy

Many pregnant people worry about taking medication or using synthetic products while they are pregnant. However, it’s essential to stick with eczema remedies that you know will effectively keep your symptoms under control. If your obstetrician or midwife advises you that a medication or product is safe, don’t feel the need to switch to a potentially ineffective or possibly harmful “natural” treatment. Oftentimes, products labeled “organic” or “natural” contain fragrances or ingredients that may irritate eczema-prone skin.

Dealing With Eczema After Giving Birth

Depending on the mode of your child’s delivery, you’ll need to take extra care of your genitals or C-section site to avoid eczema flare-ups and wound infections. In addition, female genital eczema can affect your vulva and the areas near and surrounding your anus. To treat the irritation, your doctor may prescribe mild topical steroids, sometimes with an antibiotic.

Additional tips to help alleviate genital eczema symptoms include:

  • Avoid tight pants or tights.
  • Choose underwear made of 100 percent natural material (like cotton or bamboo).
  • Keep soaps, hygiene wipes, and talcum powder away from the affected area.
  • Store anti-itch emollients in the refrigerator to provide cooling relief.
  • Get tested for other possible causes of itching, like yeast infections or sexually transmitted infections.

Be Gentle With Your Hands

Taking care of a newborn can require you to submerge your hands in water often. Between rinsing bottles, cleaning breast pump accessories, bathing the baby, and washing your hands after diaper changes, it can seem like your hands are rarely dry. For parents who are prone to irritant hand eczema, this can lead your skin to crack and it can create fissures. One solution is to put on protective rubber gloves or PVC gloves lined with cotton.

Other ideas include patting your hands completely dry with a soft towel (rather than a paper towel) and applying generous amounts of moisturizer. Avoid wearing rings made from metals (like nickel) that can make your issues worse. Take extra precautions when preparing irritating foods like citrus fruits or hot peppers. And if you’ve had other types of eczema before you were pregnant, use preventative methods to reduce your risk for developing hand eczema, too.

Breastfeeding With Eczema

When receiving eczema care, always let your dermatologist know if you’re breastfeeding. Certain medications — including those found in topical creams — are safer than others for breastfeeding parents. If you develop eczema on your nipples, your doctor can help you find a safe treatment option that will allow you to continue nursing.

If you are prescribed steroid creams, wash it off your breasts before nursing to prevent your baby from ingesting the medicine. (Oral steroids are unlikely to transmit into breast milk, but always double-check with your provider.) A lactation consultant may also help you find ways to make breastfeeding more comfortable if it causes your eczema to flare.

Talk With Others Who Understand

MyEczemaTeam is the social network for people with eczema and their loved ones. On MyEczemaTeam, more than 40,000 members come together to ask questions, give advice, and share their stories with others who understand life with eczema.

Are you living with eczema? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Kevin Berman, M.D., Ph.D. is a dermatologist at the Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Learn more about him here.
Anastasia Climan is a dietitian with over 10 years of experience in public health and medical writing. Learn more about her here.

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