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What is Pupps? Signs, Symptoms and Treatments Explained

What is Pupps? Signs, Symptoms and Treatments Explained

What is Pupps? Signs, Symptoms & Treatment pregnancy rash
PUPPS (Pruritic Urticarial Papules and Plaques of Pregnancy) is an itchy, bumpy rash that starts in the stretch marks of the abdomen in the last trimester of pregnancy. It is also called Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) and in the UK, it is known as Polymorphic Eruption of Pregnancy (PEP).

PUPPS is a fairly common rash in pregnancy appearing in 1 of every 200 pregnancies. It is a chronic hives-like rash that can be extremely irritating for suffers. PUPPS poses absolutely no long-term risk for mother or baby and the cause of the annoying condition is generally unknown.

What are the signs and symptoms of PUPPS?
Firstly PUPPS occurs mostly during a first pregnancy and a multiples pregnancy, where the skin stretches more. The dreaded itch is the first sign of PUPPS alongside its distinctive red markings that causes itching in the abdominal region. The rash appears small, almost like pink pimple-like spots and they appear in stretch marks. These spots resemble hives, eventually forming together. Other signs of PUPPS include redness and small blisters or eczema-like lesions.
PUPPS initially look like stretch mark on the abdomen, however, they can grow larger spreading towards the chest, back, hands and legs. It does not spread to the face, palms or soles of the feet. Surprisingly you will never see the rash on the naval region either.
How is PUPPS diagnosed?
There is no clinical test to diagnose PUPPS, however, your consultant may order some blood tests to rule out other infections, such as a complete blood count, liver function test, serum human choriogonadotropin (HCG) and serum cortisol. 
A PUPPS diagnosis is usually made based solely on the appearance and symptoms of the rash.

How is PUPPS treated?
Thankfully PUPPS will disappear a couple of weeks after delivery and there are numerous ways to help treat the symptoms.
  • Moisturises can help relieve itching and remove some discomfort. Invest in a cream moisturizer containing elastin, collagen, vitamin E, cocoa butter or Shea butter. It is advised to avoid moisturisers that contain Vitamin A, retinol, tropic acid, salicylic acid or retinyl palmitate. Always read the label.
  • A cool, wet compress can help relieve mild itching.
  • Soaking  in an oatmeal bath helps relieve itching, moisturizes and soothes the skin
  • Steroid creams can be subscribed by your GP. Steroid creams with 1% hydrocortisone will help reduce the itch.
  • Antihistamines may also be advised by your doctor to relieve the itching.
  • It's also advised to wear comfortable loose clothing such as soft cotton if you are suffering from PUPPS. So fabrics may aggravate the rash further.
Other things you need to know about PUPPS:
PUPPS is not contagious and cannot be passed through physical contact. Also, numerous theories say expectant mothers carrying baby boys seem to develop PUPPS more than mothers of baby girls. 
Written by Kellie Kearney staff writer at FFHQ who also blogs at