Now in the 30th week of my second pregnancy, I am suffering a super terrible itch named PUPPP (pruritic urticarial papules and plaques of pregnancy), also known as polymorphic eruption of pregnancy (PEP). There are big patches of red skin all over my stomach and breast, which get really itchy when rubbed against clothing, triggering my unconscious scratching. Scratching momentarily satisfied my itch, but resulted in more itch, more redness and purplish "bruise".
Stage 1: Early onset of PUPPP
There are smaller pink spots all over the stomach, of which some of them congregate together. During this stage, the itch is already immense. Not knowing what it could be, most mothers will be like me, I subconsciously scratched it frequently. During this "inflammation" stage, the papules and plaques are pretty distinct. As the skin is inflammed and more sensitive, I used purely aloe vera gel.
Day 3 of PUPPP
Stage 2: The spread of PUPPP
Even with minimal, light and indirect scratching, the pink spots will continue to spread in greater area. By day 5, my entire stomach is almost completely red. Even with light scratching, the skin was easily "bruised" under the surface and the patch will look a purplish-blue instead of red. That area will feel slight pain compared to the other areas of redness.
Day 5 of PUPPP
It is important not to scratch or trigger the skin further. I will recommend against any of these when you have PUPPP. You also will not want to introduce open wounds that increase risk of infection.
1) Do not use shower head.
The water blasting from the tiny nozzles hits on your skin, aggrevating it further. You may feel good during a shower bath as it reduces the itch, but unconsciously, the spots are aggrevated and begin to spread to greater area. Use a
tap or water scoop instead.
2) Do not use hot water to bath.
Similar to use of shower head, hot water provides you only with temporary relief of itch but it actually stimulates the nerves and "dries" your skin. Cold or room temperature water provides greater relief and the itch is reduced more after the bath
3) Do not rub your skin too hard while bathing
The last thing your skin wants is further stimulant. Besides using milder soap, only gently clean your skin without scrubbing.
During this stage, I have also experimented with a few external remedies:
1) Aveeno Daily Emollient Cream (Triple oat complex + ceramides)
I used this straight after bath, applying on the left side of my stomach. It provides about 3-4 hours of itch relief and I apply more whenever the itch is back.
2) 99% Aloe Vera gel
I also used this straight after bath, applying on the right side of my stomach. It also provides about 3-4 hours of itch relief. It seems like the rash spread less compared to the left side of my stomach which I used Aveeno (oat/ceramide based cream).
3) Suu balm dual rapid itch cream (menthol + ceramides)
My friend introduced this cream to me as it was effective for her. I like the menthol which provides a cooling relief but the itch relief only lasts about 2 hours. Perhaps it is lighter compared to Aveeno. This cream is formulated by National Skin Centre Singapore, especially people with dry and eczema skin. While mentol's cooling effect cacels out itch, but products higher than 1-3% concentration irritates the skin. Suu balm cream has 3%. Hence I avoid putting it direct on skin. I will always apply aloe vera first and let it dry before applying Suu balm on specific spots. As the cooling sensation makes me comfortable, I have bought the other range of products such as Suu balm wash and lotion.
During this stage, I have also experimented with a few external remedies:
1) Aveeno Daily Emollient Cream (Triple oat complex + ceramides)
I used this straight after bath, applying on the left side of my stomach. It provides about 3-4 hours of itch relief and I apply more whenever the itch is back.
2) 99% Aloe Vera gel
I also used this straight after bath, applying on the right side of my stomach. It also provides about 3-4 hours of itch relief. It seems like the rash spread less compared to the left side of my stomach which I used Aveeno (oat/ceramide based cream).
3) Suu balm dual rapid itch cream (menthol + ceramides)
My friend introduced this cream to me as it was effective for her. I like the menthol which provides a cooling relief but the itch relief only lasts about 2 hours. Perhaps it is lighter compared to Aveeno. This cream is formulated by National Skin Centre Singapore, especially people with dry and eczema skin. While mentol's cooling effect cacels out itch, but products higher than 1-3% concentration irritates the skin. Suu balm cream has 3%. Hence I avoid putting it direct on skin. I will always apply aloe vera first and let it dry before applying Suu balm on specific spots. As the cooling sensation makes me comfortable, I have bought the other range of products such as Suu balm wash and lotion.
Day 7 of PUPPP
Surprisingly, the itch reduced on day 6 night. Either I made a conscious effort not to scratch and the itch reduced, or because the itch was more manageable and I scratched less. And because of that, the redness did not spread further to other areas. The redness has also started to become paler. I also noticed papules and plaques are significantly less. Some little areas seem a little flaky, hence I apply generously more aloe vera on those areas. Whenever it feels a litle itch and bathing in cold bath, the other difference I made during day 5-6 was the following:
In terms of fluid intake:
1) Drank more water and green tea throughout the day
2) Drank lemon water in the morning (for detoxing)
3) Avoided my usual intake of milk or sweet drinks like bubble tea
In terms of food intake:
1) Had more vegetables (e.g. spinach) and fruits (e.g. apple, dragon fruit, grapes)
2) Avoided chicken and pork, but had salmon fish instead.
Day 14
Although I have less itch and no more pinkish rashes, the dark marks from the past rash seem to take many days to fade away. Meanwhile, I have started to use my stretch mark creams again and no adverse reaction. Hope it gets back to usual soon.
