Eczema is a common, chronic skin condition that can have both mild symptoms (rash, itching, dryness) and more severe ones like raw skin that leaks fluid. You might have had eczema for years, but pregnancy can also cause the condition to develop or simply worsen, thanks to all those hormones coursing through your body.
But take heart — you’re definitely not alone, as more than 31 million people have some form of eczema, and it’s more common in women.[1] Learn more about eczema’s causes, how to spot it and the safe ways eczema can be managed during pregnancy.
What is eczema?
Eczema is a skin condition that causes dryness and an itchy rash that appears on the hands, feet, ankles, wrists, eyelids and neck, as well as on the inside bend of the elbows and knees.
Atopic dermatitis is the most common type of eczema, which can be chronic, with periodic flares, and sometimes develops alongside asthma and allergies.[2]
Eczema, which usually starts in childhood and has no known cure, affects about 1 in 10 people and is seen more often in Black and Asian Americans. Severe cases can include inflamed sores that leak clear fluid and constant itching that may prevent sleep.
What are the symptoms of eczema?
Eczema symptoms vary widely from person to person, but most people with the condition experience the following:[3]
- Dry skin that may thicken, crack or appear scaly
- Swollen, puffy, raw skin that’s made sensitive due to scratching
- Itching, which may worsen at night
- Skin discoloration, including pink or red patches on fair skin, or dark red or brown patches on medium or olive skin tones. On darker pigmented skin, eczema patches can look darker at first and then become lighter or hypopigmented after weeks or months.
- Tiny raised bumps, which may ooze fluid or even bleed and scab over when irritated
What causes eczema during pregnancy?
Eczema can worsen or even erupt for the very first time during pregnancy,[4] though the most common variety, atopic dermatitis, is often hereditary. If you have atopic eczema, there's a good chance that you or someone in your family probably suffers from asthma, hay fever, allergies and/or food allergies as well.
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Atopic dermatitis and other eczema types like contact dermatitis are impacted by irritants such as chemicals, fragrances, detergents, cosmetics, dust mites and viral infections. Where you live and what you’re exposed to can also affect eczema, including cold damp weather, stress, pollution, tobacco smoke and even metals (your rings, if they still fit, might start irritating you).
Does pregnancy make eczema worse?
Yes, eczema can worsen when you’re expecting, courtesy of those raging pregnancy hormones. For some women, however, pregnancy can actually make a case of eczema somewhat better.
The reason for eczema eruptions in pregnancy may be due to an increase in active white blood cells called “helper” T lymphocytes. Alas, no one’s sure exactly why some women experience flare-ups during pregnancy, while other lucky ladies go into remission.[5]
What’s the difference between eczema and other pregnancy rashes and skin conditions?
While the symptoms of eczema are rather distinct, you may confuse them with similar skin rashes, bumps or redness. Here are a few other common skin conditions seen in pregnancy:
- Heat rash. Itchy, pimply redness on your cleavage, inner things and under your breasts are the telltale signs of heat rash.
- Melasma. Also called pregnancy mask, these dark brown spots and patches on the upper lip, nose and cheeks are caused by excess melanin production due to a rise in hormones.
- PUPPP. Pruritic urticarial papules and plaques of pregnancy is a mouthful, but it simply means an itchy, bumpy rash found on the belly, thighs, buttocks and arms.
- Linea nigra. Latin for “black line”, this dark vertical mark can show up between your belly button and pubic area by the second trimester.
- Stretch marks. Your growing pregnant body tugs at your skin, which can cause these reddish or brownish lines on the stomach, buttocks, breast and thighs to appear.
- Pregnancy acne. Surging hormones and fluid retention can cause red, pimply breakouts.
How can you manage eczema during pregnancy?
There’s a wide array of at-home remedies and a few drugstore options that can help soothe eczema symptoms. Here are some strategies for managing atopic dermatitis during pregnancy:
- Ask about topical steroids and antihistamines. Always check with your doctor first about antihistamines, which can ease itchiness, and certain topical steroids, which may be safe during pregnancy but must be used in small quantities under strict medical supervision.
- Stay away from triggers. Limit contact with potential irritants including wool, pet dander, dust, pollen, plants, jewelry and any personal care products made with alcohol.
- Avoid scented products. Perfumed body lotion and bubble bath may aggravate your already sensitive skin and your heightened sense of smell.
- Limit your soaking. Take a quick dip when you swim and aim for short showers and baths using lukewarm — not hot — water.
- Be careful with cleansers. A case of eczema will benefit from a mild, non-soapy cleanser that’s low-pH, hypoallergenic and fragrance-free.
- Check your vitamin D. There’s some evidence that being deficient in this nutrient can impact eczema, so ask your health care provider whether you’re in need of more D.
- Moisturize early and often. Gently pat yourself dry after bathing and then apply lotion right away to help lock in your skin’s own moisture and prevent dryness and cracking.
- Stay cool. Eczema symptoms can be triggered when you’re overly hot or sweaty, but of course this is easier said than done when you’re already one hot mama! The fix: wear loose cotton layers you can peel off, rather than synthetic fabrics, wool or any material that feels rough.
- Launder the smart way. Use only fragrance-free, neutral pH detergents, and double-rinse your laundry to help prevent flare-ups. Another tip: Wash new clothes before wearing to remove excess dyes and fabric finishers and cut out tags or labels that may cause irritation.
- Beware of sudden changes in temperature and humidity. A temperature spike can make you sweaty, while a drop in humidity can dry out your skin and lead to a flare-up. In other words, no steam rooms, saunas or Bikram yoga (they’re already off-limits when pregnant).
- Use a cool compress — and not your fingernails — to curb the itch. Scratching makes eczema worse and can puncture the skin, allowing bacteria to enter and cause an infection (which is potentially dangerous during pregnancy). Keep your nails short and rounded so they do less damage and wear pair of cotton gloves to bed if you tend to scratch in your sleep.
- Stay calm. Stress is a common eczema trigger, so try to avoid situations that make you tense or anxious.
Which eczema medications should you avoid during pregnancy?
It’s critical to get the green light from your doctor or dermatologist before taking any medication to treat eczema when you’re pregnant. Here are a few drugs and remedies to avoid:
- Cyclosporine. This drug has long been used to treat severe cases of eczema, but research indicates that it may be associated with an increased rate of premature birth and low birth rate in babies.[6] Skip this medication and check with your practitioner before taking any topical or systemic antibiotics.
- Protopic and Elidel. Topical prescriptions known as TIMs, or topical immunomodulators, are made to reduce inflammation, but they’re off-limits during pregnancy, because they haven’t been well-studied in pregnant women and can’t be ruled as safe.
- Herbs or aloe vera. Herbal medications should definitely be discussed with your practitioner in advance, and aloe, both in gel and latex form, may be unsafe during pregnancy and when nursing.[7]
When to see your doctor about eczema during pregnancy
Call your physician if eczema symptoms are interfering with work and home activities or they’re affecting your sleep. And seek medical advice if your skin shows signs of infection, including red streaks, scabs or pus, or the itchy skin treatments you’ve tried still offer no relief.
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