Who said pregnancy was a piece of cake? Not only am I growing bigger every day, now my skin has to itch too?? I have heard of so many mother’s complain about itchy skin from stretching, heat, etc., during pregnancy but I had no idea it would be this bad. I guess during my first pregnancy I had it really good as I didn’t have this problem what-so-ever. This time around however, I find myself scratching all the time and it is driving me crazy! I have spread it to 3 areas of my body and have been self medicating it with hydrocortisone creams until I am able to see my doctor again for some better advice. I truly believe I have got some form of eczema, a symtom I have never had before in my life until now. Being pregnant during the summer months and the excess sweating also does not help the matter any as well. I have been doing light showers throughout the day, using baby powder afterwards and other times (such as bedtime) the over-the-counter hydrocortisone cream. Also I try very hard not to scratch because I am worried that I will break the skin and spread the eczema making the problem worse. Easier said than done of course because sometimes I find myself waking up in the middle of the night scratching. The things we woman have to go through during pregnancy can really suck. Hopefully the body goes back to normal after pregnancy and our skin won’t continue to act so strange. I have heard instances where the mother can pass the infection to the newborn during contact while breastfeeding, so make sure you talk to your doctor about any skin problems you may have and know exactly what you have and how to treat it properly.
Most resources online note that skin disorders or changes in the texture of skin are the most common changes experienced by every female during pregnancy.
“During pregnancy a woman’s body experiences many changes including hormonal changes, certain changes in your skin and also blood pressure changes.
Eczema is a skin inflammation which is mainly caused when your skin comes in contact with certain types of allergens to which your skin is sensitive and can lead to several allergic reactions.
These allergens could be soaps, creams, jewelry, clothing, bacteria and it can also be caused due to excess emotional or mental stress.
The changes in the body functions during pregnancy can vary from one woman to other. If you have eczema before pregnancy, then the risk of this skin inflammation to become worse can be high for you; while for the other woman suffering with the same skin disorder, can be at lower risks of this problem or some times the inflammation can be vanished permanently during pregnancy.”
Source: skincarebeautyzone.com
Atopic dermatitis (AD) or eczema is one of the commonest skin diseases worldwide. It is more prevalent among women. Moreover, it is the most common skin condition during pregnancy, registering approximately between a third and a half of the total number of AD cases seen in dermatology clinics.
In fact, most women report the disease for the first time after they conceive. Barely 20-40% of women affected by eczema are estimated to have eczema before pregnancy. So that means 60-80% of all cases of eczema in women first occur during pregnancy. Moreover, three quarters of these women report indications within the first two trimesters of their pregnancy.
More than 50% of patients experience a deterioration of the syndrome during pregnancy (generally more during the second trimester), while only (approximately) 25% show improvement. Around 10 % of cases worsen in the postpartum period.
Therapy for atopic dermatitis during pregnancy
Though there are a variety of treatments available, pregnant women need to follow certain guidelines to prevent complications. The various forms of treatment and the associated course of action are as follows:
Treatment with topical corticosteroids
The mainstay of eczema treatment is the use of topical steroids combined with moisturizer-based emollients. The process involves taking tepid baths, applying the emollients and avoiding soap. However, one may need to seek a second line of treatment in case of severe eczema. This approach is also applicable in case of pregnant women but there are a few guidelines about their usage.
Mild or moderate topical corticosteroids combined with moisturizer-based emollients are the first line of treatment for mild to moderate eczema during pregnancy. Potent topical steroid creams are generally avoided for fear of systemic absorption into the blood and passage to the embryo.
Treatment with systemic corticosteroids
Systemic steroids are generally avoided since they can cause recurrence of flares when discontinued and may have side effects on early embryo development. Oral steroids are relatively safe during the third trimester. Though they might interfere with fetal growth, (mostly seen in asthma patients), there is no definite evidence whether it is caused by maternal disease or the oral steroids. However, for safety, most dermatologists will not use oral systemic steroids to treat eczema at any stage of pregnancy.
Systemic treatment is also not generally regarded as safe for lactating mothers as the corticosteroids will be present in the milk.
Narrowband Ultraviolet B
Narrowband ultraviolet B is the safest second line treatment during pregnancy, when topical steroids fail to manage the condition. It has been found to control acute episodes of the disease by over 30%. Ultraviolet B is also safe while breast-feeding.
Calcineurin inhibitors
It is comparatively safe to use topical calcineurin inhibitors (tacrolimus and pimecrolimus), but strictly in small amounts. It is used as a secondary therapy, but only if emollients and UV therapy has been ineffective. There is however a risk of intrauterine growth retardation. The application of the drugs is also limited to localised areas.
Other systemic treatments
If absolutely required, then the choices in systemic treatment begin with the use of immunosuppressive agents such as cyclosporin or azathioprine, but the condition of the patient and embryo must be closely monitored. Use of Azathioprine involves the risk of miscarriage, premature delivery and more rarely neonatal leucopenia, pancytopenia or inhibition of neonatal haematopoiesis.
Those undergoing systemic therapy must also keep a minimum time interval between discontinuing treatment to ensure a safe pregnancy and no harm to the newborn. Fetal growth retardation (though it may actually be caused by maternal diseases) is a risk factor in this group.
Methotrexate (another immunosuppressive agent) and psoralens plus ultraviolet A (PUVA) are best avoided during pregnancy and are unsuitable for lactating mothers.
Source: dermatitisfacts.com
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