How to treat pruritus during pregnancy

Pruritus gravidarum is a common symptom among women during pregnancy. This symptom is generally caused by certain changes in the hormones in the pregnant woman's body. Pruritus during pregnancy will not only have a certain impact on pregnant women, but if the pruritus during pregnancy affects the pregnant woman's mood, it will also affect the normal development of the child. Next, I will introduce you to some relevant knowledge about pruritus during pregnancy!

1. Causes

The causes of itching during pregnancy may be related to the excessively high estrogen levels in the pregnant woman’s blood and the bile stasis. Researchers believe that because the gallbladder emptying time is prolonged in pregnant women, the gallbladder expands and its tension decreases, resulting in bile stasis, increased bile acid and bile salt levels, and skin itching.

2. Clinical manifestations

First-time pregnant women usually do not suffer from prurigo gravidarum. Clinically, the rash is often divided into the following two types according to the period of appearance:

1. Early-onset prurigo of pregnancy

It occurs in the first half of pregnancy, especially in the third and fourth months of pregnancy. Papules often occur on the extensor side of the limbs, upper trunk, and upper arms and thighs, and are distributed symmetrically on both sides. Round, millet-sized to mung bean-sized, with a slightly flat top. It starts out white and then turns dark red, light red or normal skin color. There is an urticaria-like red halo around the papules, which may disappear after several days or dozens of days, but new papules may reappear. Because of the severe itching, especially at night, scratching causes the papules to be covered with yellow scabs. After the scab falls off, some pigmentation or depigmentation remains locally.

2. Delayed prurigo of pregnancy

It often occurs in the last two months of pregnancy, especially within two weeks before delivery. The rash morphology is the same as that of early-onset prurigo of pregnancy, and papulovesicular and urticaria-like rashes may also be seen, which resemble erythema multiforme. The rash often first occurs on old stretch marks (stretch marks) on the abdominal wall, and then quickly spreads to the whole body, causing severe itching. Due to scratching, secondary rashes such as scratches, blood scabs and lichenification may be seen. This disease will disappear on its own 2 to 3 weeks after delivery, leaving behind temporary pigmentation.

Treatment

1. Instruct patients to lead a regular life, take showers frequently, keep their skin clean, and avoid eating spicy and irritating foods.

2. Glucocorticoid hormones have a good effect on severe prurigo during pregnancy and can reduce the occurrence of stillbirth. Pregnant women should use medication for as short a period of time as possible, often using prednisone, and try to shorten the course of treatment. After the symptoms are significantly alleviated, gradually reduce the dosage until the drug is stopped. Glucocorticoids should not be used after delivery.

3. To relieve itching, local skin application is feasible. The drugs used include glycerin/sodium chloride (compound glycerin) lotion (glycerin, 95% ethanol, distilled water), antipruritic tincture (liquefied phenol, mint, salicylic acid, 75% ethanol added to 100ml), calamine lotion (calamine, zinc oxide, glycerin, calcium hydroxide solution 100ml), etc.

4. Use antihistamines, commonly used ones include diphenhydramine and chlorpheniramine.