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Pruritic Urticarial Papules and Plaques of Pregnancy

Medically reviewed by Last updated on Aug 31, 2022.

What is pruritic urticarial papules and plaques of pregnancy (PUPPP)?

PUPPP is a rash that usually occurs during the last month of pregnancy. The cause of PUPPP is unknown. Your risk may be higher if you quickly gained a large amount of weight or are pregnant with twins. Your risk is also higher during a first pregnancy. PUPPP usually goes away within 14 days after you give birth. PUPPP does not cause health problems for you or your baby.

What are the signs and symptoms of PUPPP?

You may have small, red bumps, and hives that itch. The itching may make it hard for you to sleep. It may first appear on your abdomen and then spread to your thighs, buttocks, and breasts.

How is PUPPP diagnosed?

Your healthcare provider will ask you when you first noticed the rash. He or she may ask if you have any skin or medical conditions. He or she will examine the affected areas of your skin. You may need blood tests or other tests to determine the cause of your rash.

How is PUPPP treated?

You may be given a steroid ointment to apply to your rash to decrease redness, itching, and swelling. You may also need to take an antihistamine to decrease itching. If your rash does not get better with ointment, you may need to take steroid pills.

How can I manage PUPPP at home?

  • Apply a cool compress to your rash. This will help soothe your skin.
  • Take an oatmeal bath. Add oatmeal to your bath water to help decrease skin irritation.

When should I contact my healthcare provider?

  • You have a fever.
  • Your itching does not improve or gets worse, even after you use your medicine.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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