Eczema, also known as dermatitis, is a non-contagious inflammatory dry Skin condition that can affect all age groups, from infants to the elderly. It is characterized by an uncontrollable urge to itch and causes the skin to be red, cracked, raw, or sore during a flare-up (1).

Eczema is one of the most common skin conditions of Pregnancy, contributing to about one-third to half of all skin conditions during pregnancy (2). Read this post to learn about the types, risk factors, symptoms, causes, and treatment of eczema during pregnancy.

Types Of Eczema

There are seven types of eczema (3):

• Atopic dermatitis is the most common eczema, where genetic defects in the skin barrier cause dry skin. The term “atopic” describes the tendency to develop allergies, such as eczema, asthma, and hay fever (4).

• Contact dermatitis may occur due to contact with allergens or irritants in the environment (5).

• Nummular eczema, also known as discoid eczema, is characterized by distinct oval or round, itchy lesions (6).

• Neurodermatitis is confined to one or two patches of the skin. It is itchy, and continuous itching can irritate the nerve endings under the affected skin (7).

• Seborrheic eczema is a common, scaly rash most often seen on the greasy areas of the face such as the scalp, sides of the nose, and the chest (8).

• Dyshidrotic eczema causes small, extremely itchy blisters on the palms, soles of feet, and edges of fingers and toes (9).

• Stasis dermatitis is also known as gravitational dermatitis, venous eczema, and venous stasis dermatitis. It occurs when there are blood circulation issues in the lower part of the legs (10).

You may develop more than one type of eczema at the same time. However, each type has a different cause and course of treatment. A dermatologist can help you identify the trigger and plan the treatment for your eczema.

Incidence Of Eczema During Pregnancy

About 20–40% of women experiencing eczema during pregnancy have a pre-existing history of eczema, while some experience it for the first time during pregnancy. It can occur in any trimester but occurs slightly more often in the second trimester. In addition, 10% of women experience flare-ups in the postpartum period. About 25% of women with pre-existing eczema improve, and more than 50% experience deterioration. (11).

Causes Of Eczema During Pregnancy

A combination of genetic and environmental factors could cause eczema in pregnant women. Additionally, people with eczema may have an over-reactive immune system. Some studies show that people with eczema have a variant of the gene that creates filaggrin—a protein that maintains the skin’s hydration by creating a protective barrier on the top layer—causing filaggrin-deficient skin (12).

Signs And Symptoms Of Eczema During Pregnancy

The signs and symptoms of eczema are the same in pregnant and non-pregnant people; however, they vary among individuals. In addition, the appearance of eczema may vary on different body parts of the same individual.

The principal complaint of people with eczema is itchiness, which can vary from mild to moderate. Some cases are so severe that the affected individual develops skin inflammation. People might scratch their skin until it bleeds, causing their eczema to worsen—this is called the “itch-scratch cycle.”

The following are the common symptoms of eczema (13):

• Dry and sensitive skin
• Inflamed or discolored skin
• Rough or leathery scaly patches on the skin
• Oozing
• Crusting
• Swollen patches

An affected individual may have one or more of the above symptoms, which may exacerbate during a flare-up and completely subside at times.

Impact Of Eczema On Pregnancy

Eczema does not impact the fertility or miscarriage rates, and it does not cause birth defects or premature births. However, eczema herpeticum, which occurs when a person with eczema is affected by the herpes simplex virus,may affect the baby’s growth and increase the risk of miscarriage and premature delivery (2).

Diagnosis Of Eczema During Pregnancy

Eczema is primarily diagnosed by examining the skin. Hence, inform your doctor if you have experienced any skin changes during your pregnancy. They will rule out other severe skin conditions that may harm the mother or the baby.

During diagnosis, the doctor may ask the following questions:

• When did the skin changes begin?
• Have any diet, routine, or lifestyle changes possibly contributed to the skin changes?
• How are these symptoms affecting your daily life?
• Do any factors make your symptoms better or worse?

For confirmation, the doctor may perform the following tests (14):

• An allergy skin test
• Blood tests to check for other causes of rash unrelated to dermatitis
• Skin biopsy

Treatment Of Eczema During Pregnancy

The following treatment protocols are observed for managing eczema during pregnancy (15): 

1. Topical steroids: No evidence suggests that steroid use is harmful to the fetus. Hence, if necessary, the doctor will prescribe effective topical steroid creams with minimum intensity.

2. Narrowband ultraviolet B: Narrowband ultraviolet B is artificial sunlight used to treat eczema when topical steroids do not work. This treatment is provided in a hospital setup.

3. Antihistamines: Antihistamines are well tolerated in pregnancy and may be useful in subsiding eczema, especially if accompanied by hay fever.

4. Vitamin D: Low levels of vitamin D can worsen eczema. Hence, the doctor may recommend a vitamin D3 supplement.

Alternative Treatments For Eczema In Pregnancy

Though no medical evidence is available to support these therapies, anecdotal evidence suggests the following natural remedies for eczema in pregnancy (16).

Oils: Natural oils such as coconut and sunflower oil, which have antibacterial or antimicrobial properties, can be beneficial in managing eczema. They help in reducing itchiness and improving the skin barrier function.

Diet: Avoid foods you are allergic to and those that have an inflammatory effect. For example, a gluten-free and dairy-free diet makes a difference in some women.

Probiotics: Introducing good bacteria in the body through probiotics helps in preventing eczema in some pregnant women.

Vitamins: Vitamin D supplementation and topical vitamin B12 application help manage eczema.

Consult your doctor before trying any of these natural remedies. 

Home Care For Eczema During Pregnancy

Here are some home care tips you may follow to manage eczema during pregnancy.

• Emollients or moisturizers are important in skin Daily use will make your skin less dry and prevent frequent flare-ups. Consistency is the key to managing eczema during pregnancy.

• Avoid hot showers to prevent barrier disruption. Moderate showers help in keeping the skin supple.

• Loose-fitting clothing is better as it helps the skin

• Avoid harsh soaps or cleansers, which may dry up the skin

• Staying hydrated helps in keeping the skin hydrated and healthy.

• Avoid any fragrances, soaps, or other agents that cause skin irritation.

• The itching due to eczema can be severe. However, curbing the urge to itch is essential. Massaging the skin around the affected area and using a soft washcloth to rub the affected area can help manage skin

Women with a history of eczema are more likely to experience it during pregnancy. If you plan to start a family and have a history of eczema, start using emollients and avoid triggers, such as harsh soaps before conception. Inform your OB-GYN about your eczema history, and take all the necessary precautions. Since taking precautions does not guarantee prevention, contact your healthcare provider if you notice any symptoms of eczema.

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