Eczema during pregnancy: what to do in case of gestational pruritus?

Pregnancy eczema, also known asgravida eczema, is a skin condition that develops in some women during pregnancy. It is the most common dermatosis in pregnant women, accounting for about a third of cases. Although the exact mechanisms are not fully understood, hormonal changes are thought to play a key role in its onset.

It appears that pregnancy alters immunity and tends to direct it towards a TH2 type immune response. This type of immune response is generally associated with atopy, which could explain the prevalence of eczema in pregnant women. For reference, atopy refers to a predisposition to develop common allergies.

Some women may experience a re-emergence or exacerbation of eczema that existed prior to pregnancy, while others may develop eczema for the first time during this period. It is estimated that about 20 to 40% of pregnant women suffering from eczema had previously experienced flare-ups. Intense itching is the most common symptom of pregnancy eczema, and skin lesions may appear as redness, papules, vesicles, or plaques on various parts of the body, including the abdomen, arms, legs, and breasts.

The various hormonal fluctuations that occur during pregnancy are not without consequences on the skin. While some women notice that their skin is more supple and hydrated, others feel that their skin is drier and feels tighter than usual. The hydrolipidic film then appears to be weakened and no longer fulfils its protective function. This skin dryness phenomenon promotes eczema.

Consequently, to alleviate gestational itching, it is initially recommended to apply emollient treatments, at least twice a day. This type of balm or cream has a rich texture, and hydrates and nourishes the skin while strengthening the skin barrier against daily aggressions. However, ensure beforehand that your emollient is suitable for pregnant women and that it does not contain essential oils for example. To soothe the itching, you can also apply cold water compresses to the affected skin.

Furthermore, it is important to consult a doctor when suffering from pregnancy eczema. Among the most commonly used methods, we find the application of topical corticosteroids and phototherapy. Topical corticosteroids are treatments derived from cortisone that help combat inflammatory reactions. They are used locally to soothe inflammation and itching. It is advised to apply them as soon as the eczema begins to itch, redden or take on a rough appearance, and not to wait until the symptoms are at their peak. Phototherapy, on the other hand, relies on the use of UV rays to alleviate eczema.

These two methods are safe during pregnancy. We recommend you follow the advice of your doctor who will guide you towards one treatment or another.

• REYNOLDS N. & al. Eczema and pregnancy. The British Medical Journal (2007).

• GOLDENBERG G. & al. Eczema. The Mount Sinai Journal of Medicine (2011).