Monday, September 29, 2014

here comes the PUPPP

Ugh.  Another awesome and rare symptom of first time pregnancy:  I have developed a PUPPP rash.  I'm not posting pictures, you perv, google it if you want to see rashy pregnant bellies.
For those of you who are unfamiliar, a PUPPP (Pruritic urticarial papules and plaques of pregnancy) rash is an intensely itchy rash that develops inside the stretch marks that tend to appear around 35 weeks of pregnancy.  It then spreads to the thighs, buttocks, breasts, arms, and in my case calves, and does not go away until 1-2 weeks after the baby is born.  If you're wondering if you DO have it, one of the things that distinguishes a PUPPP from other, more sinister rashes, is that it starts in the stretch marks, and that it avoids the belly button area.  The good news is, its not harmful to the baby.  The bad news is, it's way annoying and itches like a healing sunburn that you contracted on top of a patch of poison ivy.
About 1 in 200 women get a PUPPP rash in their first pregnancy, and it usually does not happen in future pregnancies.  I probably shouldn't have been surprised to get it, as my skin absolutely LOVES breaking out in hives and over-reacting to allergens, perfumes, lotions, etc., plus research has shown that 70% of PUPPP sufferers are having boys (which I am) and have large belly measurements (which I do).  Awesome.
Well, I started researching online to see if I could figure out how to deal with this latest development of gestational discomfort, and I have found a number of homeopathic remedies. If you are suffering with a PUPPP, here is some good news for you:
1. Many sites that I have looked at have mentioned that the most intense itching lasts about a week, and alluded to the fact that that is the first week.  If you are in the first week and ready to claw your skin off, hang in there! 
2.  It does not usually occur in future pregnancies, so if you are planning to have more babies after this, since you earned most of your stretch marks this time, you are most likely not going to have to deal with it.
3.  Washing with Grandpa's Pine Tar Soap 4 times a day (I know, some of us work) can really help soothe the rash.  Even though I DO work, I have found that 3 showers a day is do-able, especially if you invest in a decent shower cap.  Once in the morning, once after work, then before bed.  It smells like camping, so bonus if your husband is the outdoorsy type and that is a turn-on for him.
4.  After each of your 600 showers, slather on this fabulous stuff: Derma-E itch relief lotion.  It is watery and smells very fresh, as the active ingredient is actually Tea Tree Oil.  It sounds like it would irritate, but it is very soothing, and it actually works (for me) better than any of the hydrocortisone creams that I have tried.
5.  To soften your skin, if the above combination is making your skin feel a little tight, try a plain Coconut Oil.  I think it's much better than other body oils, as it soaks in and feels less greasy than let's say a vitamin E oil or bio-oil (which also smells like perfume).  Coconut oil is also anti-microbial, so it can help doubly in the healing process.
6.  If you can't deal with it at night (i.e. the rash is waking you up multiple times in the night) you might want to try Benadryl.  You may not need it after that first atrocious week, and the more sleep you get, the better you will feel and heal.  Benadryl is generally considered to be safe (even my midwife says it's OK!) but every pregnancy and every woman is different, so check with your healthcare provider before you start taking anything.
7.  Aveeno products: this concentrated anti-itch lotion works better than any of the 1% hydrocortisone products I have tried, with the added benefit of being steroid-free.  The active ingredient is calamine, but it doesn't make your skin all sticky and cracky afterwards.  Plus the bottle is relatively small, so you can keep it in your purse if you are still working or going out, and apply as needed.  Every once in a while, the good ol fashioned Aveeno bath is also nice.  I have found that it's relatively torturous during, but very soothing after.  Whether it's after a shower or an Aveeno bath, try to resist the urge to use a rough towel to scratch the absolute shit out of yourself.  Lastly, there is this intensive healing ointment that is great for the bit of overdrying that all of the showering and anti-itch creams are contributing to.  I have found that I can tolerate it at night if I mix in a little of the aforementioned Derms-E and put layers of tight knit clothing on top of it and slip into a Benadryl-induced hibernation of sorts.  This has been the single most beneficial element of my healing process.  Even though it feels like Neosporin all over your itchy body, in the morning you will wake up feeling slightly less itchy and much softer.  It DID take a few nights before I started to see a difference, but my red marks are healing and flattening, and my stretch marks are even getting lighter.
8.  I don't know if this is actually helping, but a few people on message boards about PUPPP mentioned drinking 2 servings of V8 each day.  I have been doing this, but I have also been doing all of the other stuff listed above, so it's hard to say how much the V8 contributes to the healing.  My only recommendation, if you are going to try this, is to get the low sodium version of V8, because the regular stuff has about 480 mg of sodium per serving, compared to 140mg in the low-sodium version.  If you don't like the taste, try to think of it as taking your medicine, and think about all of the extra vitamins and minerals you are getting!  GO YOU! 

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