Eczema may flare up or begin during pregnancy. Treatments for eczema when pregnant include mild to moderate steroids, oral antihistamines, and more.

Eczema is an umbrella term for several skin conditions that can cause color changes, itchiness, and inflammation. People of all ages can get eczema, from infants to older adults. Common types of eczema include atopic dermatitis, contact dermatitis, and seborrheic dermatitis.

Some people who have a common type of eczema may experience a change in their symptoms during pregnancy. Other people may develop eczema during pregnancy.

More than 31 million Americans have some form of eczema. It is unclear how many people develop eczema during pregnancy, but older research suggests eczema accounts for one-third to one-half of all dermatitis cases during pregnancy.

According to the National Eczema Association, females are more likely to experience eczema than males. It is nearly equally common in people of all skin colors, races, and ethnicities. However, it is slightly more common in Native Americans and Asian or Pacific Islanders.

Pregnancy affects eczema differently from person to person. However, the umbrella term “atopic eruption of pregnancy” (AEP) generally refers to dermatitis flare-ups that occur during pregnancy.

This includes flare-ups in people who have already had common types of eczema such as atopic dermatitis before becoming pregnant. They may experience a temporary worsening of symptoms, or the symptoms may temporarily get better.

In other cases, AEP can mean a dermatitis flare-up in a person who usually does not have eczema. This may be atopic dermatitis but may also be other conditions such as prurigo of pregnancy or pruritic folliculitis of pregnancy.

These usually go away after birth. In all cases, it is usually a result of the temporary impact of pregnancy on the immune system.

Less commonly, a pregnant person may also develop more severe symptoms of other types of eczema or dermatitis, such as vesicular hand dermatitis, which is also known as dyshidrotic eczema.

While eczema symptoms can be painful and uncomfortable, eczema is not dangerous to the baby, and it is not contagious.

The symptoms of eczema can include:

  • itchy skin
  • rough or scaly patches that can ooze or crust
  • skin that is dry, sensitive or inflamed

The majority of people with eczema during pregnancy will develop lesions on the creases of the joints, such as elbows, knees, and ankles. About one-third will develop lesions on their trunk or limbs.

For people with light-colored skin, eczema patches may appear red and inflamed. For people with darker skin, eczema may make skin look ashen or gray. Some patches may appear darker than the surrounding skin, or have a brown or purple hue.

Some people have all of these symptoms, while others may have only a few. Also, the symptoms can vary in severity.

Some people have severe symptoms that prevent them from doing some everyday activities, while others find their symptoms are very mild and not bothersome.

Treating eczema during pregnancy can be challenging. This is because many of the medications can harm the developing fetus. It may also depend on the type of eczema a person has.

There are several relatively safe options, including:

  • Mild to moderate topical steroids: It appears that mild to moderate steroid creams are safe to use during pregnancy. They can help relieve itching and other symptoms when applied to the affected skin.
  • Oral antihistamines: Since a person with AEP may have an overactive immune system, antihistamines may be able to help. Doctors commonly prescribe loratadine (Claritin) or cetirizine (Zyrtec).
  • Ultraviolet B: Some research has shown that UVB light has helped to reduce the symptoms of eczema, especially when steroids have not been effective. Similar to topical steroids, UVB light is safe during pregnancy.

When these treatments are not effective, other options include:

  • stronger topical steroids
  • oral steroids
  • cyclosporine and other medications that suppress the immune system

Before starting any of these medications, it is important for people to have a detailed discussion with a doctor about the risks and benefits of taking them during pregnancy.

What to avoid

A pregnant person should completely avoid certain treatments. These include methotrexate, psoralens plus UVA (PUVA), and Toctino (alitretinoin).

In addition, while eczema itself does not affect fertility, a person will need to stop these medications if they are trying to conceive to remove any potential risk to the embryo. This may also extend to the partner who will not carry the pregnancy.

A person who already has eczema and becomes pregnant, or someone trying to conceive, should speak with a doctor about the medication they are taking as soon as possible. After pregnancy, a person who is nursing may also need to avoid these medications.

Home remedies can be very effective in managing some of the discomforts associated with eczema.

Some home remedies a person can try include:

  • Moisturizing: Regularly using moisturizers and emollients is crucial when treating eczema. Choose a gentle, scent-free, and hypoallergenic lotion.
  • Taking warm showers: Hot showers can dry out the skin. Switch to lukewarm water instead, and moisturize immediately after getting out of the shower or bath.
  • Wearing loose-fitting clothing: Avoid wearing anything too tight or form-fitting. Tight clothing can hold in heat and irritate the skin. A person can also choose natural fibers, such as cotton.
  • Avoiding harsh soaps or cleansers: These products can aggravate eczema. Switch to organic and gentle ones that are hypoallergenic. In addition to soap and body washes, a person with eczema may also wish to use gentler detergents, makeup products, and perfumes.
  • Staying hydrated: In addition to being healthy for the body and growing baby, drinking enough water is essential for good skin health. It keeps skin soft and can reduce the symptoms of eczema.

Some people choose to use natural remedies to control their symptoms, including:

  • Coconut oil: Coconut oil is a natural moisturizer emollient known to reduce inflammation. People can use it as a lotion and apply it directly to irritated or itchy skin.
  • Dietary changes: Some foods can increase inflammation in the body, including the skin. If a person wishes to use dietary changes to prevent eczema flare-ups, eliminating dairy and gluten may be a good place to start. Also, eating mostly whole, unprocessed foods is good advice for anyone, particularly pregnant people.
  • Probiotics: There are healthy strains of bacteria all over the body, including the skin and gut. Probiotics may help prevent eczema in some pregnant people, although more research is needed to confirm this link.

For some people, eczema flare-ups continue after childbirth. Other people develop eczema on or around the breast and nipple, particularly if they are nursing.

Moisturizers and mild to moderate steroids can usually treat the symptoms. It is important to wash off the medication before the next feed.

Questions about treating and caring for eczema during pregnancy are common. The following may help answer some concerns.

Can pregnancy give you eczema?

Changes to the body during pregnancy can make skin conditions such as eczema occur. Hormone changes may affect the balance of cells in the body that protect the skin barrier. When this happens, immune cells may begin attacking skin cells. This can lead to eczema.

What cream can I use for eczema when pregnant?

Treatment for eczema during pregnancy can be challenging. It needs to be effective for the person with eczema but safe for the developing fetus. A person will typically use moisturizing creams and emollients as a nonmedicated option. However, they may need to take topical corticosteroids, such as hydrocortisone and betamethasone, which are also safe to use. If these options do not work, a doctor may prescribe UV light therapy, other topical steroids, or cyclosporin A.

Does pregnancy eczema go away?

People who develop eczema during pregnancy may not experience symptoms after childbirth. However, the condition might return in future pregnancies or after the child is born. If a person shows symptoms of eczema after the birth of a child, they may need stronger treatments if or when they are not nursing.

Can I use eczema treatments while breastfeeding?

People with eczema who are also nursing can use some eczema treatments. However, they will need to be cautious about exposing the infant. Some moisturizers and emollients are safe to use, but steroids or other topical treatments may not be. Consulting a doctor can help a person understand when and how to use eczema treatments while nursing.

Though uncomfortable, eczema during pregnancy is not dangerous for either parent or baby.

There are many treatment options, but it is essential for pregnant people or those trying to conceive to speak with a doctor about which options are safe for them.