What the… PUPPP?

Well, it’s been a little while since I posted. And there’s a reason (other than having a newborn). It’s called PUPPP – an acronym I have grown to loathe in epic proportions over the last few weeks – that stands for pruritic urticarial papules and plaques of pregnancy. Or, hell on earth.

It all started with a little itch on my belly about a week postpartum. Just a little itch. Within minutes I was scratching my belly so hard that the stretch marks that had popped up during pregnancy turned into raised and angry looking welts. I figured it was kind of weird, but I chalked it up to the fact that my skin had gone through a lot of changes. Then my breasts got itchy (not fun when you’re breastfeeding), my legs, and my arms. I broke out into a rash that looked like mutant chicken pox and if that wasn’t enough, it itched to a maddening level. The only thing that made it feel better, temporarily, was itching. The itching, in turn, made it all worse because then it itched MORE. The most vicious of vicious cycles… I quite literally could. not. stop.

My mind started racing (cue freak out). What could it be? Chicken pox? Shingles? Poison ivy? Poison something else? By the time I was able to see my dermatologist, I was covered in this rash. He asked a few questions, took a peek at the damage, and broke the news: it was PUPPP, a condition that most commonly shows up in women while they are still pregnant and it generally resolves at birth. Well… since I was no longer pregnant, I could not count on it going away at any particular point.

Just a glimpse of the gorgeous PUPPP on my legs!

Just a glimpse of the gorgeous PUPPP on my legs!

As if trying to take care of a newborn, dealing with all of the fun postpartum stuff that happens to your body physically and emotionally, trying to manage the itching was ridiculous. I had a steroid ointment from the dermatologist that I wasn’t crazy about using while breastfeeding, so I used it very sparingly and only when things were so bad that I was driven to tears of frustration, discomfort, and pain. I spent a fortune on lotions and potions and became even more of a regular at our local CVS (I’m really glad that place is open 24 hours).

One of the midwives suggested that this might resolve around the six week postpartum mark and lo and behold… it did! Judging from what I read online about other women’s experiences, this is not always the case. I can only hope it is on its way out and never, ever, returns. The itching started to subside, the welts calmed down, and the areas I had itched until they bled started scabbing over. I still have periods where I am itchy, but nothing like it was during the height of my PUPPP-induced insanity.

I’m writing this post because I hope other women who desperately scour Google for PUPPP information will find this. And if that’s you, there are a few things I want to share with you:

  1. IT WILL GO AWAY. It cannot last forever. But I know… when you are itching your body to complete ruin, it is really hard to see an end in sight. But it’s only temporary!
  2. Feel bad for yourself. Go ahead! Bitch, moan, complain, cry, whatever you need to do! Whether you are pregnant or with a newborn, either way it SUCKS. Wallow in your own misery for a bit, but try not to let that take away the joy of pregnancy or of a newborn – not easy to do, but also time you’ll never get back.
  3. No one, other than women who have had PUPPP, will understand the depths of your insanity as a result of this rash. Adding the discomfort and downright pain of the rash and itching on top of pregnancy (or in my case, caring for a newborn) is a recipe for crazy town. (If you need to talk to someone who can relate – even if it’s to bitch, vent, and cry about it, email me: betterbalancedlife@gmail.com. Seriously.)
  4. It seems that what brings relief for some women does not work for others. Don’t get discouraged… just try something else!

I took everything I found on the web and sifted through to identify products I would be willing to try. Here goes the list, ranked in order of helpfulness – I will add that I’m not a doctor or any sort of medical professional. This is just what I found worked for me:

  • Sarna lotion. worked really well to relieve the itch. I put it in the fridge and put it on cool – felt SO nice.
  • Ice. Perhaps the most effective relief was simply numbing the itchy area. This is hard to do if your entire body is itching, but for “spot itching” it’s a miracle. I literally slept with ice packs rigged to my legs.
  • Dandelion root tincture. Picked some of this up at the local health mart and took it 2x a day. About 4-5 days after I started taking it, the rash started to go away. Coincidence? Maybe! But I think it helped.
  • Cortisone cream. Worked somewhat, but not enough.
  • Gold Bond Medicated Lotion. Was good for when the rash started drying up, since it has a moisturizing component to it.
  • Oatmeal baths. It was too soon postpartum for me to soak in the tub, so I made a paste out of the Aveeno oatmeal bath mix and rubbed it all over my body. Biggest mistake ever…. it burned, burned, burned. Others found the oatmeal bath helpful.
  • Grandpa’s Pine Tar Soap. I bought this, but didn’t use it. It smells like campfire and I hate that smell… others have found it very helpful though! 

Elizabeth gave me enough time to write this post, but now she’s crying and hungry so… that’s all folks! Over and out – and good luck with the PUPPP, if that’s why you’re here!

*UPDATE – July 2016. We welcomed our second child, a baby boy, last December. I am so pleased to share that the PUPPP didn’t come back with this baby. I was so terrified that it would… and every itch, scratch, etc. I was sure it was going to flare up. I wish everyone the same luck on the next go-round! ❤

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31 thoughts on “What the… PUPPP?

  1. chacha63d says:

    I came across this post in a search for answers! I am 3 weeks PP and have the same exact situation that you had – so thank you for writing this! Mine popped up last week and has stayed within the belly thigh area. I am hoping it subsides soon. Thanks again.

    • I am SO glad you found it! I am so sorry that you have this horrific rash. Seriously. I’m not sure what’s worse – getting it PP or having it while pregnant. It’s horrible no matter what – but on top of taking care of a newborn… isn’t that enough?!

      I am sending you non-itchy vibes and enjoy that new baby 🙂 If you have any questions let me know – I seriously tried everything. In fact, I just found my bottle of Sarna lotion tonight while cleaning out the bathroom cabinet and was immediately brought back to the memories [shudder]. It def. got worse before it got better for me, but there was a marked improvement right around the six week mark. Hang in there! And I hope that no one tells you just to “not itch it” … they have NO clue!

      • chacha63d says:

        Thank you! Went to the derm yesterday and she gave me a prescription cream that seems to be helping. It’s spread a bit further down my leg but my hope is that it’s just “running its course.”

        In the end do you think time made it go away or the medley if remedies you tried? Thanks again – I’m so glad I have someone to commiserate with!!!

      • So glad something is working for you! Sigh – that’s a tough question. I do think time had a lot to do with it – just your body has so many hormones and it is just ridding itself of it all! The only time I noticed a marked difference in the rash itself (not just treating the itching, but the rash lessening) was after I used the dandelion – apparently rashes are linked to your liver and your liver is linked to your skin – but that could also have been good timing. It’s so hard to say!

  2. Kim says:

    Omgosh! Ur photo of ur leg is like looking in a mirror! Seriously I thought it was a photo I had just taken and somehow ended up on google search for PUPPP! Only thing is I’m only 3 months preg!! So I’m wondering if it is this and if it will last the whole pregnancy😩 I never got anything like this with my first son either so it’s strange to get something now??
    Anyway, I’m going to give the ice a try, and putting the lotion bottle in the fridge is an EXCELLENT idea 🙂

    • Oh mama! I’m so sorry. Can you see your dermatologist? They can give you a good diagnosis and even take a little biopsy to see if it’s PUPPP or something else (like, maybe an allergic reaction to something?). Keep me posted!

  3. Dana says:

    Thanks for your post!!

    I had PUPPP in last 3weeks of my pregnancy – puppp was completly gone in a hour after delivery!!! But….after 1 week!! i had it back and much worse then i had it before!
    Now it is 3weeks and it’s all over my body!!!!!!!!!!!

    Didn’t find any relief yet;((((!!!

  4. Kim says:

    Hi again!
    (Posted earlier)
    I’m 14 weeks preg and am sure it’s what I had(PUPPP), doctor never did a skin biopsy or anything like that, but just looking at photos and reading all the threads I don’t doubt it for a minute.
    I ended up going to doctors and was prescribed Predisinone(steroid) and to take Avil(antihistamine) to calm the rash down and within 24hrs it was 90% gone!
    It was ok to to take during pregnancy after the 12 weeks too.
    I understand everyone’s pain!! It’s the worst thing you can get, I was only 12 weeks and I was considering options like planning a Caesar just so bubs would come out early and rash would go. Horrible I know!!
    Might be an idea to ask ur doc about anything they can prescribe?? 🙂

  5. Cristin says:

    I am suffering through postpartum puppps right now. It’s torture!

  6. Cristin says:

    I started with an itchy rash on my stomach when baby was about 10 days old. I thought it was a yeast rash and treated it as such. It was really bad by the time baby was about 4 and a half weeks. I called my OB because I also thought I had a vaginal yeast infection and thrush with breastfeeding and they callee me in two doses of diflucan . Well, the next day the horrid rash had spread to my arms and legs. Now it is on my butt and hips also. It is horrible. I went to Urgent care 2 weeks ago and they said they thought I had a yeast rash in my stomach but because I had scratched so much, I transferred bacteria to my arms and legs. They put me on Keflex antibiotic and gave me Nystatin / triamcinolone cream for the rash. It did NOTHING! I was up ALLnight long itching. I went to the ER two days later and they diagnosed me with hives and put me in 5 days of Prednisone. They gave me a referral to a dermatologist and I went to her 3 days later. She said I have excema, and that she did I not think it was ever yeast and prescribed me triamcinolone cream and ointment. Well, here I am 2 and a half weeks later and I called on Monday because I was still terrible. They called me in a 6 day steroid pack. Methylprednisolone. I think it is helping! My rash is drying up a little although it is still really itching a lot. I just bought Grandpas pine tar soap and used it for the first time tonight. I hope it helps! I don’t wish this rash on anyone. It is horrible trying to take care of an almost 8 week old while dealing with the rash. I also have 6 other kids so it is crazy! I did buy Eucerin calming cream and it helps a little. I have sarna lotion also which is AWeSOME for the itch but I recently found out you should not use it while breastfeeding because of the camphor in it. I feel terrible for anyone with this rash. I just hope it totally goes away soon.

    • MAMA – you have six other kids and you’re dealing with postpartum PUPPP!?!!? you deserve mother of the year! if it’s any consolation, mine started to get better around the six week mark. i was over the worst of it by then it just took some time for all the bumps to go away and I have had itching around my period every month although that gets less and less each month. it’s so hormonal and crazy. hang in there!

  7. Megan says:

    For anyone else searching for relief in the middle of the night, my midwife suggested milk thistle in addition to dandilion and it works so well. It’s all suppose to help support the liver, which then helps the rash. (And would make sense as to why the previous commenter got worse with antifungals) I’ve had a pupps rash with babies 3-5. PP after #5, and flare ups since. (She is 2 and I’m currently in the middle of a flare up) the milk thistle combo does help it go away every time.

  8. Jessica says:

    Grandpa’s Pine Tar Soap worked the best for me. I was so bad I didn’t care how I smelled. After one bath I felt better. Then I started taking 3 baths a day and in a few days it was gone. My doctor gave me prescriptions, but they don’t hold a candle to the pine tar soap.

  9. Cristina says:

    I don’t know if this feed is still active, or if I will be able to find it again. But My youngest son is 26 months old. He is weening and I have had a rash so similar to your photos, I swear I took them. The itch is maddening. It is everyhere I have stretch marks and my doctor has no clue as to what it is. I have went through all my products to make sure it wasn’t a reaction to something I have been using, and nope it isn’t. I have a history of allergies, asthma, and excema, and now as I wait to see a dermotolgist I am so wondering if it is possible that this is what I have.

    Ive had this rash and itch for just over 2 months now and nothing I have tried has worked. I had my tubes tide after I had my son so I doubt very much im pregnant again. So is it possible this is what is going on with me even though Im not pregnant and my youngest is over 2 yrs old?

    Please help I am going insane with this itch and rash.

    • OH no mama! I’m so sorry for the delay. I do check the comments but not as often as I once did. Have you seen the dermatologist? What did they say? I just had my yearly skin check yesterday and asked about PUPPP and the itching I have around my period (I’m convinced they are related) and he said the hormones that caused PUPPP would be long gone. I don’t know though…

  10. Amanda says:

    I am just recovering from a terrible case of this insane rash! It was probably one of the worst things I’ve ever experienced in my life. I tried MANY different remedies – both drugs and homeopathy – as well as acupuncture and cranial sacral therapy. I washed with Grandpa’s Pine Tar soap which did help a bit and I used hydrocortisone cream which helped a lot. However, the thing that made it finally begin to go away was DANDELION ROOT!!! I took 18 pills a day and it’s now day three and, while the rash is still there a little bit, it is FAR less severe. Last night I had my first almost normal night’s sleep – no ice packs, no itching like crazy, no creams or crying, etc. For anyone going through this, I’m sorry – it is TERRIBLE! Trust me, try the DANDELION ROOT!!!!!!!!!!!

  11. Jessica says:

    Wow, your PUPPP looks awful! I had it during my third trimester with my son, and it seriously is the WORST thing ever. I also wrote a post on my blog about my experiences with it.

    My Peanut Butter Problem: Surviving a PUPPP Rash

  12. Nat. says:

    Just found this thread… I developed PUPP at 38 weeks pregnant with my daughter. The rash went away almost immediately after giving birth but came back full force within a couple of weeks. While it eventually got better, I started noticing it would flare up (though much milder) every time I got my period. This lasted almost 2 years and finally went away…until…. I just developed a strikingly similar rash (my daughter is now nearly 4), I’ve been itching like crazy and it looks and feels exactly the same. I am definitely not pregnant.. Is it possible it’s back after all this time?!? Anyone have a similar experience??

    • Hi Nat! Sorry for the delay, I’ve been a bad blogger lately. I had the same experience – rash flaring up around my period. My derm told me I was crazy, basically, and my midwife also said the pregnancy hormones should be long gone. But you and I know. We are not crazy. We KNOW the truth! I have no explanation 😦

  13. Hillary says:

    I seriously can say that pupps was probably the worst thing I have ever experienced and for some reason, I still have night mares about it even though I have been clear for about a week. I just wanted to let everyone know that I tried everything….LITERALLY EVERYTHING and nothing worked. Someone mentioned the pupps cleanse and I have been thanking her for the past week….no lie…everyday for the past week. Please try the pupps cleanse. It can be found at http://www.pupppcleanse.com. It will save you tons of agony, pain, and money.

  14. Caty says:

    Hi, I’m 2 wks into a full body case of PP PUPPS. My little girl came 4 wks early so the doctor thought I might have had PUPPS regardless of her early arrival. The GP prescribed me the oral steroid but I decided to not take it bc I’m breastfeeding. I found your post very helpful and I keep telling myself that this will end but it seems endless!!! I’m using the pine tar soap and the lotion you recommended- it gives brief relief but the rash spreads it seems by the minute. I’ll look into the dadilion root – did you breastfeed during your PUPPS? (I can’t believe you get flare ups with your period!!! I feel like I need to do PUPPS awareness or something! It’s so awful and so unknown! )

    • Oh mama! Welcome to that new baby in your life. I am so sorry you are going through this. Just know you’re not alone! (I am 10 weeks from delivering my second and terrified that I will get it again postpartum but this time I have all of you to lean on! every itch I have I wince… is this PUPPP?? so far, so good and it’s not) I did breastfeed throughout the rash. It was super uncomfortable to say the least, but it went away and breastfeeding got easier and… yes. On the other side now, 2 years later, so it’s easy to say that but I know it’s not easy for you right now. Hang in there!

      • Margot says:

        Phew, everything you say is true. This is a special kind of torture and for some reason God has chosen me as one of the postpartum PUPPPs moms. I’m going on week 5 of it now and am just in hell. This intense itching mixed with a third degree episiotomy and the baby blues the first week? I don’t know how I got through that- my poor husband held me while I cried (ugly cried) the whole
        time. I went to a dermatologist by the end of the fist week and received a cortisone injection and a prescription for triamcinolone steroid cream- this was something else that freaked me out- putting the cream all over my entire body and not letting it come in contact with my new precious baby! So I’d cover up with long sleeves and be extra careful not to get any of it on the outsides of the clothing. While breastfeeding. Ugh, it was miserable. The dermatologist hesitates to diagnose this as PUPPP because he’s “never seen a case PP”. Anyways, I stopped applying the cream 3x a day because the cortisone injection started working great and the rash went away within a week almost completely. Well, about 2-3 weeks later (after the cortisone left my system) puppp came back with a vengeance. I just went back to the dermatologist today and he was shocked I still have it. He took a skin biopsy and gave me another cortisone injection and mentioned if this is PUPPP it might be being caused by an allergic reaction to the prolactin hormone and I might have to stop breastfeeding- but I refuse to do that, so I’ll deal with this as I have to. I’ll tell ya what though, from reading everyone’s responses- I’m going to pick up dandelion root extract pills today! Also, I wanted to ask you- now that you’ve had your second child- did it come back again? 😕 I’m praying it didn’t for you!!

      • Hi! I am just coming up for air after this second baby… AND I DIDN’T GET PUPPP THIS TIME! And we had a boy – so I am super surprised. I am SO sorry you are going through this mama – it makes an already difficult time that much more difficult. I hope in the next couple weeks as your hormones level out that you find some relief. And you can have your dermatologist call my dermatologist to talk postpartum rashes. Yeesh. Please reach out if you need an understanding ear!!

  15. Mackenzie says:

    This was the best thing I’ve seen about PUPPP! Thank you for writing this!!! Everything I kept finding on Google said that it starts during pregnancy and goes away after delivery. However, I also got it at one week postpartum and I am going on my second week with it. I just want to tear my skin off! I’m so happy to see that it does go away because I don’t even wanna show my legs and it’s the middle of summer! I now have some hope that it will go away in a few weeks. Thank you!

  16. Zoya says:

    Thank you for this. I was just telling my husband if this does not go away soon or comes back after I stop the steroids (I am on day 4 of 20mg) I may have to consider suicide (no I was not suffering from PP depression until the rashes turned up!) and he must have gotten worried as went online and came back with your post 😄… Mine started on stomach literally three days before delivery and I am now 5 weeks pp. Been almost impossible to properly breastfeed or bond with my baby and I can truly say the pain and discomfort beats that of my c-section. You clearly already know exactly what I mean! The steroid has helped but I still feel a burn in place of the itch all over and just hoping that like in your case, an end is just around the corner. Thanks AGAIN 😊

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