Overview
PUPPP is an itchy bumpy rash that starts in stretch marks in the third trimester; it's harmless for the baby.
Cholestasis raises risks for the baby, so doctors may plan early delivery.
Symptoms
Common signs:
- Itching during pregnancy
- Pregnant or recently gave birth
Less common
- Itchy palms and soles
- Bumpy rash on belly
Look up a symptom: Itching · Pregnant or recently gave birth
When to get medical care
Causes
Stretching skin, hormones, liver changes.
Does it spread or run in families?
- It isn't contagious. You can't catch it from someone else.
Who is more likely to get it
- Twins
- Third trimester
Diagnosis
Your care team checks the rash.
Questions you may be asked
- Where it itches
The exam
Skin exam.
Tests
Tests, if needed:
- Bile acid and liver tests: For cholestasis.
Treatment
Soothe the skin.
Self-care
- Use fragrance-free moisturizer
- Take cool showers
- Wear loose cotton
Medicines
Medicines that may help:
| Medicine | Helps with | Good to know |
|---|---|---|
| Ursodiol | Cholestasis | Prescription. |
| Steroid creams | Itchy, inflamed skin | Use as directed; not long-term on thin skin. |
OwieClear doesn't give doses: follow the label or your healthcare professional. Medicine names here are examples, not a full list.
Which doctor treats this
- Start with your primary care provider (family doctor or internist).
- They may send you to an OB-GYN or midwife; high-risk pregnancies may see a maternal-fetal medicine doctor.
Outlook
Usually ends after birth.
Getting ready for your visit
Bring a list of your symptoms and medicines.
Questions to ask
- Should I be tested for cholestasis?
Research studies
Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.
Search ClinicalTrials.gov for studies on Itchy rash or itching in pregnancy
Sources
Last updated 2026-11-12.