Eczema in pregnancy

Overview

Eczema is a dry, itchy, red skin condition that can flare up or appear for the first time during pregnancy. It is also called atopic dermatitis. During pregnancy, changes in your immune system and hormones can trigger eczema on areas like your elbows, knees, neck, and face.

Yes, eczema is one of the most common skin conditions in pregnancy.

It mainly affects pregnant women, especially those who have had eczema before, or have a personal or family history of allergies, hay fever, or asthma.

Symptoms

Common symptoms

• Dry, scaly patches of skin that may feel rough
• Intense itching, especially at night
• Red or brownish inflamed areas
• Small raised bumps that may ooze or crust when scratched
• Thickened, cracked, or sensitive skin

Symptoms in children

• Eczema in pregnancy does not directly affect your baby before birth, but your child may have a higher chance of developing eczema in early childhood.

Symptoms in older adults

• This condition is specific to pregnancy and does not typically affect older adults.

Causes

Main causes

• The exact cause is not fully understood, but it is linked to changes in your immune system and hormones during pregnancy.
• Your skin’s natural barrier may become weaker, allowing moisture to escape and irritants to enter.

Risk factors

• Having eczema or allergies before pregnancy
• Family history of eczema, asthma, or hay fever
• Stress
• Dry skin or living in a dry climate
• Exposure to skin irritants like strong soaps, detergents, or perfumes
• Overheating or sweating

When to see a doctor

See a doctor urgently if:

• If you have signs of infection (pus, yellow crust, spreading redness, fever)
• If you have blisters or your skin feels very hot and painful
• If you have difficulty breathing or swelling of your face or lips

Book a routine appointment if:

• If your usual moisturizers or over-the-counter creams are not helping
• If the itch is keeping you awake at night
• If you want advice on which treatments are safe to use during pregnancy
• If the eczema is spreading or making you feel very distressed

Diagnosis

A doctor or dermatologist will look at your skin and ask about your symptoms, your history, and any family history of eczema or allergies. Usually no tests are needed.

Tests that may be done

• Sometimes a patch test may be done to check for contact allergies if the rash looks unusual.

What to expect at your appointment

Your healthcare provider will ask about your symptoms and examine the affected skin. They will also discuss safe treatment options during pregnancy. This is a straightforward process and usually takes 10–15 minutes.

Treatment

The goal of treatment is to soothe itching, reduce inflammation, and keep your skin moisturized. Most treatments are safe during pregnancy when used under medical advice. Always check with your doctor before using any new product.

Self-care at home

• Moisturize your skin at least twice a day with a fragrance-free emollient (medical moisturizer). Apply it after bathing.
• Use lukewarm water for baths and showers – hot water dries the skin.
• Pat your skin dry gently with a soft towel, do not rub.
• Wear soft, breathable cotton clothing and avoid wool or synthetic fabrics next to your skin.
• Keep your nails short and consider cotton gloves at night to reduce scratching.
• Avoid harsh soaps, bubble baths, and scented products.
• Keep cool – use a fan or cool compress on itchy areas.
• Manage stress with relaxation techniques, gentle exercise, or talking to a friend.

Medical treatments

Your doctor may recommend a low-strength corticosteroid cream or ointment to apply to the itchy areas for a short time. They may also suggest a mild antihistamine that is safe in pregnancy to help you sleep. In severe cases, a specialist may prescribe a short course of oral steroids. Always use treatments exactly as your doctor advises.

When is surgery considered?

Surgery is not used to treat eczema in pregnancy.

Living with this condition

Make moisturizing a daily habit. Keep your emollient in a visible place so you remember to use it. If you feel an itch starting, gently rub or tap the skin instead of scratching. Keep your environment cool and humidified if possible.

Lifestyle tips

• Take short, lukewarm baths (5–10 minutes) with an oatmeal or oil-based bath product.
• Wash your clothes and bedding with a fragrance-free, mild detergent.
• Avoid sudden temperature changes and overheating.
• Talk to your employer if you need adjustments (e.g., avoiding irritants at work).

Diet and exercise

Eat a balanced diet rich in fruits, vegetables, and healthy fats. There is no special eczema diet unless you know a specific food triggers your symptoms. Gentle exercise like walking, swimming, or prenatal yoga is fine, but avoid getting too hot or sweaty as that can worsen itching.

Mental health and emotional wellbeing

Living with itchy, uncomfortable skin during pregnancy can be stressful and affect your sleep and mood. It is normal to feel frustrated. If you feel anxious, down, or unable to cope, talk to your midwife, doctor, or a mental health professional. You deserve support – you are not alone.

Prevention

You cannot always prevent eczema during pregnancy, but you can reduce the chance of flares by keeping your skin well-moisturized, avoiding known irritants, and managing stress. If you have a history of eczema, start a good skincare routine early in pregnancy.

Complications

If left untreated

• Untreated eczema may become infected with bacteria (making it weepy, crusted, and red) or with viruses (such as cold sore virus).
• Constant scratching can lead to thickened, permanently scarred skin.
• Severe itching can cause sleep loss and affect your daily life and mood.

Long-term outlook

For most women, eczema improves or even goes away after pregnancy. Even if it persists, it can be well controlled with proper skincare and medical advice. Your baby is not harmed by your eczema. With the right support, you can keep your skin comfortable and focus on enjoying your pregnancy.

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