PUPPP rash: Round 2.

I feel like I’ve mentioned this a lot lately, but I have this pregnancy rash called PUPPP – again. I had it when I was pregnant with the Little Mister and very nearly went insane. Actually, I think I did go insane – I just pretended I wasn’t. Now I have it while expecting a Little Miss 6 years later. At first I thought maybe I was just sensitive to heat and hoped like hell it wasn’t what I thought it might be. But now I know that it is indeed PUPPP.

Having it for a second time around is like a double edged sword. On the one hand, I feel like I know what to expect and I know which mistakes I do not want to repeat: waiting too long to get help, seeing doctors etc who are not experienced, keeping it to myself and stressing all alone. I know which treatments are most likely to help and which suggestions from well meaning people and websites are probably going to make things worse.

On the other hand, because I do know what to expect, I freak out a bit because the reality of having this condition has come flooding back to me and I have to separate my anxiety about it getting much worse from the reality which is that it seemingly isn’t as bad as last time…yet.

The first time around, I used a steroid ointment prescribed by a dermatologist. This time I am using a slightly weaker cream to start with, as well as taking antihistamines before bed each night. I think these things are helping to keep the rash contained in its hot spots for the most part. Some parts of me have completely cleared up (they may have just been heat rashes all along just to confuse matters). I don’t think these treatments actually prevent me from itching, though. Especially at night or in the late afternoon, when things are quiet and I have no distractions.

I find that stress has been a factor in making it feel worse. The more I think about it, worry about it, or get myself into an anxious state, the more itchy I feel. The more itchy I feel, the more unattractive and embarrassed and hopeless I feel, the more exhausted I get. The more exhausted I am, the more likely I am to be vulnerable to anxiety. It’s a vicious cycle.

Often I wake in the night, scratching. I will struggle to fall asleep. I will feel everything. Every bit of fabric rubbing on my skin. I will think that this is surely a sign that things are getting catastrophically worse. Then in the morning, I will look in the mirror and realise that the rash hasn’t really changed since yesterday. I try to remind myself of this every subsequent night.

Here are the things that are helping me this time around:

Talk it out – get help fast – don’t let embarrassment stop you

You can get itchy with PUPPP in odd, embarrassing places. It can make you feel like a freak. But I have learned since last time that talking/blogging about this, tweeting about this, joining an online support group about this, admitting when I’m feeling mental, helps. Nobody can help you if you pretend everything’s fine. When people ask how I’m feeling as a pregnant woman, I’ll be honest now. Oh, I’m so so excited about this beautiful baby girl on the way, but I am struggling at times with itchiness – I’m actually allergic to her DNA or hormones or something! Sure, the person who asked how I am might be getting more than they bargained for, but I owe it to myself (and others) to be honest about it all. I am not one of those over sharing during small talk kinds of people, but in this instance, a simple sentence like that really helps me to feel like I’m not hiding or pretending.

I rushed to get help this time. I didn’t double guess myself. I knew the rash could be nothing but it could be PUPPP too. It was good to get my knowledgeable doctor’s take on it right away. I truly believe that early intervention has helped me to feel empowered and has maybe even slowed down its progress.

Wear breathable clothing/sleep on good bedding ASAP

No more jeans or leggings! Dresses, skirts, fabrics that feel soft on my skin. Things that breathe. It has been a challenge as the weather has been so crazy lately. Going from sunny and spring like, to cold and rainy and windy and back again. But I have minimised the amount of fabric worn on my legs in particular (the upper thighs can get really irritated from tight pants etc). I have a cotton slip for underneath sheer items of clothing (why is everything at the shops see through these days?) and I have ordered a whole bunch of cotton undies. I am currently researching mattress toppers made of bamboo or cotton, to try and improve my comfort when I sleep. I know the weather is only going to get more sweaty and hot with my baby due in February.

Beware a lot of ‘home’ remedies – there is no quick fix

Last time I was pregnant, I panicked and googled every remedy I could think of to soothe my PUPPP. I made the mistake of thinking there might be some magical cure out there. I bought every product ever mentioned and I probably confused the hell out of my skin. What works for some people might not work for others. In reality, the rash cannot ever just disappear (until you have the baby usually). You just have to manage it until it’s run its course.

Now I am more realistic. I won’t ever feel fully comfortable in my skin, but I can soothe it and I can calm myself psychologically which is honestly the most important thing to me right now.

For example, I had a freak out yesterday. I felt a bit manic and I wanted to cry. This made me feel more uncomfortable. I was a bit anxious because my inlaws were going to have the Little Mister for a couple of nights to enjoy some bonding time and give us (mostly me) a rest during the holidays. It was so kind of them and I was happy for everyone involved to do that, but the reality set in that I would have no positive distraction in the form of a loveable child who needs me to be strong. EEK.

I came home from dropping him off, to Mr Unprepared having heard the panic in my voice over the phone. He’d been to the pharmacy for advice (where he was lucky enough to get advice from my amazing mums’ group friend who is conveniently a great pharmacist), he’d run me a bath and lit some candles. He had a soothing Spotify playlist ready.

We threw some Pinetarsol wash in the bath and as soon as my body hit the water, I felt instant relief. I smelled like someone’s grandpa but it felt so good. I knew it wasn’t a cure this time around, so I just enjoyed it for what it was – as opposed to when I tried something similar last time and felt mad it didn’t fix everything. My skin felt smooth and clean afterwards. I tried to take that chilled feeling with me all the way to bed time. I slept better than I had in weeks.

Knowing people had my back and lowering my expectations really helped. You cannot underestimate the power of the mind in this situation. I know this well and learned a lot about this since my first pregnancy.

Keep busy – dress up and show up

It can be hard to find a balance between staying distracted and being a burnt out pregnant person, but I have found that if I keep moving, I can go a whole day without feeling itchy. To me, it’s important to dress up and show up. I isolated myself out of embarrassment and anxiety during my first pregnancy and I don’t know that it did me many favours. Of course I will also have to be mindful of my limits, but generally, having nice maternity clothes to wear, doing my make up, styling my hair, helps. I can’t let myself become scared to leave the house. I cannot sit around without distractions, feeling more depressed and itchy.

There’s nothing like a rash to make you feel very unattractive, very fast. Even looking at yourself in the mirror naked while you apply your rash cream can make you feel a bit confronted every night! My rash isn’t actually very visible outside of my every day clothing, but it can make you feel quite unsexy!!

Dressing up and showing up when I can makes me feel productive, empowered, less itchy, and more connected to the real world. Sitting at home thinking negative thoughts about my body does not help my mental health.

Have a mental health/self care plan

After last night’s little panic attack moment, I realised I need to be proactive so it doesn’t strike so badly next time. I started to think of things I can do next time I feel anxious enough to want to rip my skin off.

Things like:

  • take another bath if I am able to (because I have a kid who is still learning about privacy haha). If not, I can use the Pinetarsol or Calamine lotion on my skin before showering quickly to soothe myself.
  • Pick everything/everyone up and head to the beach (which is luckily right down the road) – don’t slow down to talk myself out of it. Get into the fresh air, see/feel the ocean (it’s my happy place). Distract distract distract!
  • Talk talk talk. Tell SOMEONE I am struggling. Even if it’s a stranger online in a support group.
  • Make a contingency plan to get more medical help if necessary. For example, if this isn’t better after trying all of the above, I will commit to making a doctor’s appointment ASAP and I will not put it off or make excuses. That way, I can feel a bit calmer knowing I will get help no matter what by a certain day/time. Even if it’s just making contact to say I’m not OK. Never isolate.

Have you ever had PUPPP? Did you have it more than once? What helped you? x

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