Tag: pruritic urticarial papules

We need to have a little chat.

PUPPP.

Nope. I didn’t just fall asleep on my keyboard. I’m talking about PUPPP. It stands for (wait for it…) pruritic urticarial papules and plaques of pregnancy. Yeah. Sounds complicated. I bet most of you have never heard of the damn thing (unless you know me very well via this blog or have actually googled it). Before experiencing this horrible rash first hand, I would have heard such a crazy bunch of words beginning with P and I would have shrugged it off. I don’t really know what that is and who cares, it’s just some rash that I’ll never get (it is believed to only be experienced by an extremely small percentage of pregnant women).

Because hardly anyone suffers from this condition, it was very isolating and difficult to deal with. Each case can differ in how your body responds to the awfully itchy rash, meaning treatments that work for one person might not help another. Odds are, you might not even know what it is when you first show symptoms, if you should be unlucky enough to be a part of the unfortunately exclusive PUPPP club.

I had no idea. I resorted to googling (something I do not normally recommend) when the symptoms got too crazy and I was slow to get answers (partly my fault and partly due to inexperience of some of the doctors I saw early in the piece when my baby doctor was on holiday – of course!). I felt like I knew it was PUPPP, but waiting for an actual professional opinion/diagnosis (and treatment) was like agony.

I was only 20 weeks pregnant when it got bad. Normally women get it at the very end of their pregnancies, meaning there is not long to go before they can give birth (and more often than not be relieved of the symptoms immediately), or can be induced at full term if it’s bad enough.

Yeah. Unlucky.

800px-PUPPP-abdomenPic: Side view of a sufferer’s abdomen.

I spent weeks feeling alone. I couldn’t wear clothes that might itch, sweat or cling to my skin. Difficult in winter. I felt socially isolated and while it’s hard enough to get dressed when you’re big, it was even harder to feel pretty or human with PUPPP. I itched so badly that I was afraid I’d have a panic attack about it in public, so I rarely ventured out before treatment could arrive. Even then, the steroid cream prescribed to me by a dermatologist (who thankfully knew what he was talking about) was greasy and while it helped my rash to settle down a LOT, it gave me pimples too eventually.

I was paranoid about humidity of any kind and it was a huge mental and emotional burden. I never stopped loving the Little Mister who was growing inside of me, but I’d be kidding myself (and you) if I said that I wasn’t close to depression. Bawling my eyes out in a lukewarm bathtub half the day was no life.

Why am I going on about this?

I want everyone to know about this condition. While it may never happen to you (especially if you’re a male reader haha), I want you to know what it is and how to spot it. Just in case.

I also want you to be able to seek help ASAP if you think you may have PUPPP. I didn’t. I put it down to a little heat rash and let myself get worse. If I had sought diagnosis and treatment when it first got a bit uncomfortable, by the time I got answers (it takes a while when no-one’s sure what the hell it is – odds are they may not have dealt with a case first hand very often) I might have saved myself weeks of agony. It is much better to have a false alarm and deal with a doctor who thinks you’re being a little dramatic, than to suffer on your own for too long.

Also, I am writing this post because I want anyone who is friends/family/known to someone who has this condition, to know what it’s like to go through it. I want you to understand that it’s more than a little rash. It can cover half of a woman’s body, is unsightly (therefore embarrassing) and very very uncomfortable and itchy. Think extreme chicken pox (it was like that for me anyhow). Each woman may deal with it differently, but I want you to know how bad it can be. It’s really hard to go through it alone and part of my isolation was worrying that my friends didn’t understand. I couldn’t be at social occasions very often – each day was different and I felt awful and flaky. I worried that they believed I was letting a ‘little thing’ slow me down and that I wasn’t living my life just because I was pregnant. Maybe they thought that, maybe they didn’t. They were amazing friends through it all, but that worry was just something I carried. If I’d known they were able to access great information on PUPPP, I might not have felt so insecure.

It’s hard enough to feel attractive or like you’re living your life fully and actively when you’re quite up the duff. Add complications to that pregnancy and it can be very scary and lonely. I knew that the Little Mister was doing fine inside me – I knew I was blessed even in the rough times. I could have had worse issues (well, besides my gestational diabetes which can be dangerous if untreated). However, try telling a pregnant sufferer of PUPPP that when she can’t sleep AT ALL, feels so itchy she could scratch ALL OF HER SKIN BLOOD RAW,  and lives in a lukewarm bath, waiting for an appointment with a specialist.

I put on a brave face a lot. I wish someone had said, “Lady – I know what that is and you’re fooling no-one. Let me hug you – very gently – while I listen to you whinge about it.”

Also, stop asking a PUPPP sufferer (with scars) if she’s tried bio-oil. No over the counter treatments worked for me (or were permitted during pregnancy depending on ingredients). My skin was sensitive to greasy or oily things (ie the ointment was bad enough). Most of the people who asked me if I’d used bio-oil had never even tried it. The power of advertising, I guess. It’s horrible knowing that almost nothing works. It’s worse when everyone (who’s never heard of the damn condition) suggests treatments for you, which you know will do jacksh*t or even make it worse. You probably mean very well, but you don’t have to be an expert or give advice. A kind, listening ear (and encouragement to seek professional treatment if someone hasn’t already) is probably best.

I was lucky. My symptoms disappeared IMMEDIATELY once the Little Mister had vacated my body. While I had a whole lot of other issues, that was thankfully not one of them. However, the scars and the mental effects stayed for a while. I didn’t want to see another greasy, oily ointment again. I had scars on my chest, which meant I couldn’t dress nicely over summer, without feeling like I was an acne ridden teen with chest pimples (no-one wants to see those). I was sensitive to heat, mentally and physically. It took a YEAR before I felt like I could bare my upper chest without a big ol’ necklace or high neckline to hide behind. Progress can be slow.

I am very fortunate to have a very healthy, hilarious and good natured 18 month old today, who has no idea of the hell he put me through during pregnancy! I intend to let him know during his teenage years, though 😉 In all seriousness, that (him being in my life happy and healthy) is what matters most and what got me through a tough time. PUPPP is not something I would wish on my worst enemy. It felt worse than the diabetes and worse than the infection that brought on my labour. It was worse than dealing with the healing from a C-section. Itching is seriously a form of torture. Some people handle it better than others and I will be the first to admit that I was not handling it, despite my best efforts.

There is help and support out there, but it’s important to start looking early. I’m not trying to scare anyone. I’m just trying to bring awareness to it.

I found a dermatologist who dealt with a lot of pregnancy cases. I highly recommend you seek out an experienced specialist and get the ball rolling with referrals etc fast. Also, know that it isn’t your fault. We are all quick to judge these days. It’s easy to believe that a woman having a tough pregnancy must just be a Negative Nancy or probably did something to cause her condition, because it makes us feel like we have control over our own circumstances, but during pregnancy all bets are off. You can do your best and still have some hurdles to deal with. Don’t let ignorant people bring you down.

Pregnancy is stressful enough.

So please, my hope is that if you have read this you will be a proactive sufferer, in order to make your time as a beautiful (you still are) pregnant woman a little easier. If you hear of a friend or relative having this condition, I hope that you will now know just how severe it can be and treat them with the extra love and care they deserve. A great support network can make the difference between a surviving some tough times, and depression.

Feel free to share this post and PLEASE do not be in denial. No-one wants to know about the crap things that can happen when you’re pregnant, but information is power and might save you a lot of suffering (I speak from experience).

Love and light,

Kez xo

If you have experienced this, please contact me or leave a comment – I would love for you to share your stories.

This post is a part of the Blog Every Day in May challenge.