I am Sun Yi and everyone calls me Jojo.
I am a master of medicine, a multi-platform We Media native, an attending doctor of obstetrics and gynecology in Shanghai 3A Hospital, and a member of the Popular Science Group of Obstetrics and Gynecology of Shanghai Women’s Rehabilitation Medical Association. I am committed to sharing popular science knowledge on women’s health.
Today we will talk about skin itching during pregnancy.
My patient Lily had just been pregnant for 5 months and began to suffer from skin pruritus and eczema on her stomach one after another. When I opened my clothes, my stomach was scratched like a map. I felt really distressed.
But she never went to see a doctor, on the one hand, because her mother-in-law and best friend told her that skin pruritus during pregnancy was normal; On the other hand, it is because of fear that medication will affect the baby’s health
I was going to endure it, but in recent days, it was really itchy, which made her fidgety and unable to sleep at night.
In fact, this is not an example. 30% of women will suffer from itching or other types of skin diseases during pregnancy. It seems that it will not affect the fetus, but it must not be taken lightly.
Do you need to see a doctor for skin pruritus during pregnancy?
A small part of skin pruritus is caused by ICP (Intrahepatic Cholestasis) diseases during pregnancy.
This unconventional skin pruritus generally does not cause skin damage, but the degree of pruritus varies and is mostly persistent. Pruritus starts from the palms and soles of the feet, then extends from the limbs and even reaches the face. It is lighter during the day and intensifies at night.
This kind of situation cannot only relieve itching, but also needs to improve liver function and strengthen fetal monitoring, otherwise it may cause intrauterine hypoxia and even death of the fetus.
Therefore, we still need to report to the prenatal examination doctor first. If there is no jaundice, liver and kidney function, blood routine, bile acid and other indicators are normal, then we will consider the simple skin pruritus during pregnancy.
Routine pregnancy skin pruritus, how to stop itching?
In principle, external drugs are the main drugs. If they are ineffective, they can be taken orally under the guidance of doctors to relieve itching.
I will introduce [general treatment] and [drug therapy] respectively to tell you how to deal with this difficult problem.
1. General treatment
If you are a pregnant mother with allergic constitution, you should reduce going out when seasons such as spring and autumn alternate to avoid pollen allergy.
Do a good job of sun protection when going out. Ultraviolet irritation can also aggravate eczema and itching.
Change underwear and underwear frequently, wear cotton, loose and breathable clothes, and avoid chemical fiber and tights.
High temperature and irritating bath products will aggravate itching. The bath temperature should not be too high and alkaline soap should not be used.
Reasonable diet, reduce the intake of irritant ingredients, such as chili, ginger, raw garlic, etc. If you are allergic to food, avoid contact with allergens.
Stress is directly proportional to itching. Pregnant mothers should relax and reduce stress and anxiety.
2. Drug treatment
Suggestions for local medication:
Calamine lotion and menthol applied externally are safer.
If the pruritus is serious, hormone ointment with less adverse reactions, such as mometasone furoate (to be used under the guidance of a doctor), can also be selected.
Note:
Hormonal ointment, although it has the effects of diminishing inflammation and eliminating redness and swelling, can only be used in a short period of time, not for a long time.
Pregnant mothers with itching all over their bodies can relieve symptoms by intravenous use of calcium gluconate when it is serious enough to affect sleep at night.
Recommendations for oral drugs:
Benzodiazepines (to be used under the guidance of doctors) can be used in a short period of time.
Antihistamines can also be taken orally. Chlorphenamine maleate and promethazine drugs are recommended to be used under the guidance of doctors for safety reasons.
Diphenhydramine and astemizole drugs are not recommended.
Hydroxazine hydrochloride is used abroad, 25-100mg, 1-4 times a day.
If the pregnant mother’s skin pruritus is severe and accompanied by scratching and ulceration, some antibiotics need to be added under the guidance of doctors to prevent wound infection.
If the pregnant mother still has skin allergy, she can choose vitamin C and other drugs or intramuscular injection of calcium gluconate.
After the above treatment, most pregnant mothers’ eczema and pruritus symptoms will be significantly improved.
If you are unlucky, it is really skin pruritus caused by ICP (Intrahepatic Cholestasis), you cannot stop itching alone.
Doctors need to consider comprehensively the degree of illness, pregnancy, baby’s development and the presence or absence of intrauterine hypoxia to decide on the treatment plan.