How to Handle Eczema After Pregnancy

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If you are a woman who has dealt with eczema in the past, pregnancy might be a time in your life when your eczema flares up again. Many women who have a history of eczema notice that the skin condition tends to worsen during pregnancy, thanks to changing hormones and shifts at the skin level.

But what do you do to manage eczema after pregnancy? What medications are safe while breastfeeding, and what complications should you look out for? Here are a few tips for managing your eczema after delivery and beyond.

Eczema During Pregnancy

There are actually a variety of skin conditions that can occur during pregnancy, from a rash that only appears in pregnant women called PUPPS, to itchy skin bumps that can crop up on the arms, legs, and abdomen. Of all the skin conditions that can occur during pregnancy, however, eczema is the most common.

The British Medical Journal (BMJ) notes that eczema accounts for anywhere from one-third to up to one-half of all the skin conditions that women experience during pregnancy. And maybe the most surprising fact of all is that most of those cases of eczema are new. Most of the women who develop eczema during pregnancy actually get the condition for the first time in their lives during their pregnancies. In other words, the majority of women who have eczema during pregnancy have never actually had eczema before. Just add that to the list of ways pregnancy changes your body, right?

So just when does eczema rear its unwelcome head during pregnancy? The most common time for eczema to show up during pregnancy is within the first two trimesters. Because eczema is triggered by environmental and internal triggers, however, it can be hard to predict and can really show up at any time during pregnancy. Rarely, eczema can show up for the very first time after the pregnancy is over, but this generally only occurs in about 10 percent of cases.

Eczema is managed through several different strategies during pregnancy. The focus, of course, is on making sure that none of the treatments are dangerous to the developing fetus or mother during the course of the pregnancy. Treatments are aimed at being strong enough to manage the condition while safe enough to not cause any harm to the pregnancy.

The following treatments are generally considered safe for women to use to treat their eczema during pregnancy:

  • Emollients
  • Topical steroids (that go on the skin)
  • Ultraviolet B light (although women who are pregnant should take extra caution with sun exposure because they can experience skin sensitivity)

Other treatments are used on a case-by-case basis, depending on the severity of the eczema and the doctor's discretion. These treatments might include oral steroids or stronger steroid creams for the skin, as well as antibiotic treatment that can help clear up the eczema in some cases. Pregnant women and breastfeeding mothers should avoid taking methotrexate and using PUVA therapy, however, as those two therapies do pose some potential harm to the developing fetus.

Why Does Eczema Flare-Up During Pregnancy?

It's thought that eczema tends to flare up during pregnancy because of the immune cells involved. During pregnancy, a woman's immune system shifts to favor certain types of immune cells and those changes might trigger the conditions that let eczema develop. Doctors have also theorized that there might be a skin barrier change or a shift in the skin protein process that happens during pregnancy that can give way to eczema.

Fortunately, eczema is not dangerous during pregnancy; it doesn't pose any risk to either the mother or the baby, although it can be very uncomfortable. Pregnancy can be hard enough for some women physically, so managing eczema effectively through the pregnancy and beyond is an important step.

How to Handle Eczema After Pregnancy

While a woman may experience a change in her eczema during pregnancy, she may wonder what to expect after the baby is born. The treatment for eczema might depend on whether or not the woman is breastfeeding, as some treatments are not recommended for nursing mothers.

Typically, a woman experiencing mild or moderate cases of eczema during the postpartum period can use the same treatments as early pregnancy. For example, tepid baths (not too warm and not too cold) followed by emollients and topical steroids are frequently used. Ultraviolet B is also safe to use during breastfeeding, but it's generally not a first line of treatment for eczema. If you can, try to figure out what is triggering your eczema and keep in mind, because of the pregnancy, it might be something in your environment that hasn't bothered you before but is now triggering your eczema. Things like pet dander, food sensitivities, lotions, or even detergent could be causing the eczema to flare up. It might also help to keep bathing to a minimum and avoid harsh soaps, especially as your body adjusts to not being pregnant anymore.

The only treatment that is generally not recommended for nursing women is topical calcineurin inhibitors, although the British Medical Journal notes that it's unclear just how much of the medicine passes into the milk of a nursing mother. More research has to be done to fully say if it's dangerous or safe to use while breastfeeding.

The most uncomfortable area a woman might get eczema after pregnancy is on the areola or nipples. Although it's very rare and happens in less than 2 percent of breastfeeding mothers, eczema can develop in those areas. According to the BMJ, it can occur as either a regular case of eczema or as a result of a reaction from the baby eating a certain food other than breast milk that the mother might be sensitive to. In cases of eczema on the nipples or areola, a mother will usually apply an emollient and topical steroid to the affected area in between feedings. The medicine and emollient have to be washed off thoroughly before the baby nurses again or the mother pumps, so it doesn't get into the breast milk. At this time, experts recommend that breastfeeding mothers avoid using cyclosporin and methotrexate to treat eczema during the postpartum period.

There is also some interesting research that suggests that stress can play a role in the development of eczema, so pregnant women might find it helpful to try stress management techniques, such as massage, yoga, or meditation to try to reduce the amount of stress levels in their life.

What About Your Baby?

If you develop eczema during your pregnancy, does that mean your baby is more likely to also have eczema?

In many cases, eczema is a hereditary condition, especially if it accompanies any other medical conditions like allergies or autoimmune disorders. If you have a history of eczema and other family members who also have eczema, your baby may be more likely to also develop eczema.

A Word From Verywell

Pregnancy tends to make eczema flare up in women who have had it in the past and it may even lead to new onset cases as well. In some cases, eczema might clear up on its own after pregnancy, but for others, eczema can linger even after the baby is born.

If your eczema continues after your pregnancy, there are ways to manage your eczema during the postpartum period. The most common methods for managing eczema after pregnancy are the same strategies used during pregnancy, and include the use of tepid baths, emollients, and topical steroids. Breastfeeding mothers should avoid cyclosporin and methotrexate to treat eczema.

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