Can PUPPPs harm my baby?

No. It’s a maternal skin condition with no direct risks to the baby.

How long does it last?

Most cases resolve within 1–3 weeks after delivery, though some clear up sooner.

Not at all. PUPPPs is not infectious and cannot be spread to others.

Will it happen again in my next pregnancy?

Unlikely. Most people who get PUPPPs don’t experience it in future pregnancies.

Rash on Belly or Thighs in Pregnancy? It Could Be PUPPPs

It usually starts with a cluster of itchy red bumps around the stretch marks on your belly. Within days, it may spread to your thighs, buttocks, or even your arms. You’ve tried moisturising, changed your soap, maybe even skipped your usual spicy dinner, but the rash is still there, and it’s getting worse. What you're dealing with could be a lesser-known but surprisingly common skin condition called PUPPPs.

PUPPPs affects about 1 in every 150 pregnancies, typically showing up in the third trimester. And while it's medically considered benign, the discomfort it causes can be severe enough to interfere with sleep, concentration, and daily comfort. Knowing what causes it, how to identify it, and what treatments are actually safe in pregnancy can make a huge difference.

What Is PUPPPs?

PUPPPs (pruritic urticarial papules and plaques of pregnancy) is an inflammatory skin condition that tends to occur in first-time pregnancies and usually appears in the third trimester. It’s characterised by:

Raised, red, hive-like bumps
Severe itching, especially at night
Rashes that typically begin on the abdomen but spare the area around the navel
Spreading to the thighs, buttocks, or arms

It’s not contagious. It doesn’t harm your baby. But for you, it can be agonising.

Why It Matters: PUPPPs and Its Effects on Your Body and Mind

This condition might be medically benign, but that doesn't mean it's emotionally easy or physically tolerable. Here’s what makes PUPPPs disruptive:

Constant itching, especially at night, can lead to sleep deprivation, fatigue, and increased anxiety.
Painful scratching can cause open sores or increase the risk of secondary skin infections.
Visible rash may feel embarrassing or distressing, especially if it spreads to the thighs or arms.
Delayed diagnosis can leave many pregnant people feeling dismissed or frustrated.

What Causes PUPPPs?

There’s no definitive cause, but several theories exist. PUPPPs is not related to poor hygiene or allergies. Here’s what research suggests:

Rapid stretching of the skin: Particularly in the third trimester or in multiple pregnancies, stretch marks seem to be the starting point.
Immune response to foetal DNA: Some researchers propose that foetal cells crossing into the mother’s skin may trigger a localised immune reaction.
Placental and hormonal shifts: Changes in progesterone and other hormones may influence inflammatory pathways that lead to the rash.
Maternal weight gain or large babies: More skin stretching may correlate with a higher risk.

PUPPPs is more commonly seen in first-time pregnancies and often doesn’t return in subsequent ones, though it can.

How PUPPPs Is Diagnosed

Diagnosis is usually clinical, based on the look and spread of the rash, along with your pregnancy history.
Your doctor will assess:

Timing (late pregnancy or postpartum)
Appearance (red, raised, itchy papules forming into plaques)
Location (typically starts near stretch marks, avoids the belly button)
No signs of infection or systemic illness

There are no specific blood tests or biopsies routinely done unless other conditions like pemphigoid gestationis or cholestasis of pregnancy are suspected. In unclear cases, a dermatologist may be consulted to rule out other dermatoses.

Treatment and Relief Options

While PUPPPs often goes away on its own after delivery, the itch can be severe. Treatments focus on symptom control and comfort:

Topical corticosteroids (low to mid potency): These are the most commonly prescribed relief and are considered safe for short-term use in pregnancy under medical guidance.
Oral antihistamines: Loratadine or cetirizine may be recommended to reduce itching, but again, only with medical approval.
Oatmeal baths and cold compresses: Soothing and non-invasive options to calm the skin.
Moisturisers with menthol or aloe vera: May provide temporary relief from burning or itching.
Loose, breathable clothing: Avoid tight waistbands, synthetic fabrics, or excessive heat.
Avoid scratching: Trim nails, use gloves at night if needed, and try to pat, not rub.

Always speak to a qualified medical professional before using any prescription or over-the-counter treatments while pregnant.
PUPPPs might not be dangerous, but it can feel like one of the most intrusive discomforts of late pregnancy. The itching is real. The distress is valid. And while your skin will likely recover after delivery, your comfort matters right now. Relief is possible—with the right care, support, and information.

FAQs on Rash on Your Belly or Thighs That Looks Like Hives: Could Be PUPPPs

Can PUPPPs harm my baby?
No. It’s a maternal skin condition with no direct risks to the baby.
How long does it last?
Most cases resolve within 1–3 weeks after delivery, though some clear up sooner.
Is it contagious?
Not at all. PUPPPs is not infectious and cannot be spread to others.
Will it happen again in my next pregnancy?
Unlikely. Most people who get PUPPPs don’t experience it in future pregnancies.