Scratch, scratch, scratch. All of a sudden it feels like all you can think about it how much you itch. Your pregnancy may have brought on a whole host of new “fun” experiences: dizziness, nausea, heartburn, or even trouble breathing.

You’d likely been warned about all of these from other pregnant women and weren’t shocked when you hit these milestones in your pregnancy journey. The last thing you imagined you’d be feeling though was itchy!

You hadn’t heard about intense itching during pregnancy from a lot of your friends, so now you’re wondering: What’s causing this? Is this normal? Should I be worried?

Although we can’t diagnose the exact cause of your itchiness, we’ve compiled a list of some common reasons pregnant women may be feeling the urge to scratch — and some signs you should head in to see your doctor.

There are many reasons why you may feel itchy during pregnancy. These might include:

  • Stretching skin. First pregnancies and pregnancies with multiples tend to cause skin to stretch quite a bit more than it is used to.
  • Dryness. Hormone changes in pregnancy can cause itchy, flaky dry skin.
  • Perfumes or fabrics. Different materials and chemicals can literally rub you the wrong way.
  • Hormones. The hormonal changes you experience in pregnancy can affect everything from mood to circulation to, yes, itchiness.
  • Cholestasis. This is a liver disorder that can result in the buildup of bile acids in the blood that cause feelings of itchiness.
  • Pruritic urticarial papules and plaques of pregnancy (PUPPP). This is an itchy rash that occurs around stretch marks during late pregnancy.
  • Prurigo. These crusty, itchy bumps on the arms, legs, or abdomen that can appear in any trimester.

It’s important to consider where on your body you are experiencing itching. Most pregnancies will involve some itching belly and itching breasts because the skin in these areas is going through so many changes.

Itching around your stretch marks may be a result of PUPPP, while itchy arm and leg areas are more likely to be a result of fabrics rubbing you the wrong way or prurigo.

Occasionally feeling slight itchiness is normal, but intense itching of the abdomen, arms, and legs can be a sign that your body needs some attention. Some people also experience vaginal itching during pregnancy, which may require treatment. In addition, sometimes there may be rashes associated with pregnancy itching.

Itching is not generally considered an early pregnancy symptom. In fact, many types of rashes typically only appear later in pregnancy and some may not resolve until after your baby is born.

That said, any time intense or prolonged itching appears during the course of your pregnancy it should be reported to your doctor.

Just as there are many potential causes for itchiness in pregnancy, there are a variety of ways to help alleviate any itching that you may be feeling. Consider these natural remedies you can try at home:

  • Change perfumes or detergents. You may even consider making your own soap/perfumes/detergents to avoid chemicals in commercial products that irritate your skin.
  • Wear loose clothing made from natural fabrics. (This will help keep potentially irritating fabrics away from your skin AND help keep you cool to avoid any heat-related rashes!)
  • Take an oatmeal bath or use a yogurt skin treatment. Lathering up with pine tar soap is a common home remedy for PUPPP.
  • Use a moisturizer to help with dry skin. Olive oil and coconut oil are both very moisturizing as are shea and coconut butter.
  • Apply some calamine lotion. This chalky pink liquid isn’t just for bug bites and poison ivy!
  • Increase your water intake and make sure that you’re staying hydrated. Don’t forget to include electrolytes in your hydration. Making sure to include some coconut water or a water with electrolytes added will help your body to make the most of the water that you’re providing it.
  • Turn on your humidifier and/or a fan. Keeping the air moist and cool will help with dry skin and itchy heat-related rashes.

Remember: If itching doesn’t improve or gets worse, it’s time to make plans to visit your doctor!

You should see your doctor if you have any of the following.

Signs of cholestasis

  • jaundice (a yellowing of the skin and the white area of the eye)
  • dark urine
  • lack of appetite
  • nausea
  • light stool
  • depression
  • intense itchiness, including itching feet

Cholestasis is a liver condition that results in a build-up of bile acids in the blood. There is not usually a rash, but the skin may develop a more yellow tone. In pregnancy, the condition, if it does appear, occurs in the third trimester.

Your doctor will diagnosis cholestasis with a blood test. A medical history will also typically be taken, because cholestasis can be an inherited condition and is more common if your mother or sister also had it during one of their pregnancies.

Many over-the-counter anti-itch medications will not be effective if cholestasis is the cause of your itch, but your doctor may be able to prescribe other drugs that can help alleviate some of the itchiness and reduce the amount of bile acid in the blood.

Ultimately, the solution to cholestasis is delivering the baby, and the itch will usually clear up within a few days of giving birth.

Because there is an increased chance of stillbirth, fetal distress, and preterm delivery, your doctor may want to discuss an earlier induction or more frequent monitoring during your pregnancy (and for a period after delivery) if you are diagnosed with cholestasis.

Signs of PUPPP

  • rash made up of small, pimple-like dots, typically spreading from stretch mark areas and not extending beyond the breasts
  • blisters around the rash
  • feeling extra itchy at night

Typically, your doctor will diagnose PUPPP through a skin examination. In rare cases a skin biopsy may be ordered. Blood work to rule out an infection may be done as well.

The ultimate cure for PUPPP is to deliver the baby, and the rash will usually be gone within a few weeks of delivery. Moisturizers, steroid creams, and antihistamines prescribed by your doctor, as well as itch relieving baths, can help to temporarily relieve itchiness until your due date.

Signs of prurigo

  • itchy, crusty bumps on the arms, legs, or abdomen

While moisturizers may help with the itch from prurigo, treatment typically involves topical steroids and oral antihistamines. If you’ve had prurigo during one pregnancy, there’s an increased chance that you’ll experience it in future pregnancies. While it may clear up shortly after giving birth, it can also unfortunately last for weeks or even months after giving birth.

If you feel intensely itchy or itchy for a prolonged time during your pregnancy, it’s a good idea to check in with your OB or midwife. They can prescribe medications, rule out various illnesses, and make sure that you and your little one are safe.

That intense itch you’re feeling during pregnancy could be due to many different things. It’s important to think about any other symptoms you’re experiencing, the timeline of your itchiness, and even just your daily activities to figure out how to solve this uncomfortable problem.

Because itchiness can be a symptom of a more serious condition, it’s important to consult with your doctor if it continues or any other symptoms appear.

After all, you don’t want your itching to distract you from experiencing the morning sickness, heartburn, and frequent trips to the bathroom you’ve been warned about from other pregnant women!