An itchy belly or belly button during pregnancy can result from skin stretching, dry skin, or other health conditions like cholestasis.

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When you’re pregnant for the first time, you may expect the common pregnancy-related symptoms you’ve heard about, like morning sickness, weight gain, swollen ankles… maybe even heartburn. What you might not expect is an itchy belly or an itchy belly button.

But as many formerly pregnant people can tell you, itchiness, or pruritus, during pregnancy is a lot more common than you might realize. Here’s why you may have an itchy belly or navel — and what you can do about it.

Skin stretching

It’s pretty amazing how far the skin on your belly will stretch by the time you reach full term. In fact, you might start noticing a series of red or pink stripes developing across your abdomen as your skin stretches to accommodate your growing uterus. Stretch marks are also common on the breasts, thighs, and buttocks during pregnancy.

The heavy-duty stretching can stretch the thin skin around your belly button, too. This may cause it to become itchy, or even irritated or painful.

Dry skin

Dry skin is also a common culprit of itchy skin anywhere on the body, including your burgeoning belly. Many pregnant people experience dry skin as a result of hormone changes that cause skin to lose some moisture and elasticity. You might also notice some flaking of the skin, too.

There are other possible medical conditions that could leave you scratching your belly. Some are benign, if annoying, but at least one is very serious.

Pruritic urticarial papules and plaques of pregnancy (PUPPP)

The name of this condition is a mouthful to say, but the itch that it causes is the most memorable thing about it.

Pruritic urticarial papules and plaques of pregnancy (PUPPP) — often called pregnancy rash or erythema of pregnancy — causes small red bumps and hives to develop on your skin in the later months of pregnancy. The bumps can create patches or plaques on your abdomen that itch intensely. The plaques may also spread over your thighs and buttocks.

PUPPP affects about 1 in 160 pregnancies, with research suggesting that it’s most common in the third trimester of first pregnancies or right after delivery.

The good news: PUPPP is benign and usually resolves soon after pregnancy. In the meantime, however, you can apply a topical corticosteroid to the itchy areas, along with cool compresses and oatmeal baths. If a really large area of skin is affected, however, your doctor might suggest a systemic glucocorticoid to knock out the itching.

Pemphigoid gestationis

This pregnancy-related autoimmune disorder is pretty rare — affecting about 1 in every 40,000 to 50,000 pregnancies — but it can be frustrating if you develop it. It causes a very itchy rash on your abdomen and torso.

Pemphigoid gestationis can begin at any time during pregnancy, but it’s more likely in the second or third trimester. It tends to start with a series of red bumps on your torso that may spread to other areas, and many people also develop fluid-filled blisters in the affected areas.

This condition happens because autoantibodies, known as immunoglobulin type G (IgG) autoantibodies, attack your body’s own tissues, creating inflammation and a build-up of fluid in between layers of the skin.

While the extreme itching tends to spontaneously end after you deliver your baby, you might really want some relief from the itching before you get to that point. Your doctor may start out by prescribing topical corticosteroids to apply to the affected area, and you might also be able to take an oral antihistamine to help relieve the itching.

Intrahepatic cholestasis of pregnancy

Cholestasis of pregnancy usually starts with extreme itching on the hands and feet, but the itching may spread to other parts of your body, including your abdomen.

Unfortunately, it’s not just an annoying itchy condition. It’s a condition that prevents your liver from releasing bile, which normally helps break down the foods you eat during digestion. As a result, bile builds up in your liver and then spills out into your bloodstream, causing itchiness.

One unique hallmark of this condition: There’s no visible rash associated with it. If you notice that you’re experiencing a lot of itchiness, but there is no rash in sight, you might have cholestasis of pregnancy. Don’t just slather on some moisturizer or take an antihistamine, though. Call your doctor, because intrahepatic cholestasis of pregnancy is associated with a greater risk of premature delivery, fetal distress during delivery, and stillbirth.

Besides itching, other warning signs of cholestasis include light-colored stools and a yellow tinge, or jaundice, of the skin, whites of the eyes, or mucous membranes. You may need a drug called ursodiol to reduce the level of bile in your blood, and your doctor will want to closely monitor your baby for possible complications or signs of early labor.

Cholestasis of pregnancy resolves after your baby is born.

Oh, the itch! If the itchiness is just driving you up a wall — and let’s face it, who could blame you? — there are a few remedies that you can try:

  • Moisturizer. Apply a thick layer of a heavy moisturizer to your entire belly to help with itching from dry skin. A great time to rub a big dollop of lotion into your skin is right after a bath or shower.
  • Tepid showers or baths. If you’re scrunching your nose up at the idea of a lukewarm shower, take heart. Hot water is notorious for drying out skin, but tepid water won’t have the same effect. Use a mild cleanser that won’t irritate your skin and pat your skin dry afterward.
  • Oatmeal baths. Experts often suggest tossing a handful of colloidal oatmeal into the bathtub with warm or lukewarm water as a strategy for treating an eczema flare-up. It might help your pregnancy-induced itching, too. Add the oatmeal to the running water, then soak for 10 to 15 minutes.
  • Cool compresses. Cool compresses are another go-to strategy for easing the discomfort of an eczema flare-up or itchy skin on your abdomen.
  • Topical corticosteroids. An over-the-counter product like hydrocortisone may reduce some itching. Check in with your doctor before applying a topical steroid cream to your belly, though it may be what your doctor ultimately recommends.
  • Antihistamines. An oral antihistamine may be just the ticket for temporarily reducing the itch factor, but as with any new medication, make sure your doctor is on board first.

The first thing to know is that an itchy belly or itchy belly button during pregnancy isn’t necessarily a cause for alarm. It’s likely one of those temporary things that you’re dealing with while you decorate the nursery and wash all those onesies in preparation for the upcoming birth.

However, it’s still a good idea to check with your doctor just in case. They’ll want to know if you’re experiencing any other symptoms that might indicate a more serious condition, such as cholestasis of pregnancy.

As your pregnant belly grows and the skin stretches, some discomfort and itching are perhaps to be expected. If you notice other symptoms, or if the itch is unbearable, definitely let your doctor know.