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You thought you’d experienced it all — the nausea and vomiting, the sheer exhaustion accompanied by insomnia, and those late-night cravings for pickles and ice cream. What’s that? Your boobs itch? Yeah. That’s a thing, too.

There are many reasons why your breasts and nipples may itch during pregnancy. Most are related to skin irritation or circulating hormones. There are times, however, when the itching should prompt a visit to your doctor. Here’s how to tell if it’s serious or just plain annoying.

Hormonal changes

Your hormones go into overdrive during pregnancy, and they particularly rise as you approach your due date.

With all that change comes all sorts of symptoms, including itching skin. In fact, it may be driving you absolutely crazy, but itching is quite commoneven if you don’t have a specific health condition.

Stretching skin

As you and your baby grow, your skin stretches to accommodate your new shape and weight gain. You may even notice little indented streaks or lines called striae gravidarum — stretch marks — on your stomach, breasts, hips, and butt. As they form, you may feel itching or burning.

Stretch marks may be a range of colors from red to pink to blue or even purple. They tend to fade to a lighter color with time and may cover large parts of your body.

Related: Answers to your questions about stretch marks on breasts

Eczema

Pregnancy-induced eczema is the most common skin condition you can develop during your 9 months as host to your baby. You can develop patches on your breasts and on other parts of your body.

Along with itching, you may have dry skin, red patches, cracked or scaly skin, or small, raised bumps.

Pruritic urticarial papules and plaques of pregnancy (PUPPP)

It’s quite a name, but PUPPP is yet another common reason for itching during pregnancy. With the itch, you may also see small hives or bumps on the skin. They can appear individually or in patches and generally spread from the stomach to the boobs, thighs, and buttocks.

While this condition is super unpleasant, doctors don’t exacty know what causes it. Helpful, right? Here’s how you can identify it and treat it.

Prurigo of pregnancy

Another condition specific to pregnancy is prurigo. It’s the body’s immune system response to all the changes that pregnancy brings about. You may develop little bumps on your chest or other parts of your body. They may itch and look like bug bites.

The number of bumps may be only a few at the start but increase with time. This condition can last for months and even continue after your baby is delivered.

Intertrigo

Intertrigo is just a fancy term for rash under the breast. It’s not a pregnancy-specific condition, either. Instead, you can develop intertrigo anytime there’s moisture, heat, and friction beneath the girls.

With all the breast changes you’ve been seeing, you can see how this scenario might happen, especially if you’re lucky enough to be super pregnant during summer. You may notice a red rash, itching, raw, or weeping skin. As if that wasn’t enough, your skin may even crack or hurt.

You can experience breast changes — like swelling, tenderness, and growth — even in very early pregnancy. With all these sensations may come itch even as early as the first few weeks.

Stretch marks can occur at any time, even before or after pregnancy, but one 2017 study showed that some 43 percent of women experience them by 24 weeks. Otherwise, they tend to show up later in the second trimester to early in the third trimester. These marks will likely stick around after pregnancy, but they do fade and lighten.

The same goes with intertrigo and prurigo of pregnancy — they can happen at any time. Eczema tends to develop early, usually sometime in the first two trimesters. PUPPP on the other hand, may not show up until later on in the third trimester.

Your doctor can diagnose what’s going on with your itch by examining the area. But pay close attention to timing and any other symptoms to help with identification.

Are itchy breasts an early pregnancy sign?

They may be. Again, breast changes begin early. Hormonal shifts can also trigger certain conditions. For example, around 50 percent of women who already have eczema see worse symptoms during pregnancy.

If you think you might be pregnant, take a home pregnancy test to find out. Or visit your doctor for a blood test for the most accurate results.

You may not be able to prevent itchy breasts if they arise from certain health conditions, like PUPPP or prurigo of pregnancy. That said, there are plenty of things you can do to keep the girls calm, cool, and collected.

Stay hydrated

Drink up. Pregnant women need at least 10 cups of fluids during pregnancy, and chances are that you’re not getting enough.

Side effects of even mild dehydration include dry skin, which can itch. The good news is that drinking more water can help with other pregnancy complaints, like constipation. And if you’re planning to breastfeed, you might practice drinking even more. Breastfeeding moms need at least 13 cups of water and other fluids to keep up with their hydration needs.

Wear natural fibers

A trip to your dresser may reveal why your breasts are itching. Cotton and other natural fibers, like bamboo, don’t tend to trap sweat and moisture the way synthetic fabrics do. Don’t want to invest in new bras and shirts? You might consider slipping a cotton or silk tank under your outer clothes temporarily — at least until the worst of the itching has passed.

Loosen up

While you’re at it, take a look at the size bra you’re wearing. You may want to size up a bit to give yourself — and your tatas — some more room to breathe.

You want your bra to be supportive, but not too tight or otherwise restricting. Visit your favorite shop and get a professional fitting if you can. And be sure to mention that you’re pregnant if it isn’t obvious already. Your size may change again before (and even after) delivery.

Cool down

Take a cool shower or apply a cool washcloth to calm itching instead of scratching yourself. Tepid or lukewarm baths may especially help with conditions like eczema. The key here is to have the water between 85 and 90°F (29.4 to 32.2°C). You may not have a thermometer at the ready, but water this temperature feels only slightly warm on the back of your hand.

Also: Limit shower and bath time to 5 to 10 minutes if you can. Any longer may dry out your skin.

Slather it on

Try applying a soothing moisturizer directly to your breasts and nipples. Creams and ointments are better for dry or irritated skin. Some women even use lanolin on chapped nipples. Ingredients like shea butter, cocoa butter, olive oil, and jojoba oil are good choices. So are products that contain lactic acid, hyaluronic acid, glycerin, and dimethicone.

Apply moisturizers immediately after patting skin dry with a clean towel. With whatever you choose, consider trying a patch test and watching the area for 24 to 48 hours to watch for any reactions.

Shop for shea butter and cocoa butter moisturizers online.

Switch detergents

Soaps and detergents with artificial perfumes may make skin matters worse. So, skip right past any potentially irritating additives — even if they smell amazing.

Try instead to go to “free and clear” detergents. And choose soaps for your body that are similarly simple and hypoallergenic. Good choices might include CeraVe Hydrating Body Wash or Cetaphil Daily Refreshing Body Wash.

Shop for hypoallergenic detergent and body wash online.

Eat a balanced diet

Stretch marks may be inevitable (and coded in your genetics), but they also occur during periods of rapid weight gain. Doctors generally recommend that women gain between 25 and 35 pounds during pregnancy. If you’re on the higher end of that range, you may want to speak with your doctor.

You aren’t actually eating for two. Just 300 extra calories a day is enough to support your nutritional needs and those of your growing baby.

PS: Don’t sweat it if you don’t fit exactly in the guidelines. Depending on your starting BMI, the range of recommended gain is 11 to 40 pounds. And if you’re pregnant with twins or other multiples, these numbers are higher.

There are a couple of additional conditions that cause itching in the breasts. Unfortunately, they don’t clear on their own. So, if you think you may need help, make an appointment with your doctor today.

Yeast infection

You may have only heard of getting a yeast infection, uh, down there. But yeast can attack the breasts as well. With all the changes of pregnancy, itchy nipples from yeast infections happen more often than you’d like to know. Your infection may be linked to a current vaginal yeast infection, damage to your nipples, or perhaps a recent course of antibiotics.

Whatever the case, you might experience anything from itching, burning, or stinging to pain. Your nipples may look bright pink or you may have red or dry/flaky skin or even a white rash surrounding them. You may need prescription antifungals to clear the infection.

Related: Taking care of a yeast infection on your chest

Cholestasis

Are you noticing your itching more in the evenings or at night? Is it so intense you can’t stand it? It may not be your imagination.

Cholestasis of pregnancy is a liver condition that causes intense itching with no rash. It typically shows up later on, sometime in the third trimester, but may strike sooner.

You may first notice itching on your hands and feet, but this sensation can travel to other parts of the body. You may also have nausea, loss of appetite, and yellowing (jaundice) of your skin and whites of your eyes.

Aside from being absolutely uncomfortable, cholestasis means that your liver isn’t working well at removing waste products from your body. Your doctor may recommend that you deliver your baby early to avoid complications, like lung issues or stillbirth.

Once your little one is safely here, you’ll likely notice that the itching goes away after only a few days.

You’ve got this, mama. The good, the bad, and the itchy. In most cases, you should get some relief from your discomfort with lifestyle changes or — at the very least — after the delivery of your baby.

Other conditions may require some medical attention, and that’s OK. Eventually you’ll feel more like yourself again. And that little bundle of joy will make all these scratchy months totally worth it.