Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) is a dermatological condition occurring during pregnancy, typically in the third trimester. It is characterized by itchy, red bumps and large patches of hives appearing usually on the belly, but can spread to other parts of the body. The exact cause is unknown but it’s not harmful to the mother or infant, though the intense itching can be uncomfortable for the mother.

Key Takeaways

  1. PUPPP, also known as Pruritic Urticarial Papules and Plaques of Pregnancy, is a condition that affects some pregnant women. It results in an itchy, bumpy rash appearing on the abdomen and can spread to the rest of the body.
  2. The exact cause is unknown but it is not dangerous or contagious. It is generally related to the third trimester of pregnancy, and particularly common in first-time mothers or women carrying multiple pregnancies.
  3. Although PUPPP may cause discomfort and annoyance due to itching, it typically resolves on its own after childbirth. Treatments aim to relieve symptoms and may include topical creams, antihistamines, or in more severe cases, oral corticosteroids.


Pruritic urticarial papules and plaques of pregnancy (PUPPP), a term associated with motherhood, is significant as it describes a specific skin condition occurring during pregnancy.

Generally emerging in the third trimester, PUPPP is characterized by small, itchy red bumps on the belly and can extend to the rest of the body, excluding the face, palms, and soles.

While it can cause considerable discomfort, it typically poses no serious risk to mother or baby.

However, it is important to bring any unusual skin changes to your physician’s attention to ensure correct diagnosis and effective treatment.

Hence, gaining awareness about terms like PUPPP aids in better understanding, managing and navigating such pregnancy-related changes.


Pruritic urticarial papules and plaques of pregnancy (PUPPP) is a term to describe one of the most common skin conditions that affect pregnant women. Its purpose is to diagnose a specific type of skin rash that predominantly occurs during the third trimester.

The importance of identifying PUPPP lies in the fact that it can cause significant discomfort for the expectant mother, due to intense itching associated with the condition. As such, it becomes essential to diagnose PUPPP promptly to provide suitable treatment to alleviate suffering and prevent the condition from affecting the quality of life during pregnancy.

PUPPP is used in the world of obstetrics and dermatology to classify this specific gestational dermatosis, giving medical practitioners a clear understanding of the symptoms to look for and suitable treatment options to alleviate these symptoms. Named for the characteristic appearance of the rash, PUPPP signals the presence of small, itchy hives (papules) and larger, slightly elevated patches (plaques) on the skin, mainly around stretch marks.

Although it does not pose a threat to the mother or baby’s health, recognizing PUPPP equips healthcare professionals with the knowledge necessary to provide appropriate comfort and reassurance to the anxious expectant mother.

Examples of Pruritic urticarial papules and plaques of pregnancy (PUPPP)

Example 1: Maria is a first-time mom expecting her baby at

After reaching her third trimester, she started experiencing intense itchiness on her abdomen. At first, she thought it was normal skin stretching sensations, but soon she observed small red bumps surrounding her stretch marks. Upon visiting her gynecologist, she was diagnosed with Pruritic urticarial papules and plaques of pregnancy (PUPPP). Maria was advised not to scratch to prevent worsening symptoms and given topical treatments and antihistamines to control the itchiness.

Example 2: Angela is expecting twins and in her late pregnancy, she noticed a problematic rash starting from her belly button and gradually covering her stomach with red, itchy bumps and patches. Feeling distressed by the constant itchiness and inability to sleep, she visited her obstetrician who diagnosed Angela with PUPPP. She was assured that the condition does not harm her or the babies but it can be uncomfortable. She was provided creams and antihistamines to soothe her symptoms.

Example 3: Lily, who is in her late pregnancy, experienced severe itchiness on her body. She noticed urticarial papules and plaques appearing first on her tummy around her stretch marks, which then spread to her thighs and arms. Concerned about these symptoms, Lily went to her healthcare provider. After examining her, the doctor informed her that it was a common condition known as PUPPP. She was given a detailed skincare routine, antihistamine for itch relief and the doctor advised her that the symptoms would subside after childbirth.

FAQ Section: Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP)

What is Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP)?

PUPPP is a chronic, pruritic (itchy) condition characterized by urticarial (hives-like) papules and plaques that develop in or around the stretch marks during pregnancy, typically in the third trimester.

What are the symptoms of PUPPP?

The major symptom of PUPPP is severe itching. It initially starts in the abdomen and can spread to the rest of the body except the face. Rash, redness, and inflammation might also be present.

What causes PUPPP?

The exact cause of PUPPP is unknown. However, it is not related to preeclampsia, maternal or fetal mortality, or any increased rate of obstetric complications.

How is PUPPP diagnosed?

PUPPP is diagnosed based on a physical examination of the skin and a thorough medical history. A biopsy of the skin can confirm the diagnosis.

How is PUPPP treated?

Treatments aim to soothe and control the itching, reduce inflammation, and manage any secondary skin infection. This might include topical ointments, antihistamines, or, in severe cases, oral corticosteroids.

Can PUPPP impact the health of the baby?

No, PUPPP does not harm the mother or the baby. It does, however, cause significant discomfort to the mother due to severe itching.

Related Motherhood Terms

  • Pregnancy Dermatoses
  • Postpartum Rash
  • Gestation Dermatitis
  • Prurigo of Pregnancy
  • Hormonal Rash during Pregnancy

Sources for More Information

  • Healthline: A trusted source for health advice, offering medically-reviewed articles and tips.
  • Mayo Clinic: A non-profit academic medical center, offering health information on a multitude of conditions and diseases.
  • WebMD: Provides valuable health information, tools for managing your health, and support to those who seek information.
  • Verywell Family: A resource site offering expert advice for every stage of your child’s life from preconception through the teen years.