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Postpartum Hives: Causes, treatments, and when to see a provider

This condition may be uncomfortable, but it is treatable!

Curology Team Avatar
by Curology Team
Updated on Aug 1, 2023 • 6 min read
Medically reviewed by Erin Pate, NP-C
young mother holding a kid
Curology Team Avatar
by Curology Team
Updated on Aug 1, 2023 • 6 min read
Medically reviewed by Erin Pate, NP-C
We’re here to share what we know — but don’t take it as medical advice. Talk to your medical provider if you have questions.

Before we talk about what to expect when you’re expecting, Curology is a medical practice, so we want to remind you to be particularly aware of your skincare products while trying to conceive, pregnant, or breastfeeding. If you’re a current Curology patient, let your provider know if you’re trying to conceive, learn that you’re pregnant, or are nursing. Meanwhile, stop using your Curology personalized prescription formula until you speak with your medical provider—not all skincare ingredients are confirmed to be safe for use during pregnancy or breastfeeding.

Your body goes through many changes before and during pregnancy, and that includes your skin. Some skin changes, such as the “pregnancy glow,” are often viewed favorably, while others, such as the red, itchy welts of postpartum hives, are typically less than welcome.

There are a number of medical conditions that can lead to postpartum hives; one is called pruritic urticarial papules and plaques of pregnancy (PUPPP). Most conditions that lead to postpartum hives, including PUPPP, don’t represent serious risks to your health or your baby.¹

Here, we’ll describe the symptoms of postpartum hives, what causes them, what you can do to treat them, and when it’s best to see a medical provider.

What are postpartum hives? 

Hives, or urticaria in medical terms, is a common skin condition. About 20% of all people will experience an episode of hives at some point in their life.²

A case of hives can make your life pretty unpleasant until they go away. The most common symptoms are red, itchy bumps and plaques on your skin. These spots may be flat or raised up. The intense itching associated with hives can affect your activities during the day and disrupt your sleep at night.³

Postpartum hives have the same general symptoms as hives you may experience at any other time, but they appear during the period after you give birth.⁴ ⁵

The bumps and plaques of postpartum hives frequently start on your abdomen in the area around any stretch marks (also called striae) and then spread. The most common place for postpartum hives to spread is the buttocks, legs, and chest. They typically don’t occur on the face, palms, soles of the feet, or the area right around the belly button.⁶

What causes postpartum hives 

Women who have just given birth are susceptible to all of the same causes of hives as the general public. These causes include allergen exposure, insect bites or stings, medication reactions, or infections.⁷

However, specific to pregnant or recently postpartum women is a skin condition that goes by two (rather long) names: pruritic urticarial papules and plaques of pregnancy (PUPPP) or polymorphic eruption of pregnancy (PEP).⁸ ⁹

Hives caused by PEP/PUPPP happen during or after about one in 160 to 300 pregnancies.¹⁰ Medical researchers haven’t yet narrowed down the exact cause of postpartum hives, but they’re thought to be connected to the stretching of the abdominal skin that occurs during pregnancy.¹¹

Due to the possible connection to skin stretching, postpartum hives are most commonly seen during or after pregnancies where the abdomen has experienced an unexpected amount of growth possibly causing connective tissue damage and exposure to antigens, leading to an allergic-type reaction. This can happen in first pregnancies, pregnancies with multiples (twins, triplets, etc.), or pregnancies during which there has been a large amount of weight gain.¹²

Are postpartum hives contagious? 

One of the biggest concerns that many women have with the sudden onset of postpartum hives is whether they can spread to their infant or others. Good news: postpartum hives aren’t known to be contagious!¹³ 

The temporary nature of postpartum hives can be another source of reassurance. The condition usually goes away on its own within four to six weeks.¹⁴ During this period, mothers may need to endure some itchy discomfort, but they don’t have to be concerned about spreading the hives to their newborn.¹⁵

While dealing with postpartum hives might be a frustrating experience, the prognosis for women with this condition is usually quite good. The major challenge tends to be managing the itchy discomfort and maintaining patience until the symptoms naturally subside.¹⁶  

As a mother, your well-being directly affects your baby's well-being, so don't hesitate to seek help when needed. Remember that although the postpartum period may bring unexpected challenges, it is also a time of extraordinary joy and connection with your newborn.

When to see a healthcare provider 

If you’re experiencing red, itchy bumps and plaques on your skin, you should talk with your medical provider about it to confirm that it is postpartum hives and not a different medical condition. You’ll likely also want some relief from all that scratching, and your provider will be able to tell you which anti-itch medications are safe during pregnancy and breastfeeding.

One possible complication of postpartum hives is trouble sleeping due to itching. If you’re already sleep-deprived from taking care of a little one, having that bit of sleep that you are able to get disrupted by itching can lead to exhaustion.¹⁷

In that case, it may be a good idea to see your provider to discuss stronger treatments to control your hives and let you get the itch-free sleep that your body needs.¹⁸

If you ever experience any of the following symptoms along with hives, you should contact emergency services immediately:¹⁹

  • Trouble breathing.

  • Racing heart.

  • Feeling dizzy or faint.

  • Vomiting or diarrhea.

  • Stomach pain.

These symptoms aren’t signs of postpartum hives, but they could be signs of a type of allergic reaction called anaphylaxis, which needs emergency treatment.

Postpartum hives treatment

Without any treatment, postpartum hives will usually go away on their own in four to six weeks²⁰; however, that can feel like forever when you’re dealing with a red, itchy rash. Fortunately, there are several treatment options available to help you manage the symptoms of postpartum hives. 

While your skin is irritated, you’ll want to stick to wearing light, cotton clothing. You may also find relief by taking cool, soothing baths.²¹ Other non-medication interventions that may help include  emollient creams that can moisturize and protect your sensitive skin and applying cool, wet cloths (wet soaks) on your skin to help with irritation.²²

If these treatments fail to help you control your symptoms, you may want to try over-the-counter or prescription-strength treatments. You will need to talk with your OB/GYN to determine what medicines are safe for you to use if you’re pregnant or breastfeeding.²³

The usual first-line medication for postpartum hives is topical corticosteroids, a cream or lotion that gets applied to the skin to reduce redness, itching, and irritation. Your provider might also recommend oral antihistamines to help relieve your itching. In more severe cases, systemic corticosteroids (such as prednisone) might be prescribed to quickly relieve symptoms.²⁴

FAQs

How long do postpartum hives last?

While postpartum hives are itchy and uncomfortable, the good news is that they won’t last forever. The condition usually goes away on its own, even without treatment, in four to six weeks.²⁵ It’s also mostly only seen in first pregnancies.²⁶

What is postpartum rash?

A postpartum rash is another name for the skin condition also called postpartum hives. The medical name for this condition is pruritic urticarial papules and plaques of pregnancy (PUPPP) or polymorphic eruption of pregnancy (PEP).²⁷ ²⁸

Postpartum hives occur during or right after about one in every 160 to 300 pregnancies.²⁹ The exact cause is unknown, but the condition is thought to be connected to the stretching of the abdominal skin that happens during pregnancy.³⁰

Can hormones cause hives?

Hives can be caused by many different reasons. Since postpartum hives occur at the end of pregnancy or right after you give birth when the body is experiencing large hormonal shifts, some researchers do think that hormones, such as progesterone, can play a role. However, the full causes are still unknown.³¹

Taking care of your skin postpartum

For postpartum hives, you’ll need to consult with your OB/GYN to confirm what is causing your symptoms and see what medication is suitable for you.

This isn’t the only skin condition that can come up during and after pregnancy. For other common pregnancy-related skin conditions, such as acne or melasma, you can consult with a licensed dermatology provider at Curology to create a personalized skincare routine (but we still recommend that you keep your OBGYN in the loop!).

Here at Curology, we do accept new patients who are trying to conceive, pregnant, or nursing. 

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• • •

P.S. We did the homework, so you don’t have to:

  1. Chouk C. and Litaiem N. Pruritic Urticarial Papules And Plaques Of Pregnancy. StatPearls. (2022, August 1).

  2. Schaefer, P. Acute and Chronic Urticaria: Evaluation and Treatment. Am Fam Physician. (2017, June 1).

  3. Schaefer, P. Acute and Chronic Urticaria: Evaluation and Treatment. Am Fam Physician. Ibid.

  4. Zejnullahu, V.A. and Zejnullahu, V.A. Polymorphic eruption of pregnancy. Dermatol Reports. (2022, August 3).

  5. Chouk C. and Litaiem N. Pruritic Urticarial Papules And Plaques Of Pregnancy. StatPearls. Ibid.

  6. Zejnullahu, V.A. and Zejnullahu, V.A. Polymorphic eruption of pregnancy. Dermatol Reports. Ibid.

  7. Schaefer, P. Acute and Chronic Urticaria: Evaluation and Treatment. Am Fam Physician. Ibid.

  8. Zejnullahu, V.A. and Zejnullahu, V.A. Polymorphic eruption of pregnancy. Dermatol Reports. Ibid. 

  9. Chouk C. and Litaiem N. Pruritic Urticarial Papules And Plaques Of Pregnancy. StatPearls. Ibid.

  10. Zejnullahu, V.A. and Zejnullahu, V.A. Polymorphic eruption of pregnancy. Dermatol Reports. Ibid.

  11. Chouk C. and Litaiem N. Pruritic Urticarial Papules And Plaques Of Pregnancy. StatPearls. Ibid.

  12. Chouk C. and Litaiem N. Pruritic Urticarial Papules And Plaques Of Pregnancy. StatPearls. Ibid.

  13. Chouk C. and Litaiem N. Pruritic Urticarial Papules And Plaques Of Pregnancy. StatPearls. Ibid.

  14. Zejnullahu, V.A. and Zejnullahu, V.A. Polymorphic eruption of pregnancy. Dermatol Reports. Ibid.

  15. Chouk C. and Litaiem N. Pruritic Urticarial Papules And Plaques Of Pregnancy. StatPearls. Ibid.

  16. Chouk C. and Litaiem N. Pruritic Urticarial Papules And Plaques Of Pregnancy. StatPearls. Ibid.

  17. Jain P. and James M.M.PUPPP: Demonstration of Deranged Liver Enzymes during Pregnancy Int J Nurs Midwif Res. (2007).

  18. Jain P. and James M.M.PUPPP: Demonstration of Deranged Liver Enzymes during Pregnancy Int J Nurs Midwif Res. Ibid.

  19. Schaefer, P. Acute and Chronic Urticaria: Evaluation and Treatment. Am Fam Physician. Ibid.

  20. Zejnullahu, V.A. and Zejnullahu, V.A. Polymorphic eruption of pregnancy. Dermatol Reports. Ibid.

  21. Chouk C. and Litaiem N. Pruritic Urticarial Papules And Plaques Of Pregnancy. StatPearls. Ibid.

  22. Zejnullahu, V.A. and Zejnullahu, V.A. Polymorphic eruption of pregnancy. Dermatol Reports. Ibid.

  23. Schaefer, P. Acute and Chronic Urticaria: Evaluation and Treatment. Am Fam Physician. Ibid.

  24. Zejnullahu, V.A. and Zejnullahu, V.A. Polymorphic eruption of pregnancy. Dermatol Reports. Ibid.

  25. Zejnullahu, V.A. and Zejnullahu, V.A. Polymorphic eruption of pregnancy. Dermatol Reports. Ibid.

  26. Stefaniak, A.A., et al. Pruritus in Pregnancy. Am J Clin Dermatol. (2022, February 21).

  27. Chouk C. and Litaiem N. Pruritic Urticarial Papules And Plaques Of Pregnancy. StatPearls. Ibid.

  28. Zejnullahu, V.A. and Zejnullahu, V.A. Polymorphic eruption of pregnancy. Dermatol Reports. Ibid.

  29. Zejnullahu, V.A. and Zejnullahu, V.A. Polymorphic eruption of pregnancy. Dermatol Reports. Ibid.

  30. Chouk C. and Litaiem N. Pruritic Urticarial Papules And Plaques Of Pregnancy. StatPearls. Ibid.

  31. Jain P. and James M.M.PUPPP: Demonstration of Deranged Liver Enzymes during Pregnancy Int J Nurs Midwif Res. Ibid.

*Subject to consultation. Subscription required. Results may vary.

Erin Pate is a board-certified Family Nurse Practitioner at Curology. She earned her Masters of Science in Nursing at Florida Atlantic University in Boca Raton, FL. Here at Curology, we currently focus on the diagnosis and treatment of acne, rosacea, and anti-aging concerns. We do not treat many of the conditions mentioned in this article. This article is for information purposes.

• • •
Our medical review process:We’re here to tell you what we know. That’s why our information is evidence-based and fact-checked by medical experts. Still, everyone’s skin is unique—the best way to get advice is to talk to your healthcare provider.
Curology Team Avatar

Curology Team

Erin Pate Nurse Practitioner, NP-C

Erin Pate, NP-C

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