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Causes of Pruritus During Pregnancy​

Pruritus during pregnancy is a common clinical complaint and may result from a variety of physiological and pathological factors. In many cases, it is benign and related to normal gestational changes; however, it may also indicate underlying dermatological or systemic conditions requiring medical attention.


One of the most common causes of pruritus in pregnancy is hormonal alteration. Increased levels of estrogen and progesterone can affect skin barrier function, leading to dryness and heightened skin sensitivity. Additionally, mechanical stretching of the skin, particularly over the abdomen and breasts due to fetal growth, may provoke localized itching.


Xerosis (dry skin) is another frequent contributor, often exacerbated by environmental factors such as low humidity or frequent bathing. Moreover, pregnant individuals may develop increased susceptibility to allergic reactions, including contact dermatitis caused by cosmetics, detergents, or synthetic fabrics.


In some cases, pruritus may be associated with pregnancy-specific dermatoses, such as polymorphic eruption of pregnancy (PEP/PUPPP), pemphigoid gestationis, or atopic eruption of pregnancy. These conditions typically present with pruritic skin lesions and vary in severity.


A particularly important pathological cause is intrahepatic cholestasis of pregnancy (ICP), a liver disorder characterized by impaired bile flow. ICP commonly presents with intense pruritus, especially affecting the palms and soles, often worsening at night and occurring in the absence of primary skin lesions. This condition is clinically significant due to its potential adverse effects on fetal outcomes and therefore necessitates prompt diagnosis and management.


In conclusion, while pruritus during pregnancy is often a benign symptom related to physiological skin changes, persistent or severe itching—particularly when localized to the palms and soles or unaccompanied by rash—should prompt further clinical evaluation to exclude serious underlying conditions.