Dealing With PUPPPs Or PEP After Pregnancy

PUPPPs (pruritic urticarial papules and plaques of pregnancy) and PEP (polymorphic eruption of pregnancy) - it was something that I heard about during pregnancy. It's an itchy, red, bumpy rash that usually occurs during the third trimester and starts in the stretch marks of the ever-growing belly. It's not harmful to the baby and usually goes away within days or weeks after giving birth.


But what happens when you get PEP AFTER giving birth? Like weeks after giving birth?

I want to share how I had PEP 5 weeks after giving birth to sweet LadyBug. I want to share my symptoms and treatment plan and all the details because I thought I was going crazy and I couldn't find ANY information on the internet about postpartum PEP. I even asked all my momma friends if they experienced anything similar and only one had similar symptoms that lasted about four weeks. Yes, four weeks of intense itching is no fun at all.

At about 5 weeks postpartum, I had an extreme urge to constantly itch my breasts. I thought they were dry because the weather was still cool. I slathered coconut oil on them after showers and again at night. The itching then turned to a rash and I thought I had some kind of yeast infection from breastfeeding or from dried milk in my breast pads.

I wasn't at all concerned about mastitis because my lactation consultant said I would know if I had it due to the flu-like symptoms that usually occur. I also wasn't too concerned with having thrush because LadyBug wasn't showing any symptoms. So I made it a point to change out my breast pads often, wash my maternity bras more frequently and continued using coconut oil.

After about 5 days, on a Saturday, the back of my left hand started to itch. I scratched and scratched and started to notice hives and scaling. I thought, great - now I must have eczema. You guys, momma brain makes you think all sorts of crazy thoughts. I started to research what can be done to help with the symptoms of eczema and I was fully prepared to cut all dairy from my diet.

Upon all of my research, I discovered Grandpa's Pine Tar Soap. I looked up some places around me that carried the pine tar soap and the next day (Sunday) went out to purchase it. At this point, the itching, hives and scaliness had spread up my arms. I was so miserable scratching myself that I was seconds away from calling the postpartum floor at the hospital I delivered at. But I knew they would suggest I come in to get looked at and I was only two days away from my 6-week postpartum appointment.

I waited miserably two more days in which the itching had spread from my breasts, to my arms, to my legs, and now to my hips and butt. It was torturous and even worse at night.

I sat on the exam table with the nurse and my OB just staring at me, in complete awe and sympathy. My OB said, "Wow! I have never seen anything like this. I almost want to take a picture." Definitely not something I wanted to hear from my healthcare provider. She consulted with a lactation consultant on staff and Medrol Dosepak was okayed for me to take while breastfeeding. My OB then gave me a referral to see a dermatologist.

Now if you've ever tried to make a dermatology appointment to a new office, it usually takes ages to get in. On March 21st, I was told the first appointment wouldn't be until May. MAY?! That was well over a month away and I was already beyond miserable.

Then the receptionist found a cancellation for later that week (Thursday) that I could have. I almost for a moment didn't take the appointment because I wanted to see if the Dosepak would help. But that crazy idea left my brain rather quickly and I scheduled the appointment.

Click to tweet: What happens when PUPPPs or PEP hits hard after pregnancy?

After leaving my 6-week appointment, I headed to the pharmacy and filled my prescription for the Medrol Dosepak. I also consulted with the pharmacist to see if there were any OTC creams or ointments that I could use because I wasn't comfortable with taking an oral antihistamine (it can dry up milk supply). She recommended Diphenhydramine hydrochloride 2% cream. I began the Dosepak right away and started using the Diphenhydramine hydrochloride 2% cream when the itching was unbearable.

When Thursday came around, two days after my OB appointment, the dermatologist looked at my skin thoroughly and said, "So it looks like you have postpartum PEP which is quite uncommon." She also told me that while it's uncommon, it's most often seen with first time moms of multiples or boys - neither of those fit my situation. She then prescribed me a large tub of Triamcinolone ointment and told me to finish out the Dosepak.

It took just over 4 weeks for the rash and itching to go away completely. The pine tar soap didn't offer much relief and neither did the Diphenhydramine hydrochloride 2% cream. The Medrol Dosepak helped clear up the reddest part of the rash, but I think it caused some stomach discomfort for LadyBug. The Triamcinolone ointment helped with the inflammation but nothing really solved the extreme itching. 

For your viewing pleasure, here are a few photos of what PEP looked like for me.

So as you can see, PEP is miserable and I wouldn't wish it on anyone. If you are reading this because you are experiencing similar symptoms, I am sorry. Please just know that IT WILL go away. And if you are reading this nodding your head yes to everything because you too had PEP during or after pregnancy, I am sorry! 

**This is my own personal medical story. Please seek your healthcare providers when it comes to your health. 

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