How to treat eczema during pregnancy

The hormones your body creates during pregnancy can cause eczema to develop or worsen. In fact, eczema is the most common skin disease people experience during pregnancy.

Moisturizing your skin is one of dermatologists’ top recommendations for eczema during pregnancy

Use a fragrance-free cream or ointment.

What should I do if I become pregnant and have eczema?

Talk to your dermatologist and obstetrician. Many eczema treatments are safe to use during pregnancy. However, you should avoid some while you are pregnant.

If you’re taking a medicine that shouldn’t be used during pregnancy, your dermatologist can help update your treatment plan so you can get relief from your eczema safely.

Can pregnancy cause eczema?

During your menstrual cycle, the levels of your estrogen and progesterone hormones go up and down in your body. This can cause your skin to be drier or more sensitive at various times in your cycle. That’s because these hormones affect your skin’s health: Estrogen makes your skin barrier stronger, and progesterone increases the amount of oil in your skin.

When you’re pregnant, the amount of estrogen and progesterone in your body increases. The changes in your skin barrier and hydration that follow can trigger eczema. Your estrogen and progesterone levels go back down after you give birth. This might help your eczema feel better, or trigger it to get worse. Eczema is different for every patient. You can find signs and symptoms of eczema at Eczema types: Atopic dermatitis symptoms.

Will my eczema affect my baby?

Having eczema while you’re pregnant does not harm your baby. However, if a parent has eczema, their child is more likely to develop the condition.

Some complications from eczema may affect your baby. For example, having eczema increases your risk of staph infections, which can put both yourself and your baby at risk.

When eczema worsens, it may impact your quality of life, and may even cause anxiety, mood changes, or depression. It’s important to take steps to manage your stress for your overall health and well-being during pregnancy. The best way to prevent your eczema from affecting your baby is to treat your eczema during pregnancy.

How can I safely treat eczema during pregnancy?

It’s important to treat eczema during pregnancy because untreated eczema can affect both your and your child’s health and well-being. Dermatologists know how to safely treat eczema during pregnancy.

It’s important to follow your dermatologist’s instructions

Although many eczema treatments are safe during pregnancy, you may need to use them in specific spots or smaller doses.

Eczema treatments that are safe to use during pregnancy

You can use many eczema treatments while pregnant, including:

Treatments you can do at home

• Skin care, including applying moisturizer to help repair your skin. For more tips, go to Eczema types: Atopic dermatitis skin care.

Treatments your dermatologist may recommend

• Wet wrap therapy

• Topical corticosteroids

• Topical calcineurin inhibitors (TCIs)

• Phototherapy. While phototherapy is safe, it may increase melasma and hyperpigmentation during pregnancy, and lower your folic acid levels.

Eczema treatments you should use sparingly during pregnancy

Some medications work throughout your body to treat eczema. Your dermatologist may recommend one of these treatments for short periods of time while you are pregnant, and only if other treatments do not control your eczema. Because these treatments may cause side effects, you should discuss them with your dermatologist. These include:

• Corticosteroids you take by mouth

• Cyclosporine

• Azathioprine

Bleach bath therapy may also be used sparingly during pregnancy.

Eczema treatments you should not use during pregnancy

Some eczema medicines can cause serious side effects during pregnancy. If you’re planning to become pregnant, your doctor may suggest you use contraception while taking these treatments and stop taking them several weeks or months before trying to conceive. Because of the side effects, avoid taking these medicines during pregnancy:

• Methotrexate

• Mycophenolate mofetil

• PUVA phototherapy

Dermatologists are still examining how eczema medications affect pregnancy. Because not enough is known about some treatments, dermatologists do not recommend these treatments during pregnancy:

• JAK inhibitors

• TYK2 inhibitors

• Tralokinumab

• Crisaborole

• Dupilumab

For more information on how dermatologists treat eczema, go to Eczema types: Atopic dermatitis diagnosis and treatment.

Can I treat eczema while nursing?

You can nurse your baby while treating your eczema. However, some medications can transfer into breast milk. Generally, you should avoid the same eczema treatments during nursing as you did while pregnant.

Avoid applying medication to your nipple area, as this could expose your baby to the medication. If you need to treat eczema in your nipple area, gently clean the area before nursing to remove any medication. Then, apply any topical medicines immediately after nursing. That way, the medicine can absorb into your skin before the next feeding.

When should I see a dermatologist?

If you notice signs or symptoms of eczema while pregnant or trying to become pregnant, partner with a board-certified dermatologist to get relief safely. To find a dermatologist near you, go to Find a dermatologist.

Images
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References
McMullan P, Yaghi M, et al. Safety of dermatologic medications in pregnancy and lactation: An Update - Part I: Pregnancy. J Am Acad Dermatol. 2024 Jan 25:S0190-9622(24)00109-9.

Mian M, Dunlap R, Simpson E. Dupilumab for the treatment of severe atopic dermatitis in a pregnant patient: A case report. JAAD Case Rep. 2020 Aug 9;6(10):1051-1052. PMC7509357.

Vestergaard C, Wollenberg A, et al. European task force on atopic dermatitis position paper: Treatment of parental atopic dermatitis during preconception, pregnancy and lactation period. J Eur Acad Dermatol Venereol. 2019;33:1644–59.

Weatherhead S, Robson SC, Reynolds NJ. Eczema in pregnancy. BMJ. 2007 Jul 21;335(7611):152-4.

Yaghi M, McMullan P, et al. Safety of dermatologic medications in pregnancy and lactation: An Update - Part II: Lactation. J Am Acad Dermatol. 2024 Jan 25:S0190-9622(24)00110-5.

Written by:
Brooke Schleehauf

Reviewed by:
Laurel Naversen Geraghty, MD, FAAD
Elaine T. Kaye, MD, FAAD
Elan M. Newman, MD, FAAD
Brittany Oliver, MD, FAAD
William Warren Kwan, MD, FAAD

Last updated: 9/20/24