You know you have PUPPPs when...

It's mosquito season where I live. Pesky buggers.

BUT, you know you have PUPPPs when the mosquito bites barely itch in comparison to your rash.

My poor little girls have quite a few bites, complain about the itch, and I really don't have very much sympathy. Sorry, kiddos! Mommy knows what it's like to really itch.

Let's see...how else do you know you have PUPPPs...

You might have PUPPPs if...you're medicine cabinet is full of every over-the-counter itch cream known to man.

You might have PUPPPs if...it looks like the drug store exploded on your bedside table.

You might have PUPPPs if...you've considered joining a nudest colony just to avoid the hassle of clothing.

You might have PUPPPs if...you've fantasized about swimming in the ocean all day long.

You might have PUPPPs if...you seek out privacy in public places just to scratch the "awkward" spots.

You might have PUPPPs if...you have your dermatologist in your favorite contact list.

Got any to add? Feel free to comment!!

Current Discussions: Facebook Support Group

In my perusal of the PUPPPs Facebook community, I came across a pretty active group. For those of you on Facebook, this may be a good way to get your questions answered by other PUPPPs sufferers. It seems to get a lot of traffic. 

Here's a link: Facebook PUPPPs Support Group

Reader Comment: Do iron supplements play a role in PUPPPs?

Hello PUPPPs community,

I received a comment from a reader that I thought deserved more attention and input. She noticed a correlation with beginning an iron supplement and the development of her PUPPPs. While I haven't personally experienced this, I'm quite curious if any of you have! Please comment on this post and let her know if you have or have not experienced anything similar!

Here is her comment (You can see her original comment on my Current Discussion Forums Post.):

"There is a consistent discussion on the fact that PUPPPs could be related to the liver (hence I am running out on my lunch break to get some dandilion tea, etc. today to start that treatment). But, I wanted to know if others were originally prescribed iron supplements. This is my second pregnancy. I didn't have PUPPPs during my first. The only difference is that about a month ago, I was instructed to begin iron supplements, since I was severely anemic. I stopped taking the supplements yesterday, and I am hoping this may clear up the symptoms. Are you taking any iron supplements?"

That Wild Eyed Look

My rash is going through a flare-up right now, and apparently it's obvious to my husband. He says he can tell when it's getting bad, because I get a desperate, wild-eyed look when I'm scratching. I didn't even realize I did that!

But now that He mentions it, it's a pretty good indicator. I wish I knew what factors played into the flare-ups! Once a month, it gets pretty bad for a week or so and then calms down. I'm not pleased that this current flare-up coincides with a week of weather in the upper 90's and our ventilation system going on the fritz. 

It's going to be quite a week. 

By the way, I'm in the midst of testing the black cherry juice remedy! I'll post an update after I've given it a chance for a little while longer. 

Joined Facebook

I deleted my personal facebook page months ago. I was spending WAY too much time on it. But I created a PUPPPs facebook page to continue to spread the word about the rash and create another place for people to talk about it. I have no friends or followers yet (poor me!), so have pity on me and like my page. :)

Here it is:

PUPPPs Relief Facebook Page

Patterns in PUPPPs

Has anyone else noticed a pattern with their rash?

I've had PUPPPs for 3 months now, and I've noticed that once a month, it gets worse. For the most part, my routine keeps it under control, but it has peaked 3 times since the start. At each peak, a new patch starts in a new place! 

That makes me wonder if the inflammatory response in my skin is somehow related to hormone fluctuations. Anybody else experience this?

I Finally Made the Order

I did it! I ordered a seven star needle!

"What on earth is that??" You may ask?

Here's an excerpt from my "Treatments I've Tried" post...

Chinese Medicine 7 Star Needle: supposedly complete healing relief
This is a bizarre one! I recently found out about this treatment through puppps.org. It uses a Chinese medicine device designed to treat hives. Here's a pic...

Crazy looking, no? Apparently, you tap the hive until it starts to bleed, and then that hive NEVER itches again. The testimony on puppps.org is really compelling!!! Otherwise, I don't think I'd even consider this treatment! You can find videos on youtube if you want to see the treatment in action. I'm currently building up the courage to order one from amazon. I'll let you know!

Well, I finally ordered one! $5 on amazon with free shipping. That's pretty cheap if it truly gets rid of the rash. The shipping was abominably slow, sadly. It'll probably be 3-4 weeks before it arrives, but when it does, I'll test it on myself and let you know!

My PUPPPs Story: Baby #3

Baby #3 was my worst case of PUPPPs.

At 15 weeks, the first patch of rash started up in the exact same place as before. I knew what was coming. I couldn't believe it had started so early. I was distraught but still mildly hopeful that the dandelion root would kick it before it got bad.

The belly at 15 weeks, just as the rash began.

No luck. 

It spread, and it spread fast. At 17 weeks, I was in tears. I was bloodied from scratching and not sleeping. I could not perform daily tasks like dressing or meal prep without scratching. It was not something self-control could manage. Once again, I could not NOT scratch! It felt like bugs were crawling under my skin! I was puffy and red all over! I couldn't stand it when anyone touched me, especially my children. 

I could not fathom 5 months of it ahead of me. I was already close to losing my mind. 

So, I let go of any resolve I once had to avoid steroids, and I made an emergency appointment at the dermatologists. (See this post for more details on that.) I bet dermatologists don't get many requests for emergency appointments! 

After many curious staff at the office were sufficiently impressed by my predicament, I got my prescription for topical steroids. Triamcinolone was to be my rescue. And it was.

Mine looked a lot like this. This is not a picture of my tub-o-cream, just a very similar one. 

I went through more than one tub. 

After two days of intense introductory treatments designed to super-saturate my skin with the drug, the rash started lessening. I was beginning to feel relief and a touch of sanity returning. I was SO VERY relieved. The thought had crossed my mind that the steroids might not work, and I didn't know what I'd do! So, finding relief was such a relief!

I continued to use the cream daily throughout the pregnancy. My rash never completely disappeared. It was only tamed. However, I could function, and I could sleep, and I was content with that. I hated to be taking a drug that had no conclusive safety record in pregnancy, but I was sure I'd have been put in some kind of mental facility without it. No exaggeration. 

After I gave birth to my 3rd sweet little girl, my rash did worsen for a month before it cleared up. This was a first for me, but the steroid cream did seem to help keep it from reaching an intolerable state. It disappeared completely after that.

Baby Girl #3, tiny bundle of love.

As far as my body was concerned, I noticed very few side effects from the cream. My skin did become very thin feeling where I used the cream the most. It was delicate. It would bleed easier if I scratched too hard. But that was it. 

My baby, on the other hand, was another story. She was SO yeasty. She had yeast in every fold of skin. The worse areas were her underarms, neck folds, and diaper area. Red skin with a cheesy discharge. We tried quite a few different over the counter things, natural treatments, and one prescription. All of these were topical things and ineffective.  That yeast was stubborn! 

As she got older and had fewer skin folds, it got a little better, but it still hung on. When she started eating solid food, I began a special diet for her. I had researched a bunch and decided she needed gut healing. Babies are colonized with whatever bacteria mommy has in her and on her on their way out into the world. Steroids change your body chemistry and make a happy environment for yeast. While I didn't experience any noticeable yeast symptoms, I'm sure I was harboring a ton of yeast at the time of the birth. They made their home on (and in!) my unsuspecting infant. 

Since yeast is usually a problem that is not just skin deep (it loves the digestive tract), I decided we'd try to heal baby's problem from the inside out. We put her on the GAPS diet (GAPS stands for Gut and Psychology/Physiology syndrome). It's a grain-free diet that uses a lot of bone broth and probiotic food. You can find more info on the GAPS diet here and here. Please comment and let me know if you'd like a post with more details on how we did the diet. 

She remained on the diet for roughly 6 months, and her yeasty rash issues finally cleared up! It was not an easy fix, but it was worth doing.

 Happy yeast-free toddler just after her first birthday.

So, that's baby #3's story, from the beginning of the rash to the cure of the side effects from the steroids. It was quite an ordeal. 

With this current pregnancy, I really didn't want a repeat of the steroid experience. And I haven't needed them yet! At nearly 25 weeks along, I've had PUPPPs for 10 weeks now. I think I've finally figured out a routine that works for me, and I look forward to compiling a summary of it in another post with #4's story!

Disclaimer: I am not recommending the particular drug that worked for me. Please talk to your doctor before starting any course of treatment! 

A Silver Lining to the Common Cold

That's an unlikely post title, no?

I know this is my PUPPPs blog, but I'm living with the itch AND a cold right now, so I may as well tell you about it. 

It's a little crazy, but the fever, aches, sore throat, and completely plugged sinuses have taken my mind off the itching! I'm rather miserable, but less itching is definitely a silver lining.

So, here I am in the middle of summer, hunkered in my hoodie and fleece jammies...researching the common cold. Ironic.

Now, let's be logical, if you're reading this because you have PUPPPs, you are about to or already do have children in the house. Children, the little germ factories, are the main way adults get infected. They're worth it, trust me. But with children in the house, you are going to become quite accustomed to colds, so you might as well buff up on your sniffly knowledge. 

I came across a fascinating webpage all about the common cold from Cardiff University in the UK. Here's a link to the article: link

Here's the run down in case you'd rather skip reading the full article. 

• Incubation period for the common cold is 2 days. Super short!
• You are most contagious when you have the early symptoms (sneezing, coughing, runny nose).
• The virus is commonly present in your nose and throat, but it doesn't take root unless your immune system takes a dive (like if you get stressed). 
• Your mother was right! Getting chilled can give you a cold! A study took roughly a hundred college kids and chilled their feet in ice water for a while. Compared to the control group, they were statistically way more likely to get a cold! Researchers believe the chilling of the feet constricts the blood vessels in the nose and throat, thereby lowering your immune reponse (due to the lack of immune system cells that would normally be present with the blood in that area!) The gist? You get cold, you're more likely to get a cold. This is also probably the reason colds are more common in fall and winter. 
• There are roughly 200 different viruses that causes common cold symptoms. Awesome. This means you can get one cold right after another. Your body will be immune the first cold, but not prepared to fight off the second one. 
• Symptoms usually last 7-14 days. 
• You'll first feel sick where the first viruses attach themselves. If it's in your nose, you'll probably get a runny nose first. If it's in your throat, you'll get a dry scratchy throat. 
• Many infections don't cause symptoms. The virus takes root, but your body fights it off before you start to feel sick. Come on, body! Why didn't we do that this time?! 
• You can't tell the difference between a cold and a flu based on the symptoms. They can act very similar. A flu is often worse than a cold. There are some laboratory tests for the flu. 
• Your nose doesn't actually get blocked with snot. It gets plugged up, because the blood vessels in your nose swell up. It gets all inflamed in there, and then the tiniest amount of mucous blocks the rest. Lovely. 

(Image from the Cardiff University website for common cold info)

Well, after all that, I'd say our trip to the beach was our downfall. We all got chilly in that blissfully cool air. And then we all got sick. It sure felt good! Next time, I'll bundle up better. 

Greetings from the sick house

What do you do when you have PUPPPs, crazy seasonal allergies, and 3 kiddos with a nasty cold?

Not much. 

Sorry for the brief hiatus in posts. 

Skin brushing

File this one under humor. Or irony. 

I'm always on the look-out for itchy skin cures. I got a tip to look into dry skin brushing, and off I went to google. 

At first, I was rather intrigued. OooOooo, I thought. It's supposed to increase circulation and help move lymph? Well, that's great for detoxing! This could be an awesome addition to my PUPPPs treatment routine! And it helps minimize cellulite also? Bonus! 

Here's a link that describes it's benefit in more detail: dry skin brushing

Other itchy people even seemed to like it! Eczema sufferers were touting it's benefits: dry brushing for eczema

I did run across some skeptics. This article had a few quotes from dermatologists that were not super confident in the miraculous claims that the skin brushing fans were spouting: NY Times article

After taking it all in, I examined the nitty gritty more closely. And I laughed. 

Ok, so, step 1 seemed to be getting a naturally bristled brush (like my trusty boar-bristled favorite). Check. 

Step 2. Starting at the ends of your extremities, brush towards your heart. Hmm. Ok. Simple enough. I'm already using my hairbrush to scratch like crazy, so I'm half way there!

Then the cautions. Be sure to avoid current outbreaks of any rashes (like eczema...and PUPPPs!?) or sensitive areas. Haha! 

So then, where does the miserable PUPPPs sufferer have left to brush??? One's fingernails?? The tips of our noses??

Uh huh. 

Well, perhaps skin brushing to cure PUPPPs is out. I am curious if anyone out there has used it successfully in their non-itchy lives to good effect. Any miraculous cellulite disappearances? Anyone?

And that is how my evening of research turned into a wry chuckle. Goodnight, fellow itchy people!

Beating the Heat (and the itch)

At home, it's been close to 100 degrees. Heat & PUPPPs just don't mix. However, at the coast, it's been in the 60's. Yes, please!!

I wish it was possibly for all PUPPPs mommas to head to the chilly ocean for a stretch. I don't have much advice to offer in this post except the encouragement to stay cool this summer! 

So chilly we had to be bundled up. Yay!

Pelicans! 

Sea anemones. They closed up when you poked them. 

Starfish. I wonder who munched his 5th leg?

And the all-time beach fave, salt water taffy. Absolutely delightful. 

I'd like to thank the icy water and the brisk wind for their soothing anti-itch properties! Spending the whole summer at the beach sounds pretty nice right now!

Dermatology Article

Did you know PUPPPs used to be called "Nurse's late onset prurigo," "Bourne's toxemic rash of pregnancy," and "Toxic erythema of pregnancy?"

Neither did I! 

I found this write up on PUPPPs by the American Osteopathic College of Dermatology and thought it was a really great summary on the rash. It's thorough with tidbits of info I hadn't found before. 

(example of PUPPPs rash from the article)

Here the link to the article. Happy Researching, fellow itchy people! 

News Headline

Scanning through the news yesterday, this headline caught my eye...

"Mystery Rash Caused By Electronic Devices"

http://mobile.wnd.com/2014/07/mystery-rash-caused-by-electronic-devices/

Sadly, not the answer to PUPPPs. But it might be worth taking note of if you have a history of allergies to metals. It would certainly be a bummer to find out you were exacerbating your PUPPPs with your tablet time. 

Current Discussion Forums

Anyone else out there having trouble finding discussion forums with active conversation? I certainly am!

Here are links to the most recently active that I can find:

I-am-pregnant forum (last active 32 days ago, as of this post.)

Babycenter forum (last active 8 days ago, as of this post. I reactivated it, and someone posted after me.)

What to Expect Forum (Best I can tell, this was last active in May of 2014)

Another What to Expect Forum (Last active in February of 2014)

ALL the other forums I can find are years old! There is a serious lack of conversation for currently suffering mommas.

Feel free to start chatting in the comment sections of any of my posts! I'll check on comments daily.

Boy or Girl? Does PUPPPs mean boy?

According to this scientific study, no, having PUPPPs does NOT mean you are having a boy.

I think we've all wondered at that statistic that 70% of PUPPPs babies are boys. I know for me personally, that's just silly. I've had THREE GIRLS so far.

Well, this study, published in a 2005 volume of the British Journal of Dermatology, was done in two big hospitals in Austria and London. It looked back at a group of 181 patients with PUPPPs and analyzed the data. Statistically, boys were no more likely than girls in the group.

Ha! Finally, a little piece of research that backs up MY story!

I think I'll do a little non-scientific study of my own and put up and poll about gender over on the right side of my blog. Please vote if you know the gender of your PUPPPs baby! By the way, if you're viewing the blog using the mobile version, you won't be able to see the polls. Click on the website version at the bottom of the page.

Here's the summary of the article: click here

PUPPPs & Epidurals

Here's a little something for those of you considering an epidural for pain relief in labor.

This 2006 case study from the Canadian Journal of Anesthesia follows the experience of one woman with PUPPPs. She had been on strong steroids for the rash, which lowered her immune system. Her lowered immune system allowed some nasty bacteria to take root at the site of her epidural. She got an infection that required surgery within a week or two of her baby being born!

Here's a visual of where an epidural is usually placed:

(image from pregnancy.about.com)

Keep in mind, this is just one woman, but the article makes the point that an epidural with a compromised immune system can have additional risks. So talk to your doctor about that before you decide!

Here's the article: link

Surviving in Public with PUPPPs

I'm going to a wedding this weekend...and I have to bring PUPPPs with me. Obnoxious party crasher.

Here's my survival plan.

First of all, let me just say that if my PUPPPs was at its worst, I would skip the wedding. The rash is no joke, and I'm in no condition to go out in public when it's peaking! So, my advice if you are supposed to be attending the nuptials of friend's this summer? Skip it! And don't feel bad!

However, my rash is tolerable at this point, so I'm going to attempt attendance.

• Bring your favorite ointment! I plan to slather myself every chance I get. I'll be excusing myself to the restroom frequently to reapply. 
• Keep it brief! I'm only staying as long as I need to. Things can get dicey if I'm away from my itch-reducing routine for too long.
• Be comfortable! I'm wearing a loose fitting dress. No tight stuff for me! (See my post about clothing tips for PUPPPs.) 
  
• Consider pre-treating. If you have a silver bullet for itch relief that isn't appropriate to use in public, make sure you take care of it right before! I plan to increase my dose of dandelion root before I go and make all efforts to NOT scratch for a day or two prior. Both those things keep the inflammation at bay. 

A note about going to work with PUPPPs...

I'm so happy to be a stay at home mom at present. Life would be so much more complicated if I was attempting to make it through a work day with PUPPPs. If anyone has tips about working with PUPPPs, please PLEASE feel free to comment. The only thing I can think of is bringing a cooler of ice packs with you to work everyday and applying them liberally! It would probably be helpful to bring your superiors on board with the condition of your rash so that they can have a better understanding of how to accommodate you. 

Dandelion Root: Tincture or Capsules?

One "cure" you'll find all over the PUPPPs websites is Dandelion Root. Apparently, that lovely yellow weed in all of our yards has helped a lot of people! Herbalists for decades have known that dandelion is a good liver cleanser. Taraxacin and choline are the chemical compounds in dandelions that aid the liver. (source)

Here's the rundown on the liver. The liver is the major workhorse for processing junk. It's like a filter for the blood. Nasty stuff goes in (paint fumes, pesticides, chemicals in your lotion, you name it...), and the liver has to work to remove it. When we're pregnant, we're filtering for two! Not only that, but we produce way more hormones than normal. These are also processed through the liver. The alternative medicine world thinks all this may have something to do with PUPPPs.

Many of us PUPPPs sufferers have turned to dandelion root as a remedy. But there are options! Capsules? Tincture? I'll give you the pros and cons of both so you can decided which is best for you.

Tinctures

What is a tincture? It's a liquid extract of a plant. Think of vanilla extract. It's made by dropping some vanilla beans in alcohol until all the vanilla-y goodness comes out. What's left is delicious. With herbs, what's left is a potent form of the plant. Most herbalists seem to agree that a tincture is often stronger than the dried herb itself. Actual numbers seem to be lacking. One herbalist said tinctures are 5-10 times stronger than the herb itself. I would bet that it mostly depends on the quality of the herbs you start with and how much care is put into the making. As far as actually taking a tincture goes, it's pretty simple. Put your drops in some water and drink it down. Dandelion tincture is a bit bitter but totally doable, in my opinion.

The gist? If a tincture is stronger, it is most likely faster acting and better at it's job. The downside? Tinctures tend to be pricier than capsules.

Capsules

I think most of us are familiar with this form of the supplement. Dried and/or powdered herb is placed into a capsule that your body breaks down. You take it like you would any other pill. Opinions in the herbal world seemed to be a little more down on capsules. You have to digest the contents before your body can make use of it. There's more waste as lots of the plant is just fiber that passes through. You may have to take more to get a therapeutic effect. (Here's a source about some of that.)

The gist? Possibly a little slower acting and less potent. The upside? A little more reasonably priced.

The conclusion I came to for myself is that I like to have both on hand. One is great for the flare ups. One is more practical for maintenance. Both are getting me that liver cleansing goodness!

One big message that I got from all my research was that regardless of whether you're taking a tincture or a capsule, the main thing is making sure you are buying from a quality source! Research your herb supplier and be confident in their passion for their products! You don't want junk and filler. You want pure therapeutic herbs, my friends, so do your homework!

For more reading: 

Here's a good article put together by the University of Maryland Medical Center about dandelion. (click here)

Here's a list by WebMD of medications that may interact with dandelion. (click here) Please, be sure to consult with your care provider before starting new supplements. 

Research Blurb: An Extreme Case of PUPPPs

I feel so sorry for this woman! It took THREE courses of steroids (prednisone, the strong stuff) to kick her PUPPPs well into her postpartum period. She must have been miserable!

The main thrust of the article is that the typical treatment didn't work for this woman, and she needed more extreme care. It also points out that it seems obvious that it was an issue with her immune system function.  The authors state, "While this study does not provide a definite answer, it lends evidence to the possibility of a subtype of PUPPP that clearly has an immunologic basis."

It's no wonder that allergy meds don't work! Evidence is showing that it's NOT a histamine (allergic) reaction!

Here's the full text of the article for those curious research fans out there...

full text article

Does Daddy Play a Role in PUPPPs?

Ok, I'm excited. No, I didn't find a cure. But I ran across some studies that might give clues to a possible cause of PUPPPs. And I'm a bit of a research geek, so this stuff gets me going.

I've heard websites suggests that the rash could be our skin's response to the father or baby's DNA before, but I hadn't found the research to back it up! Today, I found 2 articles that shed some light on the subject.

In the first article, reported in a 1992 journal of Dermatology, there was a case of a mom who developed PUPPPs for the first time in her 5th pregnancy. Not only was it weird for it to be her first time, but it was noteworthy that her 5th pregnancy resulted from a different father than the previous 4 pregnancies! The major change was the father of the baby! Fascinating! Here's the article if you'd like to read it in its entirety.

The next article from the Journal of the American Academy of Dermatology is also from 1992. I couldn't read the full text without paying $35 bucks, but the summary was fascinating enough! The article was an analysis of 4 cases of PUPPPs. The first two were twin sisters married to twin brothers! First of all, how crazy is that?? Secondly, both women got PUPPPs! The other two cases were two women married to brothers. They also both got PUPPPs! So their theory is that the rash is a response to "circulating paternal factors." In other words, something about the father seems to play a role! Here's a link to the article summary.

Both articles suggest strong links to something about Daddy bringing about this rash. My husband wasn't too pleased to hear that. I don't blame him. But I can't help but be excited to gain more insight!

Is that not fascinating stuff? I know, it doesn't really help us at all with the itching, but there's something therapeutic about learning more about this crazy rash.

Treatments I've Tried

Here's my comprehensive list of treatments I've tried in the past. I'll rate them on a scale of 1-10, 1 being not helpful at all and 10 being complete healing. I'll also indicate whether it simply brought temporary relief or actually worked to heal the rash. 

Alternative Treatments:

Oatmeal Baths: Rating - 2, temporary relief
These baths (I used the Aveeno brand) felt ok while I was in them, but left zero lasting relief once I was out.

Epsom Salt Baths: Rating - 1, neither temporary or healing relief
While I normally love a good epsom salt bath, I found no relief from the itching with these.

Herbal Baths: Rating - 2, temporary relief
I had another friend with PUPPPs that found huge relief from herbal baths that included herbs like comfrey, calendula, lavender, plantain, red raspberry, and others. The bath felt sort of nice while I was in it, soothing even. Sadly, there was no change in the itch as a result of the multiple treatments I tried.

Aloe Vera: Rating - 2, temporary relief
Aloe, which I refrigerated to increase the cooling effect, alleviated the itch while it was drying. However, as soon as it dried, I was reaching for something else.

Banana Peels: Rating - 1, neither temporary or healing relief
I read somewhere that someone found relief from rubbing banana peels on their rash. Pretty bizarre. That was not the case for me. It stung a bit, but did not decrease the itch at all. Here is a link to one momma that DID find relief with banana peels: Click Here.

Sun Bathing: Rating - 1, neither temporary or healing relief
I think the theory here is that the UV or the release of vitamin D is supposed to help. Not for me! No help at all. I tried multiple sessions just to be sure.

Charcoal Poultices: Rating - 1, neither temporary or healing relief
This one makes me laugh, just because of the giant mess it made. Charcoal in general is like a zillion tiny sponges. It's awesome treating food poisoning, because it actually soaks up the toxins and bad bugs that are making you ill. I read that charcoal poultices also help some skin conditions in that same way. You paint yourself with a paste of charcoal and water and cover the mixture so that it doesn't dry out. It doesn't work dry. That becomes tricky when the rash is ALL over! I decided to try it on my worst patch, which was at the top of my belly. My mom help paint me with the paste, and then we wrapped me in plastic stretch wrap to keep it from drying out! What a sight! Black goo wrapped up like yesterday's leftovers! Anyway, I tried it for a couple days and then gave up. It wasn't helping, and it was torture to have my itchiest spot covered where I couldn't get to it!

Grandpa's Pine Tar Soap: Rating - 1, neither temporary or healing relief
I'm sorry to say that the soap that seems to help so many people gave me no relief! I didn't notice ANY reduction in the itch. Glad it helps so many others though! If I were starting over, I would still try it, as it seems to bring relief for lots of PUPPPs people!

Sulfur Soap: Rating - 1, neither temporary or healing relief
This soap is recommended for rashes like poison oak, so I thought I'd try it. It was no help, and it was stinky.

Dandelion Root: Rating - 6, healing relief
I drank the tea and took the tincture. When the rash was bad, I tried to drink a cup of tea a day and take 2 droppers of tincture 3x/day. (This was at my midwife's recommendation.) During the 4 times that I've had PUPPPs, this remedy hasn't always worked. I do believe it was the reason my rash became tolerable with my 2nd pregnancy, but it wasn't enough to help my rash on my 3rd pregnancy. I am currently taking it with my 4th pregnancy, and it seems to be contributing to keeping my rash from driving me crazy. I am sleeping through the night.

Nettle Tea: Rating - unsure, healing relief
I drink this tea off and on, but drank it consistently in my second pregnancy. It may have contributed to the healing. It's easy to add a teabag of this stuff when you are already steeping a bag of dandelion tea. Traditional Medicines is the brand I used.

Apis Mellifera homeopathics: Rating - 1, neither temporary or healing relief
Once again, I was disappointed to find that a remedy that seemed to help a lot of women did nothing for me.

Acupuncture: Rating - 1, neither temporary or healing relief
I really gave this one a shot, because lots of people said you can't tell with just a few treatments. I even tried a couple different practitioners. I know it has helped some people, but it did nothing for me.

Ice Packs: Rating - 8, temporary relief
This is definitely my favorite treatment for temporary relief. I have a whole post on it here. Icing the itch would calm it down sometimes for hours. This meant sleep! Keep a cooler of ice packs by your bed so you don't have to get up in the night.

Essential Oils: Rating - 9, temporary AND healing relief!
This has been revolutionary in my 4th pregnancy with PUPPPs! I wish I had experimented with it in earlier pregnancies! I made a blend of peppermint, lavender, geranium, frankincense, myrrh, eucalyptus, tea tree, and ylang ylang essential oils. The cooling effect of the oils calms the itch immediately and keeps it calm for hours and hours. The anti-inflammatory properties of all the oils seems to heal the rash! It's awesome!! Here's a link to my recent, thorough explanation of this treatment and a recipe for the blend: Click HERE.

Not-So-Natural Things I've Tried:

Sarna Cream: Rating - 2, temporary relief

This lotion, found at most drugstores, uses menthol and camphor to calm itches. Unfortunately for me, it brought little relief. I would describe it as a mild cooling effect that lasted roughly 5 minutes.

Benadryl: Rating - 1, neither temporary or healing relief
I noticed absolutely zero reduction in symptoms from benadryl pills, either 25 mg or 50 mg doses.

Over the counter hydrocortisone cream: Rating - 3, healing relief
I've found that this brings mild relief. It is NOT an instant relief, but if used consistently, I noticed a slight reduction in the intensity of the itch. I would estimate it took 3-5 days to notice any effect.

Benadryl cream: Rating - 1, neither temporary or healing relief
Again, similar to the pill form, I found zero relief from this antihistamine cream.

Vistaril (hydroxyzine): Rating - 1, neither temporary or healing relief
This heavy-duty prescription antihistamine did nothing for me. It was intended as a sleep aid, and it didn't work for me. The thought is that it makes you sleepy enough that the itch doesn't wake you up. I noticed zero improvement in my sleep from this pill.

Prednisone: Rating - 5, healing relief
Sadly, this nasty steroid did work for me, but my experience was brief. 2 days before giving birth to my first baby, I broke down and took this. By the time I went into labor, I did notice a big drop in the itch. I was feeling much better. I stopped the drug after my girl was born, and the itch did return, though not as intensely for about a month. Talk to you doctor or midwife extensively and give careful consideration before you go forward with this steroid.

Topical triamcinolone 0.1%: Rating - 7, healing relief
This is a topical steroid that was my saving grace with Baby #3. Within 2-3 days of starting treatment, I found a huge reduction in the symptoms. I was more comfortable with this than taking oral Prednisone, because the general opinion of the medical world is that less of the drug gets into your system when it's applied to your skin versus taking a pill. I still had flare-ups periodically, but I would just increase my usage temporarily, and it would calm things down. However, though I didn't notice any side-effect for myself, my baby was born was some serious yeast issues. She had yeast in her diaper area, arms pits, and neck folds until she was roughly 9 months old. Steroids suppress your immune system and allow bad bugs like yeast to grow. It is my understanding that the steroids caused my natural flora (my personal collection of bacteria on my skin, in my gut, and even in my birth canal) to change. Thus, when my baby was born, she was colonized with more bad bacteria than good. We spent months battling this yeast. I will tell her story in more detail in a future post. For now, please know that steroids have side effects worth considering before using them. I learned my lesson with baby #3 and have done everything possible to avoid taking them with this current pregnancy rash. 

Alternative Treatments on my list of things to try:

Chinese Medicine 7 Star Needle: Rating - 4, temporary & healing relief
This is a bizarre one! I recently found out about this treatment through puppps.org. It uses a Chinese medicine device designed to treat hives. Here's a pic...

Crazy looking, no? Apparently, you tap the hive until it starts to bleed, and then that hive NEVER itches again. The testimony on puppps.org is really compelling!!! Otherwise, I don't think I'd even consider this treatment! You can find videos on youtube if you want to see the treatment in action. I'm currently building up the courage to order one from amazon. I'll let you know! UPDATE: I tried it!! Click HERE for the review!

Black Cherry Juice: theoretical healing relief UPDATE: rating - 4, healing relief
Apparently this juice is supposed to heal the rash due to its anti-inflammatory properties. A little juice drinking in exchange for rash healing sounds awesome! I think I found this one on a babycenter forum. I'll keep you posted! UPDATE: see THIS POST for my experience trying the Black Cherry Juice remedy!

PUPPPs...alternate acronyms

PUPPPs. It stands for Pruritic Urticarial Papules & Plaques of Pregnancy.

What a mouthful. 

Pruritic means itchy. 

Urticarial means hive-like.

Papules means raised, hard puffy spots on the skin. 

And plaques are just abnormal spots on the skin. 

So really, it means...strange itchy, puffy hives of pregnancy. 

I think they could have done better than that. But if they are going to use PUPPPs, here are my suggestions for what it SHOULD stand for...

Phenomenally Ugly Pink & Purple Pimpley-things

Persistent Ultra Painful Peculiar Protuberances

Person Uncontrollably Prone to Picking & Pouts

Perilous Unbearable Perplexing Persistent & Prickly

Pregnant Upset Pitiful Panicky Person

Puzzling Ugliest Psychotic Preposterous rash of Pregnancy

Powerful Unpredictable Pervasive Puffy rash of Pregnancy

Any other suggestions? I think the medical community could use them!

A Really Helpful Page

One of the sites I've found to be a great resource is Naomi Kritzer's page all about PUPPPs. She has listed every remedy she's heard of and talks about the effectiveness of each. She gave me the go ahead to post a link.

Here's the Link.

Hope it's helpful to someone out there!

The Dermatologist

What I'm about to relate is probably a common experience for PUPPPs sufferers. Now you'll know you're not alone!

During my 3rd pregnancy with PUPPPs, I was at the end of my resolve to avoid steroids and headed into a dermatologist appointment. My PUPPPs was the worst it has ever been. Having to put on socially acceptable clothing for the appointment had been torture. I couldn't even fill out the admission forms without setting down the clipboard to scratch. I could feel the eyes of the other patients in the waiting room on me and my squirmy self.

When they called me back, the nurse felt so bad for me that she immediately went to find some ice packs to get me through the appointment. As I cooled the burning itch, more and more people kept filing in to the exam room.

I was feeling a bit like a spectacle! 

Apparently, PUPPPs is rare enough that many of the staff hadn't seen it! There were a couple different nurses, two or three doctors, and a nurse practitioner. They Oooed and Ahhed. They all expressed how sorry they were for me. And then they all consulted on what to prescribe.

That wasn't exactly confidence inspiring. I went home with my steroid and got into a routine of "slathering" it on. But that's a story for another day.

Going along with feeling of being a spectacle at the dermatologists...

When I was 16, I had a horrible zit. Oh, it was bad. My mom actually let me skip school and ballet class. It was on the very tip of my nose. I was giving Rudolph a run for his money. My mom felt so sorry for me that she took me right in to the dermatologist that day. The doctor was an older man. I got the impression that he'd been practicing for decades. He came in and sat down without glancing up at me.

But when he did? Oh my.

He actually exclaimed. Loudly. His exact words were "That's the biggest one I've ever seen!" The dermatologist that had been practicing for decades said my zit was the biggest he'd ever seen!!

The biggest zit he'd ever seen. Wow.

I was a strange combination of mortified and gratified. I may have had a horrific growth on my beak, but at least I wasn't overreacting! He proceeded to get out some kind of medical binoculars, tilt my head toward the light, and go in for a close up. Talk about a spectacle. It wasn't exactly a boost to my teenage self-esteem. I must have recovered somehow, but visiting the dermatologist for PUPPPs definitely brought back old memories!

My PUPPPs Story: Baby #2

When we found out we were expecting again, I wasn't too concerned about PUPPPs. Everything I read said that it was a first pregnancy thing and rarely reoccurred.

Well, at 22 weeks, I defied statistics. It was back. I was extremely distraught at the thought of facing the rash for last 18 weeks of the pregnancy. I barely survived the 4 weeks at the end of the last pregnancy! There were many tears. 

Interestly, the rash appeared in the EXACT same spot that it had started in the first place, on my upper torso. It slowly spread in a very similar manner until it covered my entire body except my face, palms, and soles of feet. I was taken over by red itchy bumps. 

This time around, we had moved, and I had a new midwife, whom I LOVED! She spent so much time with us, listened so well, and became a friend. She had ideas on PUPPPs that my previous midwife didn't even mention! From her research and experience, PUPPPs seemed to be related to liver function. She recommended I start dandelion root tincture, milk thistle tincture, and yellowdock tincture. She was comfortable with those herbs in pregnancy and said I needed to start cleaning my liver. She also recommended putting a little lemon in my drinking water, another gentle liver cleanse. 

I started immediately. 

The rash continued to my least favorite stage. The Can't-Sleep-at-Night Stage. I can cope pretty well until it gets to that stage. Once it's keeping me up at night, I begin to loose it. 

That's when I pulled out all the stops. Out came the bizarre remedies. There were many trips to a couple different acupuncturists. No luck. I got muscle tested by a practitioner that then recommended a bunch of supplements that had unknown safety in pregnancy. I didn't take them since I was unsure. Again, another dead end. I tried charcoal poultices. What a mess. That deserves it's own post. I tried pine tar soap. I tried sulfur soap. I tried Sarna cream. There were even banana peels in there somewhere. I tried sunbathing. (It was February!!) I tried it all. 

I was using my cooler of ice packs at night (see here for more info on ice packs) to get a little more rest than I would otherwise be getting. Nothing seemed to be helping. 

Then, a couple weeks after the rash had reached the keeping me up at night stage, it faded. 

I wish I could say I knew which thing helped. My best guess is that the liver tinctures slowly took effect. 

The rash continued until delivery. Sometimes it was worse, but mostly, it was tolerable. After the initial miserable month or so, things settled down. I was sleeping at night again. I stayed on the tinctures through the whole pregnancy, just in case. 

I was so thankful for my support system through that pregnancy. My midwife was very patient to listen to my rash saga at every visit. She continued to research it for me and suggest new things to try. She wouldn't have looked down on me if I had decided to go the mainstream route and do steroids. But with her help, and my husband's support, we made it through another pregnancy with PUPPPs and had another beautiful girl.

By this point, I realized I might be facing the rash again when we got pregnant again. I dreaded it, but was excited for more children. Little did I know, next time it would start at 15 weeks! 

What is PUPPPs?

Let's go over the basics for any newcomers to this rash. 

Pruritic Urticarial Papules and Plaques of Pregnancy. 

Translation? Red, puffy CRAZY itchy rash for pregnant women. 

Some people abbreviate it PUPPs, but as far as I can tell, the medical professionals use PUPPPs or just PUPPP. In the UK, it is sometimes called PEP (polymorphic eruption of pregnancy). 

Why they can't come up with a better name, I don't know! It's a mouthful to explain and you get pictures of puppies when you google it. Ridiculous. 

About 1 in 160 pregnant women get it. (source) It typically starts in the 3rd trimester and resolves within a month or two of baby's arrival. For some women, it starts on stretch marks and moves outward, but it really can start anywhere. The people who should know have no good idea what causes it. Theories range from baby DNA irritating skin to some kind of inflammatory process relating to stretching skin. The alternative medicine world believes it has something to do with our livers not handling pregnancy hormones well. Maybe it's all 3! Who knows. But until better studies are done, we are in the dark. The itchy, scratchy dark. 

Here are a few pictures of my rash in various stages (I didn't take pictures of my worst rashes. I think I was too overwhelmed and disgusted):

Here are a couple photos from another miserable momma who gave me permission to post these. 

If that looks familiar, you may very well have PUPPPs. I highly recommend a visit to your care provider. And I'm so sorry!

Treatments in the mainstream medical world typically involve steroids and strong antihistamines. They do help some people, though potentially serious side effects exist. That is worth significant thought. I used steroids with baby number three (#3's Story) and had a normal kiddo with some serious yeast issues. Yeast growth is one of the less serious side effects of steroids.

Alternative therapies are numerous and varied! Some include Grandpa's Pine Tar soap, Dandelion Root, various creams and lotions, etc. I will do my best to cover all the options to keep you informed! I have tried almost everything! (See my survival tips label on the right to find them all in one place. If you are using the mobile version, click on "web version" at the bottom of the page to view the labels. Here is my post about Treatments I Tried.) 

Wherever you are in your PUPPPs journey, I hope you find some helpful relief tips here! 

I really enjoy chatting with other PUPPPs sufferers and hearing their stories, so please feel free to comment on any of my posts! I also love it when people vote on my polls! (FYI: Once again, you have to be in the website version of my blog to see them. If you're in the mobile version, just scroll down to the bottom and click on "web version.")

Hot & Cold Shower Treatments

I'm pretty sure we're all familiar with the relief that a cold shower brings to PUPPPs, but I've found a twist that could actually help beat back the rash. 

Hot AND cold showers. Here's what I've gathered from my reading. It's all pretty common sense. 

A hot shower increases circulation in our skin. You know how your skin gets red under the hot water? That's the body bringing more blood to the surface and opening up those tiny blood vessels (capillaries) right beneath the top layers. 

Our blood is like a big bus. It carries everything our body needs and doesn't need to the various organs and cells. Good things and bad things hop on the bus and travel around. When you want healing to take place, you need that bus working efficiently and frequently. So how do you get it to take more trips to your rash?

After getting comfortably warm in a hot shower, turn the water as cold as you can stand! The hot water brought lots of blood to the surface, and the cold water does the opposite. It forces all that blood back to the center of your body, carrying with it toxins and junk from your skin. Your blood will take it to your various waste eliminating organs (so make sure those organs are functioning well! More on that to come in future posts!). 

According to the various sources I've read, one cycle with the hot and cold water is great, but six or seven cycles are even better. Wash that skin from the inside and out! 

Here's a quick recap on how to do it:

1) Get nice and toasty first in comfortably warm water. Make sure your whole body gets evenly warmed. 

2) Turn the water as cold as you can take it and stay in it until your skin is cooled down all over. 

3) Repeat this cycle 5-10 times, and always end on a cold cycle. 

Personally, if I didn't have PUPPPs, I wouldn't have the guts to do this. But my PUPPPs makes it feel SOOOO good. The hot water feels like it scratches the itch everywhere it touches. SO satisfying! And then the cold water chills it down and calms the itch. It's a huge improvement on the cold shower alone. I highly recommend it! Plus, it's one of those things that can't really hurt to try. But PLEASE PLEASE be sensible about the hot water temperature! NO overheating & hurting that little one inside you. Listen to your body about how hot to get the water, and switch to cold before you overheat. 

Happy showering, folks! 

Here are a few links in case you'd like to do further reading: 

Hydrotherapy

The James Bond Shower

Alternating hot and cold showers for health benefits

Hot & Cold Hydrotherapy Treatment

Once, again, please use good judgement on the water temp!!