From the Guidelines
Topical treatments for pruritus during pregnancy are preferred to minimize systemic absorption.
Recommended Topical Treatments
- A mild over-the-counter topical steroid such as hydrocortisone 1% cream or ointment can be used for short periods, typically up to 7-10 days 1.
- For more severe itching, a topical antihistamine or antipruritic like diphenhydramine 1% cream or calamine lotion may be considered 1.
- Emollients can be used to prevent dryness of skin, and cooling gels (e.g., menthol gels) can be applied to affected skin areas 1.
- It's essential to avoid using topical steroids on the face, neck, or areas of thin skin, and to use the lowest effective potency and quantity necessary to control symptoms.
Important Considerations
- If itching persists or worsens, consult a healthcare provider for further evaluation and guidance 1.
- Systemic treatments such as ursodeoxycholic acid (UDCA) may be considered for severe cases of pruritus, but topical treatments are generally preferred as first-line therapy 1.
From the FDA Drug Label
Uses temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to: eczema psoriasis poison ivy, oak, sumac insect bites detergents jewelry cosmetics soaps seborrheic dermatitis temporarily relieves external anal and genital itching Directions for itching of skin irritation, inflammation, and rashes: adults and children 2 years of age and older: apply to affected area not more than 3 to 4 times daily PRINCIPAL DISPLAY PANEL - 28.4 g Tube Carton TopCare health ™ MAXIMUM STRENGTH • OUR PHARMACISTS RECOMMEND • NDC 36800-099-02 Hydrocortisone 1% Cream ANTIPRURITIC (ANTI-ITCH) Intensive Healing Formula † NET WT 1 OZ (28.4 g)
The topical treatment for pruritus is hydrocortisone 1% cream 2, which can be applied to the affected area not more than 3 to 4 times daily 2.
- Key uses: temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to eczema, psoriasis, poison ivy, oak, sumac, insect bites, detergents, jewelry, cosmetics, soaps, and seborrheic dermatitis 2
- Important consideration: for external anal and genital itching, and for children under 2 years of age or under 12 years of age, ask a doctor 2
From the Research
Topical Treatments for Pruritus during Pregnancy
There are limited studies that provide evidence on the effectiveness and safety of topical treatments for pruritus during pregnancy. However, some studies suggest the following:
- Topical corticosteroids are considered a treatment of choice for localized psoriasis during pregnancy 3
- Other topical agents, such as topical tar products and topical tazarotene, should be avoided during pregnancy due to unclear risks of teratogenicity 3
- Topical medications have little systemic absorption and are considered safer than oral or parenteral agents, but their safety profile must be assessed cautiously due to limited available data 4, 5
- There is a need for well-designed randomised controlled trials to evaluate the effectiveness and safety of topical pharmacological interventions for treating pruritus in pregnancy 6
Safety of Topical Medications during Pregnancy
Some studies provide recommendations on the use of topical medications during pregnancy, including:
- Topical anti-scabies and anti-lice therapy can be used in pregnancy, but with caution and careful assessment of the safety profile 4
- Topical dermatologic medications can be used in pregnancy, but with careful consideration of the potential effects on the fetus 5, 7
- Pruritus in pregnancy requires a thorough work-up and consideration of the diagnostic tests and choice of treatment to minimize potential effects on the fetus 7