Does atopic dermatitis (eczema) worsen or improve during pregnancy and why?

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Last updated: May 29, 2025View editorial policy

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From the Research

Eczema can either improve or worsen during pregnancy, with the outcome largely dependent on individual factors such as hormonal changes and immune system responses. The management of eczema in pregnancy is crucial to minimize its impact on both the mother and the fetus. According to the most recent study 1, eczema is a common condition in pregnancy, and its management requires a careful approach to avoid harming the fetus.

Factors Influencing Eczema in Pregnancy

  • Hormonal changes: Pregnancy increases cortisol production, which can have natural anti-inflammatory effects, potentially improving eczema symptoms 2.
  • Immune system changes: The immune system's shift during pregnancy can either exacerbate or alleviate eczema symptoms.
  • Stress and psychological factors: Increased stress during pregnancy can worsen eczema symptoms.

Safe Treatment Options

  • Moisturizers: Essential for maintaining skin hydration and reducing itchiness.
  • Mild topical steroids: Like hydrocortisone 1%, these are considered safe for use during pregnancy, as stated in 3.
  • Antihistamines: Such as loratadine or cetirizine, can be used for itching, but their use should be guided by a healthcare provider.

Practical Management

  • Using fragrance-free products to minimize skin irritation.
  • Wearing loose, cotton clothing to reduce skin friction and irritation.
  • Avoiding known triggers and taking lukewarm showers to manage symptoms.
  • Staying hydrated to help maintain skin health.

Avoiding Harmful Treatments

  • High-potency steroids and medications like methotrexate or cyclosporine should be avoided due to their potential harm to the fetus, as highlighted in 4 and 5.

The goal of managing eczema in pregnancy is to control symptoms effectively while ensuring the safety of both the mother and the fetus. This requires a balanced approach, considering the potential benefits and risks of different treatments, as discussed in 2.

References

Research

The management of severe eczema in pregnancy.

Clinical medicine (London, England), 2025

Research

Management of Allergic Skin Disorders in Pregnancy.

Immunology and allergy clinics of North America, 2023

Research

Topical Corticosteroids: Choice and Application.

American family physician, 2021

Research

Treatment of atopic dermatitis in pregnancy.

Dermatologic therapy, 2013

Research

Eczema in pregnancy.

BMJ (Clinical research ed.), 2007

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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