From the Research
The treatment of polymorphic eruption of pregnancy (PEP) primarily focuses on symptom relief, especially the intense itching, with first-line treatment including topical corticosteroids and emollients, as supported by the most recent study 1. The goal of treatment is to manage symptoms until the condition resolves on its own, typically within days to weeks after delivery. Key considerations in treatment include:
- Topical corticosteroids of moderate potency, such as triamcinolone 0.1% or betamethasone valerate 0.1%, applied twice daily to affected areas, as mentioned in earlier studies 2, 3.
- Emollients and cool compresses to soothe the skin, which is a common recommendation across studies 2, 4, 5.
- Oral antihistamines like cetirizine 10mg daily, loratadine 10mg daily, or diphenhydramine 25-50mg at bedtime for severe itching, with diphenhydramine being particularly helpful for nighttime symptoms due to its sedating effects.
- In severe cases that don't respond to these measures, a short course of oral corticosteroids like prednisone (starting at 20-40mg daily with a taper over 1-2 weeks) may be necessary, although this is less commonly recommended and typically based on clinical judgment. It's also important to reassure patients that PEP is a benign condition that doesn't affect the fetus, as consistently reported across the studies 2, 4, 3, 1, 5. Lifestyle adjustments such as avoiding hot showers, wearing loose cotton clothing, and maintaining cool ambient temperatures can help minimize exacerbation of symptoms. Given the self-limiting nature of PEP and its resolution postpartum, treatment should focus on symptom management rather than attempting to cure the condition, as emphasized by the most recent and highest quality evidence 1.