What to know about severe itching during pregnancy

Dryness, stretching skin and eczema can itch, but intense itch without an obvious rash can also accompany a pregnancy-related liver condition that requires blood tests and maternity follow-up.

A visible rash helps narrow the possibilities. Dry, inflamed patches may occur with atopic dermatitis or contact dermatitis; raised transient welts occur with hives; and burrows or itch affecting close contacts can fit scabies. Skin stretching over the abdomen may also feel itchy.

Itching from intrahepatic cholestasis of pregnancy can be intense, may disturb sleep and often involves the palms and soles, yet the skin may look normal apart from scratch marks. The condition cannot be confirmed by appearance, so the maternity team may arrange liver-related blood tests.

Use lukewarm rather than hot water, apply a plain fragrance-free moisturiser, wear loose breathable clothing and place a cool compress on itchy areas. Keep nails short to reduce skin damage from scratching.

Contact your obstetric or maternity team before starting an oral antihistamine, medicated cream, herbal product or supplement. They can choose an option suited to the stage of pregnancy and examine any rash for a specific cause.

Seek same-day maternity advice for severe or worsening itch, itch on the palms or soles, or itch without a clear rash. Also report dark urine, unusually pale stools or yellowing of the eyes or skin promptly.

Contact maternity services urgently if your baby's movements are reduced or changed from their usual pattern. Emergency help is appropriate for breathing difficulty or swelling of the lips, tongue or throat.

Ask whether the distribution suggests a skin disorder or cholestasis, whether blood tests are needed or should be repeated if symptoms persist, which itch treatments are suitable during pregnancy, and what fetal-movement changes should trigger an immediate call.