Pruritic Folliculitis During Pregnancy

First described in 1981, pruritic folliculitis (PF or PFP) is a relatively rare but benign skin condition that occurs in about one in three thousand pregnancies, according to a review article in the American Journal of Clinical Dermatology. That being said, some experts believed that the incidence of pruritic folliculitis of pregnancy may be higher because it could be misdiagnosed as bacterial folliculitis.

What Is Pruritic Folliculitis of Pregnancy?

The rash consists of several small red bumps (called papules) that may or may not be filled with pus (called pustules). In fact, the condition resembles acne, but the main difference is that there are no bacteria present in the bumps—in other words, the pustules are sterile. These bumps are usually on the shoulders, upper back, arms, chest, and abdomen, and may be very itchy. However, there is also research suggesting that some women may not experience any itchiness (contrary to the name of the rash; "pruritic" means "itchy").

Other conditions that may mimic pruritic folliculitis include bacterial folliculitis, pityriasis folliculitis, drug- or chemical-induced acneiform eruptions, or some other rashes specific to pregnancy (for example, PUPP or prurigo of pregnancy).

When Does Pruritic Folliculitis Develop?

Pruritic folliculitis of pregnancy typically develops in the second and third trimesters of pregnancy. It resolves spontaneously within two to eight weeks after delivery. The good news is that this rash is benign, and there are no scientific reports clearly linking this rash to any adverse effects on the baby.

Causes 

The cause of pruritic folliculitis of pregnancy is unknown. Some investigators believe it is caused by hormonal changes. It doesn't appear to be caused by abnormalities of the parent's immune system.

Treatment

Pruritic folliculitis of pregnancy is typically treated like mild acne. Benzoyl peroxide has been used with some success, but antibiotics are not needed. Oral antihistamines are used to treat itching. Low potency topical corticosteroids are also sometimes used, as well as ultraviolet B light therapy.

Be sure to discuss any medications (including anything applied to the skin) with your healthcare provider first, to ensure it is safe for the baby.

A Word From Verywell

The vast majority of pregnant people undergo skin changes during pregnancy, and while most are not concerning and go away after delivery of the baby, such as linea nigra, there are a select few that may pose a risk to the mother or baby. This is why it's important not to self-diagnose a skin problem during pregnancy. Get it checked out by your doctor.

Finally, if your dermatologist does diagnose you with pruritic folliculitis of pregnancy, be assured that there are treatments available and that while potentially a nuisance, the rash will go away eventually.