Eczema during pregnancy and breastfeeding

Eczema is a non-contagious condition where your skin becomes dry and scaly and can feel itchy. Eczema is also known as atopic dermatitis.

If the first episode of eczema happens during pregnancy, it can be called an atopic eruption of pregnancy.

It can be a long-term condition that gets better, but then comes back again later. Eczema causes your skin barrier to weaken, which can make you more sensitive to irritants.

Eczema causes dry, scaly, itchy, red skin. It usually affects the:

• face
• wrists
• ankles
• insides of your elbows
• back of your knees

Atopy is a problem with the immune system that makes you more likely to have allergic conditions such as eczema, asthma and hay fever (allergic rhinitis).

You are more likely to have eczema if someone in your family has one of these conditions.

What are eczema triggers?

Eczema triggers are substances or conditions that lead to eczema flare-ups. Different people have different triggers.

There are some triggers you can't avoid, such as:

• weather changes
• low humidity
• other illnesses
• stress

Some common avoidable triggers include:

• making your skin too hot or being in rooms that are overheated
• perfumes or scented products such as make-up, skin lotions and laundry powder
• irritating materials such as wool, polyester or acrylic in your clothes
• swimming in chlorinated pools
• house dust mites, grass, pollen or animal dander
• washing your hands too often, which can damage your skin's protective barrier

It is important to know what your eczema triggers are and how to avoid them to prevent flare-ups.

Eczema is the most common skin condition you can develop in pregnancy. Some people have symptoms of eczema for the first time during pregnancy (known as atopic eruption of pregnancy), while others experience a flare-up during pregnancy.

You are more likely to get eczema symptoms in the first 2 trimesters of pregnancy. If you had eczema before you were pregnant, it may get better or worse during pregnancy.

While eczema can be uncomfortable, it does not affect fertility, risk of miscarriage, premature birth or birth differences. Your baby may be more likely to get eczema, asthma or hay fever if you or your baby's close relatives have eczema.

Will I still have eczema after my baby is born?

If your eczema started during pregnancy, it will usually get better after your baby is born. If you have eczema that began before pregnancy, you are likely to have future episodes. You can avoid triggers to try and prevent future flare-ups of eczema.

You can get eczema while you're breastfeeding. You can also have a flare of eczema on your areola or nipple due to irritation from breastfeeding.

Your doctor will diagnose eczema by examining your skin.

Some doctors may ask you to have a blood test, which can show an increase in a protein called IgE that is associated with eczema, hay fever and asthma.

Eczema in pregnancy is treated by improving your skin health and treating the skin irritation.

You can improve your skin health by:

• having one short shower a day and not making it too hot
• using soap-free wash
• putting on an emollient (moisturiser) once you are dry
• using a thick moisturiser at least twice a day to protect and improve your skin barrier

Medicines for eczema in pregnancy

Your doctor may recommend steroid creams or ointments for your eczema flare-ups.

They may also recommend oral antihistamines to reduce the itch. If you are having trouble sleeping because of the itch, ask your doctor if you can use an antihistamine at night that causes drowsiness.

If your eczema is severe, you may be referred to a dermatologist for steroid tablets or narrow Ultraviolet-B (UVB) phototherapy (light therapy).

If you take other medicines for eczema, speak to your doctor to check which ones are safe to take in pregnancy. Do this as soon as you start planning a pregnancy or when you find out you are pregnant. Some medicines don't have enough safety data for use in pregnancy.

Read more on medicines in pregnancy.

Medicines for eczema during breastfeeding

You can use emollients, steroid creams or ointments and UVB phototherapy while breastfeeding. Some medicines do not have information on their safety while breastfeeding, so it's important you speak to your doctor or pharmacist about your options.

If you have eczema around the areola or nipple, you can apply creams or ointments to this area. It is best to apply any creams or ointments after a feed and wipe them off gently before your next feed.

Read more on using medicines while breastfeeding.

You can prevent eczema flare-ups by avoiding triggers, such as those listed above, or those you notice for yourself. You can also follow the recommendations listed above to keep your skin healthy.

Mothersafe has a fact sheet about eczema in pregnancy and while breastfeeding. Call them on 1800 647 848 for advice on medicines in pregnancy and breastfeeding.

Languages other than English

Eczema Support Australia has fact sheets on eczema care, available in several community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

• The Koori Maternity Service (KMS) program provides access to holistic, culturally safe maternity care for Aboriginal and/or Torres Strait Islander peoples in Victoria.
• The Australian Breastfeeding Association has resources on breastfeeding for Aboriginal and/or Torres Strait Islander families.