Common skin conditions during pregnancy can be classified into: hormone-related, preexisting, and pregnancy-specific. Hormonal changes during pregnancy may cause benign skin conditions including striae gravidarum (stretch marks); hyper-pigmentation (melasma); and hair, nail, and vascular changes. Preexisting skin conditions, such as atopic dermatitis, psoriasis, fungal infections, and cutaneous tumors may change during pregnancy. Pregnancy-specific skin conditions include pruritic urticarial papules and plaques of pregnancy (PUPPP), prurigo of pregnancy, intrahepatic cholestasis of pregnancy, pemphigoid gestationis, impetigo herpetiformis, and pruritic folliculitis of pregnancy. PUPPP seems to be the most common of these disorders.1

Antihistamines and corticosteroids are commonly used to manage pruritic skin conditions in pregnancy. PUPPP is treated with oral antihistamines and topical corticosteroids, while systemic corticosteroids are needed for severe symptoms. Prurigo needs to be managed with midpotency topical corticosteroids and oral antihistamines. Pruritic folliculitis is managed with topical corticosteroids, topical benzoyl peroxide, or ultraviolet B light therapy.1

Indian Aloe (Aloe barbadensis) contains over 200 naturally occurring nutrients such as vitamins, minerals, sugars, amino acids, enzymes and acids, which helps in the digestion. The products prepared from Aloe have several properties such as emollient, purgative, antibacterial, antioxidant, antifungal, antiseptic.2 Aloe vera can be used as a skin moisturizer and helps in skin hydration.3 Muco-polysaccharides bind moisture into the skin. The amino acids also soften hardened skin cells and zinc acts as an astringent to tighten pores. Aloe vera gives a cooling effect and also acts as a moisturizing agent.4

Almond oil [Oleum amygdalae] exerts anti-inflammatory, immunity-boosting and anti-hepatotoxicity effects. It can effectively treat dry skin conditions such as psoriasis and eczema. Almond oil has emollient and sclerosant properties and has been used to improve skin tone.5

Chaste tree (Vitex agnus castus) is known for its analgesic properties.6 Vitex also has anti-inflammatory and antioxidant properties.7

Rubia cordifolia, or Indian Madder, is used in blood, skin and urinary diseases. The herb has anti-inflammatory, antipyretic, analgesic, antiseptic, rejuvenating and tonic properties. Topical application of Indian Madder reduces edema, exudation and itching.8

Yashada bhasma (zinc) is a natural mineral used in traditional medicine for the treatment of various skin ailments. It has been found to inhibit bacterial growth on the skin and inflammation.9 Yashada bhasma is a traditional herbomineral preparation that has an important role in the normal functioning of skin. It affects the synthesis of collagen. Yashada bhasma has been described to have antimicrobial properties, and is known to improve complexion and moisture holding capacity of skin. It is also known to work as a rejuvenator.10 It has also been noted to relieve itching, eruption and burning sensation in eczema.11

A formulation containing aloe vera, almond oil, chaste tree, Indian madder and yashada bhasma has the potential to provide relief in pruritic skin conditions during pregnancy on account of the constituents’ antimicrobial, antiseptic, emollient, anti-inflammatory and antipruritic properties.

References

1. Tunzi M, Gray GR. Common Skin Conditions During Pregnancy. Am Fam Physician. 2007 Jan 15;75(2):211-218.
2. Khanam N, Sharma GK. A critical review on antioxidant and antimicrobial properties of Aloe vera L. International Journal Of Pharmaceutical Sciences And Research. Available from: http://ijpsr.com/bft-article/a-critical-review-on-antioxidant-and-antimicrobial-properties-of-aloe-vera-l/?view=fulltext. Accessed on April 9, 2018.
3. Bhuvana KB, Hema NG, Patil RT. Review of aloe vera. International Journal of Advanced Research 2014;2(3):677-91.
4. Sahu PK, Giri DD, Singh R, et al. Therapeutic and Medicinal Uses of Aloe vera: A Review. Pharmacology & Pharmacy 2013;4:599-610.
5. Ahmad Z. The uses and properties of almond oil. Complement Ther Clin Pract. 2010 Feb;16(1):10-2.
6. Arora V, Lohar V, Singhal S, Bhandari A. Vitex negundo: A Chinese Chaste Tree. International Journal of Pharmaceutical Innovations 2011;1(5):9-20.
7. Tandon VR. Vitex negundo: A Chinese Chaste Tree. Natural Product Radiance 2005;4(3):162-5.
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9. Verma SR, Sultana S, Thiyagarajan OS, et al. Yashad bhasma (Zinc calx) and Tankana (Borax) inhibit Propionibacterium acne and suppresses acne induced inflammation in vitro. Int J Cosmet Sci. 2014 Aug;36(4):361-8.
10. Datta HS, Mitra SK, Patwardhan B. Wound Healing Activity of Topical Application Forms Based on Ayurveda. Evid Based Complement Alternat Med. 2011; 2011: 134378.
11. Chandran S, Patgiri B, Galib R, Prasanth D. A Review through Therapeutic Attributes of Yashada bhasma. International Journal of Pharmaceutical & Biological Archives 2016;7(5):6-11.