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Rashes during pregnancy - Moisturizers come to the rescue

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eMediNexus    15 September 2018

Pregnancy is associated with complex skin changes on account of endocrinological, immunological, metabolic, and vascular alterations. More than 90% women experience skin changes during pregnancy. Dermatoses specific to pregnancy include atopic eruption of pregnancy, polymorphic eruption of pregnancy (syn. pruritic urticarial papules and plaques of pregnancy (PUPPP), pemphigoid gestationis, and intrahepatic cholestasis of pregnancy. Atopic eruption of pregnancy involves eczema in pregnancy, prurigo of pregnancy/prurigo gestationis, and pruritic folliculitis.1

Pruritus in pregnancy is often caused by dry skin.2 Most skin conditions associated with pregnancy tend to resolve postpartum and require symptomatic treatment only. Topical moisturizing agents and antihistamines are often advised in pregnancy associated pruritus.1

The pruritus can have adverse effects on sleep and quality of life, and might also lead to, or worsen, depression.2 Intense moisturization may thus be required to manage the dry skin conditions experienced during pregnancy.

Moisturizers are commonly used agents to manage dry skin as they may replace skin’s natural oils, cover tiny fissures in the skin, and provide a protective coat. They can also slow down the evaporation of the skin’s moisture, and maintain hydration.3 Moisturizers play a significant role in managing dry skin conditions and maintaining healthy skin. Several disorders that present with the generally recognized symptoms of dryness are treated when moisturizers are used on dry skin.4

Moisturizers are classified as occlusives, humectants, emollients and protein rejuvenators. Glycerin is a humectant. Humectants have the potential to attract water upon application to the skin and improve hydration of the stratum corneum.3 Glycerin has high hygroscopic property and occurs naturally in skin.5,6 Glycerin is an effective moisturizer and humectant and a potential skin protectant. It hydrates the stratum corneum, assists in absorption of water from the atmosphere and reduces the evaporation rate from the surface of the skin.7 A study in atopic dermatitis patients has also shown that glycerin-containing cream may be a suitable alternative to urea/sodium chloride in the treatment of atopic dry skin.8

Cocoa butter, on the other hand, is an excellent emollient and an effective moisturizer and skin softener.9 It is an FDA-recognized skin protection agent.10 Cocoa has antioxidants and anti-inflammatory properties.11 Cocoa butter contains fatty acids; it is a mixture of monounsaturated and saturated fatty acids and is commonly used in skin moisturizers.12 It penetrates deep-down into the skin and hydrates from within.13

These two agents may together provide intense moisturization to dry itchy skin during pregnancy and may prevent and/or relieve the itchy skin conditions commonly seen during pregnancy.

References

  1. Vora RV, Gupta R, Mehta MJ, et al. Pregnancy and skin. J Family Med Prim Care. 2014 Oct-Dec; 3(4): 318–324.
  2. Bergman H, Melamed N, Koren G. Pruritus in pregnancy: Treatment of dermatoses unique to pregnancy. Can Fam Physician. 2013 Dec; 59(12): 1290-1294.
  3. Lynde CW. Moisturizers: What They Are And How They Work. Skin Therapy Letter 2001;6(13). Available from: http://www.skintherapyletter.com/dry-skin/how-moisturizers-work/.
  4. Lodén M. The clinical benefit of moisturizers. J Eur Acad Dermatol Venereol 2005;19(6):672-88.
  5. Roussel L, Atrux-Tallau N, Pirot F. Glycerol as a Skin Barrier Influencing Humectant. In: Lodén M, Maibach H (eds). Treatment of Dry Skin Syndrome. 2012; Springer, Berlin, Heidelberg.
  6. Tucker R. What evidence is there for moisturizers? Available from: https://www.pharmaceutical-journal.com/files/rps-pjonline/pdf/pj20110416_cpd.pdf.
  7. Fluhr JW, Bornkessel A, Berardesca E. Glycerol — Just a Moisturizer? Biological and Biophysical Effects. Available from: http://www.scientificspectator.com/documents/personal%20care%20spectator/Glycerol%20a%20Moisturizer.pdf.
  8. Lodén M, Andersson AC, Anderson C, et al. A double-blind study comparing the effect of glycerin and urea on dry, eczematous skin in atopic patients. Acta Derm Venereol. 2002;82(1):45-7.
  9. Duke JA. The Green Pharmacy Anti-Aging Prescriptions: Herbs, Foods, and Natural Formulas to keep You Young Anti-aging prescriptions.
  10. Correa MCM, Nebus J. Management of Patients with Atopic Dermatitis: The Role of Emollient Therapy. Dermatol Res Pract. 2012; 2012: 836931.
  11. Scapagnini G, Davinelli S, Di Renzo L, et al. Cocoa Bioactive Compounds: Significance and Potential for the Maintenance of Skin Health. Nutrients. 2014 Aug; 6(8): 3202–3213.
  12. Katz DL, Doughty K, Ali A. Cocoa and Chocolate in Human Health and Disease. Antioxid Redox Signal. 2011 Nov 15; 15(10): 2779–2811.
  13. Leng MS, Njinkoue JM, Ndjouenkeu R. Uses and quality assessment of cocoa butter sold in retail markets in Yaounde capital city, Cameroon. International Journal of Scientific & Engineering Research 2016;7(11):142-57.

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