A case of PUPPs cleared with homeopathic salt

Pruritic urticarial papules and plaques of pregnancy (PUPPs), otherwise known as Polymorpic eruption of pregnancy (PEP) is one of the most common conditions associated with pregnancy, and is characterized by urticarial papules and plaques with pruritus on the abdomen, buttocks and thighs. Although it can occur in other areas of the body. In most cases, the skin lesions develop in the third trimester and usually disappear within 7 to 10 days after birth.

It’s a rash that starts off as tiny, itchy red bumps in the stretch marks on the abdomen. It’s distinguishing characteristic is that it surrounds, but never affects, the navel. These little red bumps get bigger, forming large patches that spread down the legs, and up the chest. Eventually, most of the body can be covered in the itchy, eczema like rash. Conventional treatment consists of topical or oral corticosteroids.

Sarah came to see me when she was 30 weeks pregnant with a maddening itch all over her body. It was worse around her shins and her bump. She had been diagnosed with PUPPs in her last pregnancy too but this time onset was earlier at 28 weeks. Last pregnancy she developed it around 39 weeks, and continued to suffer with it for several weeks after the birth, which was very difficult on top of recovery from an emergency c-section.

This time Sandra was doing everything she could to shift the rash. There was no way she could face another 10 weeks of itching, she was ‘cracking up’. She was taking nettle, dandelion, and oat straw daily. Avoiding dairy, gluten and potatoes which seemed to aggravate the rash. And taking probiotics too. Sandra had also tried a homeopathic remedy called sulphur. None of which helped.

Sarah felt like her blood was bubbling she was so hot, burning up and sometimes red in the face. She was suffering from painful tightness and knots across her shoulders. Sarah was also anaemic and her energy levels were low, and she sometimes felt breathless.

The first remedy I prescribed was Apis mel 30c based on the appearance (rosy, red erysipelas, rough eruptions on skin) of the rash, sensation (itchy, burning), and modalities (<heat and warmth of clothes, room, bedding), excessive amniotic fluid (Polyhydraminos), and heartburn in pregnancy. The rash and itch improved for a couple of days but then came back.

Sarah described how she was feeling more emotional and tearful in her pregnancy, more sensitive to sad things, irritable at times, mood up & down. When I asked Sarah how she was expressing her irritability? She responded that she was ‘bottling things up’. Sarah said she usually only cries in private, and tries not to cry in front of her son. Sarah had feelings of sadness about her last birth which didn’t go as she wished. This emotional picture confirmed my next prescription - Natrum Muriaticum (Nat mur).

I recommended Sarah to take Nat mur 6c three times daily until improvement. A week later Sarah reported ‘rash has gone way down, still a bit itchy but much better. Having a couple of really itchy flare ups every now and then especially during the night...definitely feels like it’s working its way out, I’m delighted!’.

I recommended to continue taking Nat mur 6c. A week later Sarah sent a message saying rash has improved really well, although still a little bit itchy on my belly at night, but it is way better all round for sure!’. The following week I received a message from Sarah - ‘I’m delighted...I feel way less stressed....it’s great’.

At Sarah’s first follow-up 6 weeks later she was feeling good, the stress she was feeling for a few weeks had subsided. The rash was completely gone, but she still got a little itchy on her abdomen if she became hot and sweaty. Sarah couldn’t ‘believe how much it cleared’, and said ‘I’m feeling way less stressed, i was feeling miserable. I’m now back to myself, rash was one big stress. On Nat mur the stress lifted, my shoulders were killing me as well, so tense, but I feel a lot better now. It was a big shift.’

10 days later I received a message from Sarah saying the itch was coming back - ‘I'm very tired, and feeling a bit stressed so that probably brought it on’. I recommended Nat Mur 30c 3 times daily until improvement. After 2 days Sarah reported she was ‘definitely feeling better and less itchy, I am repeating it again today as I'm still just a tad itchy. But energy and stress levels way better!’.

Sarah remained rash free for the rest of her pregnancy and post-birth which allowed her to fully enjoy the final stages of pregnancy this time round.

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