Eczema and Pregnancy: What to Expect and How to Stay Comfortable

Pregnancy is a time of profound change—and not just emotionally or hormonally. Your skin goes through a transformation too. For those with eczema, or atopic dermatitis, pregnancy can either be a period of unexpected relief—or intensified flare-ups.

The unpredictability of eczema and pregnancy can be frustrating, especially when your treatment options suddenly become more limited. In this guide, we’ll cover how pregnancy affects eczema, what you can do to stay comfortable, and how to protect both your skin and your baby with safe, dermatologist-recommended approaches.

How Pregnancy Affects Eczema

Hormonal Changes

During pregnancy, the body undergoes major hormonal shifts, especially increases in estrogen and progesterone. These changes can influence how your immune system behaves—and because eczema is an immune-driven condition, flare patterns may change.

Interestingly, a study published in Archives of Dermatology found that approximately 50% of women with pre-existing eczema experience a worsening of symptoms during pregnancy, while about 30% report improvement (Ong & Tillmann, 2006).

Immune System Shifts

Pregnancy promotes a more Th2-dominant immune response to help protect the fetus. Since eczema is also driven by Th2 cytokines, this may exacerbate inflammation, itchiness, and barrier dysfunction.

Skin Sensitivity

Increased skin sensitivity and changes in sweat and sebum production can make pregnant women more vulnerable to irritation, heat rashes, and eczema flare-ups—particularly on the abdomen, thighs, neck, and chest.

Can Eczema Develop for the First Time During Pregnancy?

Yes. In fact, a condition called Atopic Eruption of Pregnancy (AEP) includes eczema-like symptoms and affects up to 5% of pregnant women, even if they’ve never had eczema before. This form typically appears early in pregnancy and may present as itchy patches on the trunk, limbs, or face.

AEP should be diagnosed by a healthcare provider, as it can be mistaken for other pregnancy-related dermatoses such as PUPPP or pemphigoid gestationis.

How to Manage Eczema During Pregnancy: A Safety-First Approach

Treating eczema while pregnant is a balancing act: you want effective relief without compromising your baby’s safety. The management strategy focuses on three pillars: lifestyle changes, safe topical therapy, and minimal systemic exposure. Here’s how to navigate it wisely:

1. Use a Gentle, Consistent Skincare Routine

Maintaining the skin barrier is your first line of defense. Choose products that are:

• Fragrance-free
• pH-balanced
• Free of essential oils and parabens
• Clinically tested for sensitive skin

NellaDerm’s NovaNella Eczema Stick is formulated specifically for eczema-prone, sensitive skin—offering deep hydration without any harsh chemicals, ideal for use during pregnancy.

2. Moisturize More Often

Pregnancy can cause skin to become dry and more reactive. Apply a rich moisturizer 2–3 times daily, especially after showering. Remember the “soak and seal” method: moisturize within three minutes of bathing to trap water in the skin. This prevents the hot water from evaporating and further drying your skin out.

Check out our blog about the best moisturizers for eczema.

3. Avoid Common Triggers

During pregnancy, your tolerance to triggers may shift. Common irritants include:

• Synthetic fabrics (choose cotton or bamboo)
• Scented body washes or shampoos
• Overheated rooms (use a fan or air conditioning to stay cool)
• Stress (which increases cortisol, aggravating inflammation)

Wear breathable cotton fabrics and switch to fragrance-free detergents and body products.

4. Opt for Safe Medical Treatments (In Consultation with Your Doctor)

While many standard eczema treatments are considered safe during pregnancy, always consult your doctor and dermatologist before starting or continuing any treatment. They will weigh the benefits against any potential risk using the most current safety guidelines. Some common options include:

Crucially, avoid oral steroids and high-potency topical corticosteroids unless prescribed and closely monitored by both your dermatologist and obstetrician.

Navigating the Itch: Safe, Non-Medical Relief Strategies

The itch associated with eczema can be unrelenting, and the desire to scratch can be overwhelming—but scratching further damages the skin barrier and increases the risk of infection. Here are safe, drug-free methods to minimize discomfort during your pregnancy:

Lukewarm Baths with Additives

While hot baths can dry out the skin, lukewarm soaks can be incredibly soothing. Consider adding:

• Colloidal Oatmeal: A finely ground oat powder that disperses in water and helps calm inflammation and relieve itch. This is a universally recommended, safe treatment for all stages of pregnancy.
• Baking Soda: Adding a quarter-cup of baking soda to bathwater can provide temporary relief from itching.

Limit soaks to 10-15 minutes, and always apply your moisturizer immediately afterward while the skin is still damp.

Wet Wraps and Cool Compresses

For localized, intense flares, wet wrap therapy can provide profound relief by cooling the skin and increasing the penetration of moisturizers or topical medications.

• Cool Compresses: Place a clean, cool, damp cloth directly over the itchy patch for 10-15 minutes. The coolness temporarily desensitizes the nerve endings and reduces the urge to scratch.
• Night-Time Gloves: Wear soft, white cotton gloves or socks on your hands at night. This protects the skin from damage caused by unconscious scratching during sleep.

Prioritizing Stress Management

Stress and anxiety elevate cortisol levels, which are inflammatory hormones that can directly trigger or worsen eczema flares. While you can’t eliminate all stress during pregnancy, intentional management is a powerful therapeutic tool:

• Mindfulness and Deep Breathing: Integrating short, daily meditation or deep breathing exercises can lower stress hormones.
• Gentle Exercise: Low-impact activities like prenatal yoga or a daily walk help reduce inflammation and improve mood. Be mindful to shower promptly afterward to rinse off sweat.
• Adequate Sleep: While challenging, prioritize sleep. Poor sleep directly contributes to increased inflammation and flare severity. Use antihistamines (if approved by your doctor) to help break the nighttime itch-scratch cycle.

What About Stretch Marks and Eczema?

Stretching skin on the belly can become extra itchy—especially when compounded by eczema. This is a common point of irritation, as the skin is under maximum tension. To reduce friction and irritation:

• Apply a gentle moisturizer after bathing to the belly and breasts.
• Use lukewarm water for showers to avoid stripping natural oils.
• Pat skin dry with a soft towel instead of rubbing, which can damage inflamed skin.
• Avoid tight clothing that rubs the midsection, opting for loose, seamless maternity wear.

Eczema and the Genetic Link: What is the Risk for the Baby?

One common concern for expecting parents with eczema is the risk of their baby developing the condition. Eczema has a strong genetic predisposition, but it is not a guarantee.

Understanding the Inherited Risk

The likelihood of a child developing eczema or other atopic conditions (like asthma or hay fever) is significantly increased if one or both parents have a history of atopy:

• One parent with atopy: The child has approximately a 25-30% chance of developing eczema.
• Both parents with atopy: The risk jumps significantly to 60-70%.
• No family history: The background risk is around 10%.

The Role of Filaggrin Gene Mutation

Dermatologists often discuss the filaggrin (FLG) gene mutation. This protein is essential for building a healthy skin barrier. If a parent carries a mutation in this gene, they are more likely to pass on the genetic vulnerability that leads to eczema and severely dry skin. This biological knowledge empowers parents to take proactive steps early on.

Proactive Postpartum Care

While there is no proven way to prevent the disease from developing, recent research suggests early intervention may minimize the severity or delay the onset of infant eczema. Your dermatologist may recommend:

• Daily Emollient Use: Applying emollients to a newborn’s entire skin surface daily from birth may help reduce the risk of eczema development in high-risk infants.
• Maintaining Skin Integrity: Avoiding harsh soaps and bathing in lukewarm water. A dermatologist can advise on the best infant skincare routine if there is a known family history.

Q&A: Eczema and Pregnancy

Q1: Will my eczema affect my baby?

No, eczema itself doesn’t harm the fetus. However, severe scratching or infection can lead to complications. Keeping the skin barrier healthy reduces these risks. This is why strict adherence to a safe treatment plan provided by your doctor is essential.

Q2: Can I use hydrocortisone cream while pregnant?

Yes, low-potency topical corticosteroids like 1% hydrocortisone are generally safe. Use the smallest effective amount and avoid prolonged use without medical supervision. Always clarify the product’s potency with your pharmacist or doctor.

Q3: Will my eczema go away after giving birth?

For some, eczema improves postpartum. However, hormonal fluctuations (especially the drop in estrogen), sleep deprivation, and the stress of new motherhood can also prolong or trigger severe flares. Stick to a consistent, gentle skincare routine and prioritize rest and self-care in the postpartum period.

Q4: Are Oral Medications Completely Off-Limits During Pregnancy?

No. While they are a last resort, some systemic medications may be necessary for severe, debilitating cases. For instance, oral corticosteroids may be used briefly for a severe, acute flare-up if the risk of uncontrolled disease is greater than the risk of the medication. Immunosuppressants like cyclosporine are also used in rare, refractory cases, but this always requires coordinated care between the dermatologist, obstetrician, and patient. Never self-prescribe or stop a prescribed medication without consulting your entire care team.

Eczema Postpartum: Navigating the “Fourth Trimester”

The postpartum period, often called the “fourth trimester,” brings its own set of challenges that directly affect eczema. The focus shifts from the health of the fetus to the demands of motherhood and the return to hormonal normalcy.

Hormonal Crash and Immunity Rebound

After delivery, there is a rapid drop in pregnancy hormones, particularly estrogen and progesterone. The immune system also shifts from the Th2-dominant state to a more balanced, or even Th1-dominant, state. This rapid change can act as a major trigger, leading to a significant increase in eczema flare-ups for many women in the first few months after giving birth.

Sleep Deprivation and Flare-Ups

New parents are notoriously sleep-deprived, and studies have established a clear link between chronic sleep disruption and increased systemic inflammation. Lack of sleep lowers the itch threshold, making minor irritation feel severe and exacerbating the itch-scratch cycle. Establishing a routine, even a fragmented one, and asking for help is vital to keep flares under control.

Eczema and Breastfeeding

If you choose to breastfeed, certain medications and skincare ingredients can pass through breast milk. This is an essential conversation to have with your care team.

• Topical Steroids: Low-to-medium potency steroids are generally safe while breastfeeding. The key is to avoid applying them to the nipple and areola area to prevent ingestion by the infant.
• Oral Medications: Oral antihistamines are often acceptable, but systemic medications like biologics require a careful risk assessment, though many are considered low-risk given their large molecular size, which limits transfer into milk.
• Nipple Eczema: Eczema on the breasts or nipples is common and often mistaken for thrush. A dermatologist can correctly diagnose this, often prescribing safe, barrier-repairing balms or low-potency topical steroids to be washed off before feeding.

Emotional Impact: You’re Not Alone and Resources are Available

Skin conditions during pregnancy can feel embarrassing, isolating, or frustrating—especially when they appear in visible areas like the face or arms. You’re not alone. Many mothers-to-be struggle with eczema-related sleep disturbances, confidence issues, or uncertainty about which products are safe.

Be kind to yourself. Managing eczema during pregnancy isn’t about perfection—it’s about reducing triggers and protecting your skin barrier. Talk to your healthcare provider about psychological support if the stress or lack of sleep is impacting your mental health. Connecting with support groups for mothers with chronic skin conditions can also provide validation and practical tips.

Final Thoughts

So, what’s the bottom line on eczema and pregnancy?

• Eczema may worsen, improve, or even develop for the first time during pregnancy.
• Hormonal and immune system changes often influence how your skin behaves.
• A consistent, fragrance-free, barrier-supportive skincare routine is your best ally.
• Treatments should always be guided by a healthcare provider—but many safe options exist, including low-potency topicals and phototherapy.
• Proactive care for your baby’s skin and managing postpartum flares are key to long-term success.

With the right care, products, and professional support, you can minimize discomfort and enjoy your pregnancy without the added stress of chronic skin inflammation.

Explore NellaDerm’s eczema-safe skincare, trusted by women at all stages of life—including pregnancy. Your skin deserves the same care you’re giving to everything else right now.

Table of Contents

• Eczema and Pregnancy
• How Pregnancy Affects Eczema
• First Time Eczema
• Managing Eczema
• Itch Relief Strategies
• Stretch Marks & Eczema
• Genetic Link
• Q&A Section
• Postpartum Care
• Emotional Impact
• Final Thoughts