By Kelly J. Riibe | Updated January 2026

Kelly is a mom of four who has experienced pregnancy complications firsthand, including a severe postpartum case of PUPPs rash.

Quick Answer: PUPPs (Pruritic Urticarial Papules and Plaques of Pregnancy) is an intensely itchy rash affecting about 1 in 250 pregnant women. In my case, it started at 38 weeks with small red dots near my belly button, then exploded postpartum into a full-body rash that lasted nine weeks. While oral steroids helped the initial flare-up, ice water foot soaks were the only consistent relief I found for the burning sensation.

My PUPPs Story: An Unexpected Fourth Pregnancy Complication

By my fourth pregnancy, I thought I'd seen it all – swollen feet, endless nights of tossing and turning, and all-day morning sickness. My son went right up to his scheduled C-section (just three days before his due date), making those final weeks feel endless.

Then came PUPPs – a hideously itchy skin condition with a deceptively cute name.

When the Rash First Appeared (Week 38)

At 38 weeks pregnant, I noticed small pink and red raised dots clustering around my belly button. My doctor examined them and suggested they were hormone-related, recommending I leave them alone. With all the other late-pregnancy discomforts competing for attention, I dismissed the bumps and focused on waiting for my baby's arrival.

The Postpartum Explosion

After delivering my son via C-section, I was riding high on new baby bliss and hospital help. But on discharge day, those small red speckles had transformed into a full-blown blanket of rash covering my entire distorted belly.

The on-call OBGYN barely glanced at it, attributing the rash to surgical tape allergy. She handed me an over-the-counter ointment recommendation and sent me home without a second thought.

She was wrong.

Getting the Real Diagnosis: PUPPs

The rash kept spreading like wildfire. Hydrocortisone cream did absolutely nothing against the itchy lava creeping across my arms, legs, and neck.

At my two-week postpartum check-up, my obstetrician took one look at me, constantly scratching every limb while the rash radiated outward from my stomach, and immediately diagnosed PUPPs. Those tiny week-38 dots? They were the early warning signs.

What is PUPPs? It stands for Pruritic Urticarial Papules and Plaques of Pregnancy—a rare but intensely uncomfortable skin condition that causes severe itching and raised, red bumps.

The Relentless Itching: What It Really Felt Like

I itched everywhere except my palms and face. The rash migrated from my deflated postpartum belly to my chest, shoulders, hands, feet, and ankles. While the secondary flare-ups weren't as visually dramatic as the initial stomach explosion, they tormented me for weeks.

The worst spots: My knuckles and feet, especially at night. The sensation between my toes felt like fire ants biting me constantly.

What I Tried (And What Actually Worked)

My obstetrician prescribed an oral steroid that helped clear the initial stomach flare-up but barely touched the spreading discomfort.

I scoured online pregnancy forums and tried every remedy desperate moms swore by:

• Pine tar soap — The internet's miracle cure for PUPPs did nothing for my itching. It just made me smell like a campfire. My husband diplomatically called it "dirt-ish and campy." My toddler was more direct: "Mommy, you smell stinky."
• Oatmeal baths — No relief
• Cold compresses — Minimal help
• Sunshine — Didn't work
• Baggy clothing — Made no difference
• Aloe vera — Useless
• Ice water foot soaks — THE ONLY THING THAT WORKED. When the burning sensation between my toes became unbearable at night, I'd dunk both feet in ice water. This was the only remedy that gave me enough relief to get through nighttime baby feedings.

Why I'm an Unusual PUPPs Case

Most women who develop PUPPs fit a specific profile: first-time mothers, those who've undergone IVF, or women carrying multiples. I checked none of these boxes – this was my fourth pregnancy with no fertility treatments.

Additionally, while PUPPs typically appears during the third trimester and resolves after delivery, mine was subtle during pregnancy but erupted with a vengeance postpartum.

The Long Road to Recovery

Nine weeks postpartum, I was still itching. The angry red bumps and speckled patches were finally shrinking. I no longer needed ice baths to survive the night, and that pine tar soap sat abandoned in my shower corner like a failed experiment.

Fun fact: PUPPs always resolves eventually, but there's no firm schedule. For me, significant improvement took over two months.

Was It Worth It?

Every time I held my newborn son, the misery faded. Enduring uncontrollable itching was absolutely worth it for my little blessing.

That said, when he's old enough to complain about itchy bug bites, I plan to just roll my eyes at him. He has no idea what real itching feels like.

What You Need to Know About PUPPs

Who gets it: About 1 in 250 pregnant women

Risk factors:

• First pregnancies
• IVF/fertility treatments
• Multiple pregnancies (twins, triplets)
• Male fetuses (though not definitively proven)

Symptoms:

• Intensely itchy rash starting on the abdomen
• Red, raised bumps and plaques
• Spreads to arms, legs, chest, and other areas
• Spares the face and palms
• Worsens at night

Treatment options:

• Oral steroids (most effective for initial flare-ups)
• Antihistamines
• Topical corticosteroids
• Ice water immersion (my personal lifesaver)

Good news: PUPPs doesn't harm your baby and always goes away eventually (even if it takes weeks or months).

Need more support for pregnancy complications? Read about cholestasis, another intensely itchy pregnancy condition that requires immediate medical attention.

About the Author: Kelly J. Riibe is a mom of four who navigates the chaos of parenting with honesty and humor. She lives with her husband, four kids, a Jack Russell Terrier, and maintains a mildly curbed addiction to Diet Coke.