What are postpartum hives?

The postpartum period can be challenging for most new mothers, especially those with no support system. New mothers are generally so focused on their babies that their own health takes a backseat. In the days following your delivery, there are many hormonal changes that take place, which can have an impact on your health. Postpartum hives are a common problem that many women experience after giving birth. Here's everything you need to know about postpartum hives.

Hives, or urticaria, occurs on the skin as swollen or raised pale red bumps or plaques on the skin.[1] They can also be skin-colored. They tend to appear all of a sudden and are usually caused as a result of an allergic reaction. Sometimes the cause remains unknown. Hives are also commonly known as welts, weals, or nettle rash.

During pregnancy, the body naturally suppresses its immune system so that the growing fetus does not get rejected during pregnancy. Due to this process, it also shifts the normal sensitivities of the body. When the body is immuno-suppressed, it is incapable of effectively fighting off allergens and any inflammatory things that can cause the body to react, including foods or environmental allergens.[2] 

Hives develop when the body's already weakened immune system reacts to specific allergens and, as a result, releases a protein known as histamine and other chemicals into the bloodstream.[3] Histamine causes the blood vessels to swell up, allowing the plasma to leak or spill into the skin. When this plasma starts to build up in the skin, it leads to inflammation and causes an itchy rash to appear on the skin's surface.[4] 

Postpartum hives are often observed on the feet, arms, and back. The reasons why some women develop hives after giving birth vary from person to person. Still, high levels of stress associated with having a new baby and hormonal changes are believed to be the common causes of postpartum hives.[5]

Some people also refer to postpartum hives as PUPPP, which stands for pruritic urticarial papules and plaques of pregnancy. However, PUPPP is not the same as postpartum hives because PUPPP is an itchy rash that manifests itself on the stretch marks of the stomach during the last trimester of the pregnancy.[6,7]

See: Ayurvedic Treatment For Skin Disorders

Causes of Postpartum Hives

While stress and hormonal changes are known to be the most common causes of postpartum hives, there are various other causes as well that may trigger hives after delivery. These include:

·        An underlying illness or disorder, such as an overactive or underlying thyroid[8]

·        Insect bites 

·        Seasonal allergies[9]

·        Medications such as penicillin or aspirin[10,11]

·        Exposure to extreme weather conditions, such as direct sun exposure or extremely cold conditions

·        Food sensitivities

There are no studies at present that can indicate how common postpartum hives are, but it is expected that this condition affects nearly 20 percent of women after they give birth.[12] 

As the causes listed above indicate, the chances of a woman developing hives after giving birth are just the same as they would be at any other time. After all, if a person has particular food sensitivities or allergies, then this trigger will always cause an allergic reaction, regardless of whether they have given birth or not.

See: Case Series Showing Efficacy of Virechana Therapy for Hives or Urticaria

Postpartum hives symptoms

The symptoms of postpartum hives tend to vary from person to person, but may include:[13]

·        Red bumps or swelling on the skin's surface

·        Raised welts on the skin's surface

·        Blanching of the skin - you may observe the affected areas of the skin become white or very pale

·        Moderate to severe itching

·        Scaly skin 

·        Burning sensation

·        Pain in the area where the bumps are visible

See: Treatment of Hives with Acupuncture and Traditional Chinese Medicine

Natural treatment of postpartum hives

Treatment of Postpartum Hives

In general, postpartum hives do not need any medical treatment and tend to resolve by themselves in a few weeks. 

Postpartum hives generally last for five to six weeks, but if even after six weeks, they do not get better, or they become episodic and start occurring every few months, then you will need to see a doctor. Episodic hives that arise over months and years is known as chronic hives, and every time you experience a breakout, it is known as a flare-up or an episode of hives.[14] 

It is useful to see a dermatologist to rule out any underlying health condition, such as an infection. Health conditions such as thyroid disorder, diabetes, or rheumatoid arthritis can also cause chronic hives. You will need to undergo further medical testing to determine if these are the cause of your chronic hives.[15] 

There are various things you can practice to alleviate the symptoms of pain, itching, or burning that may be associated with postpartum. Here are specific suggestions that can help you get relief from your symptoms:

· Even though you have a new baby to take care of, you must take enough rest and look after yourself to avoid anxiety and stress. 

· Wear light and breathable clothing to allow your skin to breathe. It's best to wear loose-fitting cotton clothes.

· Keep yourself well-hydrated. Water is vital for your skin. It helps maintain moisture and keeps the skin healthy by flushing out toxins from the body.[16] 

· Apply a cold compress to the itchy skin couple of times a day. Using ice cubes wrapped in a cloth can help, but if cold temperatures are a trigger for your hives, then avoid doing this. 

· Prevent dry skin by using a moisturizer (fragrance-free, preferably) several times a day. 

· If you are going to be out in the sun, apply a good quality sunscreen lotion before you step out.[17] 

· There are several types of over-the-counter topical creams and lotions available that help soothes the welts. You can also request your doctor for a prescription ointment or cream. These topical creams help relieve the burning sensation as well. 

· Oatmeal is another great remedy for postpartum hives. Its anti-irritating, anti-inflammatory, and soothing properties offer rapid relief from itching and swelling.

· Apple Cider Vinegar: Apple cider vinegar is another fantastic remedy that you can try at home. It has antihistamine properties that provide relief from inflammation. It also regulates the body's immune system reaction.

· Chamomile: Chamomile is another safe herb for both you and your baby. Being a natural antihistamine and with anti-inflammatory properties, it alleviates swelling, itching, and inflammation.

· Calamine lotion: To treat skin rashes due to hives, calamine cream is also quite powerful. It can provide rapid relief from itching and hasten the healing procedure.

·Aloe Vera: For managing postpartum hives, aloe vera is extremely effective because of the anti-inflammatory, soothing and moisturizing properties.

· Turmeric milk: The anti-inflammatory spice turmeric helps stimulate the body's natural anti-inflammatory corticosteroids. Additionally, with natural antihistamine and antioxidant properties, it offers rapid relief from symptoms of hives.

· Manage your stress levels - stress has been found to be a significant trigger for causing hives. 

See: Functional Medicine treatments for Skin Diseases

Ayurvedic treatment for postpartum hives

The remedy to any allergic reaction is an anti-allergy medication prescribed by a doctor or natural antihistamines. In Ayurveda, a state named Sheetapitta is clarified, which bears similar indicators of Urticaria. It can be efficiently handled through the Ayurveda system of medicine. Though it isn't a life-threatening problem, it seriously affects the quality of life. 

Ayurveda views these to be the causative factors:

- Excess consumption of salty (lavana) and pungent (katu) food

- Excessive consumption of mustard (sarshapa sevana)

- Exposure to the cold wind (sheeta maruta samsparsha)

- Contact of cold substances (sheeta paneeya samsparsha)

- Day sleep (Diwaswapna)

As the factors indicate, Ayurveda views postpartum hives to worsened with exposures to the cold breeze. Vata and Kapha doshas are aggravated and consequently, they're mixed up with pitta dosha. Further, they spread throughout the body and lodge in the outside surface of the body (beneath the skin) and create reddish rashes with extreme itching and pricking sensation. Therefore, the condition sheetapitta, resembling the qualities of Urticarial rashes is manifested.

Ayurvedic remedies for postpartum hives

- Don't eat any sweet food as sugar will make the itching worse, be it sugar, jaggery, or alcohol. You can have honey.

- Keep foods light and digestible to give your digestive system great flushing.

- Attempt to eat cooked split g (split beans ), bitter gourd, and pomegranate, since they have skin-soothing properties.

- Applying aloe vera pulp or infusion to the affected regions will also aid in reducing the inflammation.

- Prevent ghee or processed oil and instead use olive oil for cooking.

- Turmeric boosts the body's resistance and wellness quotient by a good deal. One teaspoon of turmeric mixed with a glass of milk should function to provide relief.

- Massage skin using room-temperature organic mustard oil for 15 minutes, then have a bath with a natural or castile soap with cool water.

Ayurvedic treatments for postpartum hives

- Body removal treatment (samshodhana)

- Avoidance of causative factors (nidana parivarjana)

- Oil massage

- Oral medications (shamanoushada)

- Yavakshara and saindhava lavana mixed mustard oil application

- Medicated oil prepared from the medication of Eladi gana

- Application of olive oil throughout the body.

Single herb usage

Single herbs recommended in Urticarial rashes:

Guduchi -- Tinospora cordifolia (Willd.) Miers.

Amalaki -- Emblica officinalis Gaertn.

Nimba -- Azadirachta indica A. Juss.

Parnayavani -- Coleus amboinicus Lour.

See: Foods for clear healthy skin

Are postpartum hives contagious?

Most causes of postpartum hives aren't contagious, but the cause of the hives has to be evaluated. There are viruses, bacteria, and parasites that can cause hives. Although allergies can cause hives, other things may also result in hives. Knowing the cause can help address ways to avoid this reaction and prevent the spread of hives.

- Allergic hives: Contact an allergen is the most common cause of hives. Allergic hives are not contagious. Common allergens that can trigger hives are pollen, insect bites, medicines, and foods.

- Infection-induced hives: Some fungal infections and bacterial infections can cause hives. Examples of these conditions include strep throat, colds, and mononucleosis. These kinds of hives themselves are not contagious, but when the condition that triggers them spreads, you also could develop hives should you develop the condition.

These infections can spread through poor hygiene, airborne germs from sneezing and coughing, and sharing eating utensils, contact with feces, or contact with the saliva of the infected individual. You are at more risk of developing a disease and getting hives if you have a medical condition that affects your immune system, are pregnant, are less than five years old or more than 65 years old, or have an undeveloped or suppressed immune system.

See: Cloudy urine during pregnancy causes & treatments

Summary

Postpartum hives can cause a lot of discomfort and stress in your life, especially when you are already anxious about taking care of your new baby. Stress and hormonal changes are believed to be the most common causes of postpartum hives. Managing your stress levels can help to a great extent in preventing postpartum hives. You can try indulging in activities that you enjoy, such as meditation, listening to music, or even a quick walk around the block to unwind at the end of the day. If you find your symptoms getting worse, then you should consult a dermatologist at the earliest.

See: Functional Medicine treatments for Skin Diseases

References

1. Zuberbier, T., 2003. Urticaria. Allergy, 58(12), pp.1224-1234.

2. Saarikoski, S., and Seppälä, M., 1973. Immunosuppression during pregnancy: transmission of azathioprine and its metabolites from the mother to the fetus. American Journal of Obstetrics & Gynecology, 115(8), pp.1100-1106.

3. Fedorowicz, Z., van Zuuren, E.J., and Hu, N., 2012. Histamine H2‐receptor antagonists for urticaria. Cochrane database of systematic reviews, (3).

4. Kaplan, A.P., Horáková, Z., and Katz, S.I., 1978. Assessment of tissue fluid histamine levels in patients with urticaria. Journal of Allergy and Clinical Immunology, 61(6), pp.350-354.

5. Deacock, S.J., 2008. An approach to the patient with urticaria. Clinical & Experimental Immunology, 153(2), pp.151-161.

6. Callen, J.P., and Hanno, R., 1981. Pruritic urticarial papules and plaques of pregnancy (PUPPP): a clinicopathologic study. Journal of the American Academy of Dermatology, 5(4), pp.401-405.

7. Matz, H., Orion, E., and Wolf, R., 2006. Pruritic urticarial papules and plaques of pregnancy: polymorphic eruption of pregnancy (PUPPP). Clinics in dermatology, 24(2), pp.105-108.

8. Dreskin, S.C., and Andrews, K.Y., 2005. The thyroid and urticaria. Current opinion in allergy and clinical immunology, 5(5), pp.408-412.

9. Mazzotta, P., Loebstein, R., and Koren, G., 1999. Treating allergic rhinitis in pregnancy. Drug Safety, 20(4), pp.361-375.

10. Epstein, E., 1951. Chronic urticaria following Penicillin therapy. California Medicine, 74(6), p.429.

11. Grattan, C.E.H., 2003. Aspirin sensitivity and urticaria. Clinical and Experimental Dermatology: Clinical dermatology, 28(2), pp.123-127.

12. Lawlor, F., 2014. Urticaria and angioedema in pregnancy and lactation. Immunology and allergy clinics of North America, 34(1), pp.149-156.

13. Carr, T.F., and Saltoun, C.A., 2012, May. Urticaria and angioedema. In allergy and asthma proceedings (Vol. 33, No. 3, p. 70). OceanSide Publications.

14. Kaplan, A.P., 2012. Treatment of chronic spontaneous urticaria. Allergy, asthma & immunology research, 4(6), pp.326-331.

15. Zauli, D., Grassi, A., Ballardini, G., Contestabile, S., Zucchini, S., and Bianchi, F.B., 2002. Thyroid autoimmunity in chronic idiopathic urticaria. American journal of clinical dermatology, 3(8), pp.525-528.

16. Wolf, R., Wolf, D., Rudikoff, D., and Parish, L.C., 2010. Nutrition and water: drinking eight glasses of water a day ensures proper skin hydration—myth or reality?. Clinics in dermatology, 28(4), pp.380-383.

17. Monfrecola, G., Masturzo, E., Riccardo, A.M., Balato, F., Ayala, F. and Di Costanzo, M.P., 2000. Solar urticaria: a report on 57 cases. American Journal of Contact Dermatitis, 11(2), pp.89-94.

See: Facial Acupuncture For Skin Rejuvenation

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