Eczema and Pregnancy Australia: Managing Eczema Symptoms During Pregnancy
Eczema and pregnancy in Australia is a topic many Australians find themselves researching at a time when they want clear, reassuring information — not anxiety-inducing uncertainty. Pregnancy changes the body in profound ways, and the skin is no exception. Some Australians find their eczema improves during pregnancy; others find it flares more frequently or more severely than before; and some develop eczema symptoms for the first time during a pregnancy with no prior history of the condition. Understanding eczema and pregnancy in Australia — why symptoms change, what triggers become more relevant during pregnancy, and what gentle skincare habits support skin comfort — gives a practical foundation for managing this period with as much confidence as possible, alongside appropriate professional guidance.
Can Pregnancy Affect Eczema?
Yes — pregnancy can affect eczema significantly, and eczema and pregnancy in Australia is an individual experience with no single predictable pattern across all women.
The immune system undergoes substantial changes during pregnancy — shifting its balance to protect the developing baby while maintaining maternal health. These immune shifts affect inflammatory skin conditions including eczema in ways that are highly individual. Some women find their eczema calms significantly during pregnancy — particularly in the second and third trimesters — while others experience their most significant flares during pregnancy, particularly in the first trimester.
Hormonal changes — including the significant rise in oestrogen and progesterone during pregnancy — affect skin hydration, skin barrier function, and inflammatory response. The direction of these effects varies between individuals, which is why eczema behaviour during pregnancy is so difficult to predict in advance.
Approximately 50% of women with pre-existing eczema experience worsening during pregnancy, approximately 25% see improvement, and approximately 25% experience no significant change. This variability means that personal experience during previous pregnancies is one of the most reliable predictors of what the current pregnancy may bring — but it is not guaranteed to repeat.
DermNet NZ provides detailed clinical information on pregnancy and the skin including the full range of skin conditions that can develop or change during pregnancy.
Why Eczema May Flare During Pregnancy
Hormonal Changes
The dramatic hormonal changes of pregnancy — particularly the sustained elevation of oestrogen and progesterone — affect the skin's barrier function, sebum production, and inflammatory response. In women whose eczema is sensitive to hormonal fluctuations, the sustained hormonal environment of pregnancy can trigger or maintain flare activity, particularly during the first trimester when hormonal changes are most rapid.
Skin Barrier Changes
The skin undergoes physical changes during pregnancy — stretching as the body changes shape, experiencing altered hydration levels, and responding to changed hormonal signals that affect barrier function. For women with pre-existing eczema whose barrier function is already compromised, these pregnancy-related barrier changes can further reduce the skin's ability to retain moisture and exclude irritants.
Stress and Sleep Disruption
Pregnancy — particularly first pregnancies — involves significant psychological adjustment, physical discomfort, and sleep disruption that accumulates across trimesters. As explored in the eczema and stress guide, stress affects eczema through multiple inflammatory pathways. The disrupted sleep of pregnancy — covered in the eczema and sleep guide — compounds this stress effect by compromising the overnight skin barrier repair processes that eczema-prone skin depends on.
Environmental Triggers
Pregnancy often brings changed living patterns — more time at home, changed dietary habits, different clothing choices, and altered routines — that can introduce new or increased exposure to eczema triggers including household cleaning products, fragranced personal care products, and environmental allergens.
Common Symptoms of Eczema During Pregnancy
The symptoms of eczema and pregnancy in Australia follow the same general pattern as eczema outside of pregnancy — but may present with greater intensity or in locations that weren't previously affected.
Itching. Itch is the most prominent and most disruptive symptom — and pregnancy eczema itch can be particularly intense, compounding the general itch that many pregnant women experience from skin stretching and increased blood flow to the skin surface.
Dry skin. Widespread skin dryness — extending beyond usual eczema sites — is common during pregnancy, particularly in the third trimester. The skin's moisture demands increase during pregnancy and may exceed what a standard moisturising routine provides.
Redness. Redness at eczema-affected sites — which may appear more pronounced during pregnancy due to the increased blood flow and vascular changes of pregnancy affecting skin appearance.
Flaking and scaling. Dry, scaling skin at eczema-affected areas — worsened by the reduced humidity of indoor environments and by the skin stretching that accompanies pregnancy physical changes.
Heightened sensitivity. Products and fabrics previously tolerated may cause increased irritation during pregnancy — the changed hormonal and immune environment of pregnancy can lower the threshold for skin reactivity.
Where Does Pregnancy Eczema Commonly Occur?
Hands
The hands are one of the most commonly affected areas — increased hand washing during pregnancy, contact with new cleaning and hygiene products, and the skin barrier changes of pregnancy combine to make the hands a frequent eczema site.
Arms
The inner elbows and forearms — classic atopic eczema locations — often flare during pregnancy, particularly during periods of stress and disrupted sleep. New involvement of the forearms and upper arms is also reported by some women whose eczema expands to new sites during pregnancy.
Legs
The lower legs and shins — where eczema can develop particularly in association with the circulatory changes of pregnancy — are frequently affected. Dry skin on the lower legs is extremely common during pregnancy and can be accompanied by eczema flare activity in women with a history of the condition.
Neck
The neck and upper chest are areas where pregnancy-related eczema commonly develops or worsens — possibly related to increased sweating, clothing contact, and the hormonal skin changes concentrated in the upper body during pregnancy.
Skin Folds
The skin fold areas — underarms, beneath the breasts, abdominal folds — experience increased moisture and friction during pregnancy as the body changes shape and sweating increases. These areas are prone to eczema and irritant contact dermatitis during pregnancy, particularly in the third trimester.
Pregnancy Eczema vs Other Pregnancy Skin Conditions
Several skin conditions specific to pregnancy can look similar to eczema — and accurate diagnosis is particularly important during pregnancy because management differs between conditions.
Atopic Eruption of Pregnancy
Atopic eruption of pregnancy (AEP) is the most common pregnancy-specific inflammatory skin condition — it encompasses eczema-like presentations that develop during pregnancy, including in women with no prior eczema history. AEP produces dry, itchy, eczema-like patches — often on the trunk, arms, and face — that are driven by the immune system changes of pregnancy. It is benign for both mother and baby but warrants professional assessment to confirm the diagnosis and discuss management.
PUPPP Rash
Pruritic urticarial papules and plaques of pregnancy (PUPPP) — also called polymorphic eruption of pregnancy — is a different condition producing intensely itchy raised bumps and plaques, typically beginning in the stretch marks of the abdomen in the third trimester and spreading outward. PUPPP can look similar to eczema but has a distinctive distribution and timing. It resolves after delivery and requires professional assessment to distinguish from eczema and other pregnancy rashes.
Contact Dermatitis
New contact dermatitis developing during pregnancy — from changed skincare products, new cleaning products, or altered product sensitivity — can produce eczema-like symptoms. The changed immune environment of pregnancy can make some women more susceptible to contact sensitisation during this period.
Psoriasis During Pregnancy
Psoriasis during pregnancy follows a different pattern from eczema — many women with psoriasis find significant improvement during pregnancy, particularly in the second and third trimesters, due to the immune shift of pregnancy. The psoriasis and pregnancy guide covers the psoriasis pregnancy experience in detail — the management considerations differ significantly from eczema and pregnancy.
Skin Care Tips During Pregnancy
Managing eczema and pregnancy in Australia through skincare focuses on the gentlest possible approach — particularly relevant during pregnancy when product safety considerations add an additional layer of complexity.
Use fragrance-free products throughout. Fragrance is the most common contact allergen and skin irritant — eliminating it from all cleansers, moisturisers, and body products during pregnancy removes one of the most significant eczema triggers while also addressing general skin sensitivity that increases during pregnancy.
Moisturise consistently and generously. The skin's moisture demands increase significantly during pregnancy. Applying a fragrance-free emollient after every shower or bath — while the skin is still slightly damp — and reapplying to dry or itchy areas through the day supports barrier function more effectively than a single daily application.
Choose gentle, pH-balanced cleansers. Harsh soaps and fragranced body washes strip the skin barrier and worsen eczema-prone skin. A fragrance-free, pH-balanced gentle cleanser maintains skin barrier integrity while meeting the increased hygiene awareness common during pregnancy.
Wear soft, breathable fabrics. Cotton and bamboo clothing next to the skin reduces friction and heat accumulation — both relevant triggers for pregnancy eczema. Avoiding tight, synthetic fabrics in areas prone to eczema reduces the sustained irritant contact that worsens flares.
Avoid known triggers where possible. Personal trigger avoidance — whether fragranced products, specific fabrics, heat, or certain foods — remains the most impactful practical management step during pregnancy as at other times.
Discuss any topical products with a healthcare professional. Some topical ingredients commonly used for eczema management are subject to additional caution during pregnancy — discussing specific products with a GP or dermatologist before use provides reassurance appropriate to the individual pregnancy context.
The moisturisers and creams collection at Australian Psoriasis and Eczema Supplies includes fragrance-free emollient options suited to sensitive skin during pregnancy — though individual product choices during pregnancy should be discussed with a healthcare professional.
Common Eczema Triggers During Pregnancy
Heat and sweating. Pregnancy increases body temperature and sweating — creating conditions that trigger eczema flares particularly in skin fold areas and during Australian summer. Staying cool, wearing breathable fabrics, and rinsing promptly after sweating reduces this trigger's impact.
Stress. The psychological demands of pregnancy — anxiety about the birth, changing relationships, financial considerations, physical discomfort — create sustained background stress that affects eczema through the inflammatory pathways stress activates.
Fragrances. Sensitivity to fragrance often increases during pregnancy — both through general heightened skin sensitivity and through the nausea that many fragrances trigger in the first trimester. Eliminating fragranced products during pregnancy benefits both eczema management and general pregnancy comfort.
Certain fabrics. Wool and synthetic fabrics that create friction and heat against eczema-prone skin worsen pregnancy eczema particularly as clothing fits more tightly in the second and third trimesters. Soft cotton maternity clothing reduces this sustained friction trigger.
Dry weather and indoor heating. Australian winter during pregnancy — with its dry indoor heating environments — creates the same low-humidity challenge for eczema-prone skin as at other times, but with increased moisture demands as the pregnant body requires more skin hydration overall.
When Should You Seek Professional Advice?
Professional assessment is appropriate during pregnancy when:
- Eczema symptoms are significantly worsening and not responding to gentle skincare management
- There is uncertainty about whether the skin condition is eczema, atopic eruption of pregnancy, PUPPP, or another pregnancy-specific rash — correct diagnosis matters for appropriate management
- Signs of secondary infection appear — increasing warmth, spreading redness, yellow crusting, weeping, or significant pain — as covered in the infected eczema guide
- Significant itch is disrupting sleep substantially and affecting daily functioning
- Questions arise about which specific topical products are appropriate during pregnancy
- Any prescription treatment for eczema is being considered — including topical corticosteroids, which require assessment of appropriate strength and duration during pregnancy
A GP or dermatologist can assess the specific presentation, confirm the diagnosis, and advise on management options appropriate for the individual's stage of pregnancy and eczema severity.
Frequently Asked Questions
Can pregnancy make eczema worse? Yes — eczema and pregnancy in Australia frequently involves worsening of symptoms, particularly in the first trimester when hormonal changes are most rapid. Approximately 50% of women with pre-existing eczema experience worsening during pregnancy, driven by immune system changes, hormonal shifts, stress, and sleep disruption.
Can eczema start during pregnancy? Yes — eczema and pregnancy in Australia can involve first-onset eczema, including through the pregnancy-specific condition atopic eruption of pregnancy (AEP). Some women develop eczema symptoms during pregnancy for the first time, with no prior history of the condition. New skin symptoms during pregnancy warrant professional assessment to confirm the diagnosis.
Does eczema affect the baby? Eczema itself does not directly harm the developing baby. However, children born to parents with eczema have a higher likelihood of developing eczema themselves — the genetic component of atopic eczema means it can be inherited. Managing eczema symptoms during pregnancy is primarily about maternal comfort and skin health rather than direct fetal impact.
Can eczema improve during pregnancy? Yes — approximately 25% of women with pre-existing eczema see improvement during pregnancy, particularly in the second and third trimesters as the immune system adapts to the pregnancy environment. The improvement is often not maintained after delivery, when the immune system returns to its pre-pregnancy state.
What causes itchy skin during pregnancy? Itchy skin during pregnancy has multiple possible causes — eczema flares, atopic eruption of pregnancy, PUPPP rash, skin stretching, increased blood flow to the skin, dry skin, and contact dermatitis are all common contributors. Persistent or severe itch during pregnancy — particularly in the third trimester — warrants professional assessment to identify the cause and rule out conditions requiring specific management.