After seven and a half delightful psoriasis-free years, I must admit I'd become a little bit complacent about my skin. One thing I vowed I'd never do is take clear skin for granted - twenty years of battling eczema and psoriasis, and speaking to people suffering with their skin on a daily basis has always reminded me how fortunate I am to be fully in control. I keep on top of my exercise, my diet is strict 80% of the time, I take my daily probiotic, and I work with a therapist to manage stress. What I hadn't accounted for was a little alien-being growing in my tummy throwing all that into turmoil! 

My Pregnancy and Skin Worries

I chat with so many ladies each day who ask about pregnancy and postpartum flare ups. When I found out I was pregnant I instantly wondered about the hormones surging around my own body and how they might affect me and my skin. 

Hormones and Skin

Hormones have always played a role in my skin. My jawline acne used to get notably worse at particular times in my cycle, psoriasis used to irritate me more during my period (although I'm certain now that also had something to do with my increase in sugar consumption!) and at times of high anxiety, all those cortisol stress hormones pumping around my body would redden and dry my eczema.

Lots of hormone levels begin to change during pregnancy, here is what I learned about the four main culprits: 

Human chorionic gonadotropin hormone (hCG) - Made exclusively during pregnancy. HCG levels found in our blood and urine rise a lot during the first twelve weeks. They're thought to be the reason we experience nausea and vomiting during the first trimester. 

Estrogen - Usually formed in the ovaries, estrogen helps develop the female sexual traits. Estrogen is also made by the placenta during pregnancy to help the uterus grow, regulate key hormones and trigger the development of baby's organs.

Progesterone - Also made by the ovaries and placenta during pregnancy, progesterone stimulates the thickening of the uterine lining for successful implantation of a fertilised egg.

Human placental lactogen (hPL) - Made by the placenta, hPL not only provides nutrition to the fetus, it also stimulates milk glands for breastfeeding.

First Trimester Sickness 

My hCG levels must have been off the scale, because I've never experienced nausea like I did during those first twelve weeks! It felt never ending. Many women also report lack of energy and total exhaustion during the first trimester, that never hit me, which was both a blessing and a curse! Lying in bed feeling what can only be compared to constant motion sickness is definitely not helped by being unable to sleep it off. 

Gentle exercise and fresh air are recommended for most women in early pregnancy, but you can see on my fitness tracker how my steps dropped off as those early weeks went by. On one occasion I stopped on my hike to chat to a regular dog walker along the little lane up from the cottage, I had to make my excuses after five minutes to go and be sick behind a tree. It's classy this pregnancy lark! 

Second Trimester Skin Flares

Thankfully morning (all day) sickness subsided in the second trimester and I got that lovely surge of energy so many of my mum friends told me about. My appetite returned, I began to feel much healthier and I finally had plenty of energy to begin transforming the spare room into a nursery. This was the glowing pregnancy vibe I had hoped for! My excitement however was short lived as in week 16 I noticed those tell tale little red dots appear in a circle on my inner arm. 

Instantly I suspected guttate psoriasis. Most people would not have even noticed such a tiny circle of bumps, but for those of us who have battled skin problems I think we become hyper vigilant don't we?

The pattern was distinctive and pretty much identical to the flare seven years ago which changed my life. Back then, what began as a tiny circle of dots on my lower abdomen soon spread to little red psoriasis droplets all over. My doctor diagnosed guttate psoriasis and offered to prescribe methotrexate, which shocked me into making the significant lifestyle changes I wrote about in Radiant. Could it be that despite my uber healthy diet, consistent exercise programme and concerted efforts to manage stress, the pregnancy hormones were outdoing all that goodness? 

I knew getting stressed was not going to help the situation, so I made an extra concerted effort to practice meditation, drink more water, take my probiotics and focus on healthy juices and plant-based foods. I had to get this under control. My skin however had other ideas! Soon those little raised, red dots had spread down my arms, across my tummy and onto my boobs. To most people it would look like a mild, raised rash, but being so conscious of the early signs of a psoriasis flare, my anxiety was real. 

Not only was I worried that these tiny dots were growing to grow and merge into that all too familiar plaque psoriasis, the constant itching was intense, especially since the weather had finally started to warm up.

Midwife Suggests PUPPP 

Fortunately the spreading and merging never came. The following week my midwife took one look at my skin and referred me to the doctor, suggesting I might be suffering from 'pruritic urticarial papules and plaques of pregnancy'. PUPPP is very common, particularly during second and third trimesters. 

Topical corticosteroids are typically considered the first line of medical treatment for PUPPP in cases when the itching is localised, often in conjunction with oral antihistamines. I'm all too aware of the damaging long-term impact of applied steroids, so this was absolutely not a route I wanted to go down! 

Keen to understand what was happening in my body to create this flare, I began researching PUPPP. Like so many skin conditions, the triggers and mechanisms and not fully understood, but here are some reasons our skin might react. 

Fetal Cells

Fetal cells can migrate to different parts of our body whilst pregnant, including skin cells. Whilst this is designed to protect us against certain diseases, the immune system can also view these fetal cells as a foreign body it needs to wage war against and therefore goes into overdrive. 

Liver and Kidneys

The liver is our body’s main organ of detoxification and our kidneys are in charge of filtering our blood. If the liver or kidneys are overworked and unable to detoxify properly, that can result in them turning to our body's largest organ of elimination - our skin - for support. This is where we might see skin eruptions as the body tries to expel toxins through the epidermis. 

Natural PUPPP Healing Protocol

Before you embark on any detoxification programme, you should always have a chat with your doctor. This is even more important through pregnancy. Firstly, it's vital to exclude the possibility of your skin rash being a threat to you or your unborn baby, secondly you need to ensure that making these changes and / or taking supplements is safe for both of you. 

Without biopsies and further in depth examinations, the correct diagnosis of a skin condition can be difficult. My own doctor agreed my pregnancy flare could be PUPPP or the early signs of guttate psoriasis (since I've had that many times before). With Covid, in-person appointments are even harder to get, and relying on a doctors thoughts via a video consultation is not ideal.  

My focus - regardless of diagnosis - was two-fold: soothe the itching and irritation on the surface of my skin, which was disturbing my sleep and making me feel incredibly uncomfortable and secondly working on gut, liver and kidney health to ease any burden those rampaging hormones might be throwing in there. 

Here is what I did during my second trimester to heal my skin. 

Increased Water Intake - I'm already very diligent about drinking lots of water, but I made absolutely certain I was getting my three litres of filtered water each day, adding freshly squeezed lemon juice to my water bottle for extra alkalinity. 

Took / Applied Probiotics - I am so thankful I spent the past eighteen months developing this wonderful Multi Strain Biotic! How incredible to have created something that has not only helped so many other people, but now directly benefited me when I most needed it. Not only did I take my 15ml shot each morning, I also applied a little to a bamboo pad and compressed it against the worst patches on my skin. You can see the amazing difference it made to that first raised ring here:

Salt, Oatmeal, ACV and Bicarb Bath-time - I alternated between beneficial Dead Sea Salt soaks and soothing oatmeal baths. I also added a cup of apple cider vinegar and a cup of bicarbonate of soda to the water. Both are thought to support the body by relieving itching, irritation and infection.

Coconut Oil - this was always my go-to when my psoriasis was at its worst. Coconut Oil is antiviral, antifungal and antibacterial. Its antimicrobial properties, make it effective at killing bacteria on the skin. It's also highly moisturising and can help reduce inflammation as well as discomfort.

Soothing Spray - my lifesaver! This helped me get back to a comfortable sleep pattern. With a natural blend of ballon, blackcurrant and sunflower oils, I kept the Soothing Spray bottle in my fridge and sprayed it on regularly, making sure to do so particularly before bed. 

Upped the Plant-Based Meals & Juicing - that awful nausea through my first trimester completely put me off juicing! In fact it put me off most foods for a good few weeks. As soon as my appetite returned I made an extra effort to enjoy plenty of greens, including Green Juices and a green juice cleanse alongside healthy, plant-based meals. Doing a strict, juice only cleanse is not recommended in pregnancy, but healthy eating alongside juicing is always beneficial. 

Grandpa's Pine Tar Soap - I read so many amazing anecdotal reviews of this soap for treating PUPPP on mum blogs and forums. WARNING: it stinks!! Reminiscent of that awful coal tar shampoo the doctor used to prescribe for my scalp psoriasis, Pine Tar Soap is thought to have powerful antiseptic properties and has been used for over two thousand years to treat skin problems. Made from pine tree resin, you can read more about the studies into it here. Pine Tar Soap is widely available on Amazon where you can check out plenty of reviews from other expectant mums. 

Skin Purity Tea - with dandelion root, calendula, chamomile and nettle most often recommended by naturopaths for treating PUPPP, I immediately turned to my Skin Purity Tea to help me heal. Three large mugs enjoyed throughout the day. 

Milk Thistle - knowing it was vital to support my liver, I added in twenty drops of Milk Thistle Tincture each morning alongside my probiotic. There are varying opinions on whether Milk Thistle should be taken whilst pregnant, so please check with your midwife or GP before adding this to your natural PUPPP healing routine. 

PUPPP Natural Treatment Shopping List

These are the products I used from my range to naturally heal my pregnancy skin flare. Save 25% when buying all five by using code: PUP25 at checkout. 

• Multi Strain Biotic - Buy here
• Skin Purity Tea - Buy here
• Soothing Spray - Buy here
• Skin Saviour Balm - Buy here
• Milk Thistle - Buy here

Additional products to search for online. Here's what I bought, but you might find products cheaper locally where you are:

• Tesco Organic Coconut Oil
• Grandpa's Pine Tar Soap on Amazon (UK)
• Dead Sea Salts (I used this Amazon seller and buy huge bags!) 
• Apple Cider Vinegar (find a brand like this with 'the mother')
• Bicarbonate of Soda 1kg bag on Amazon (UK) 

These links are merely designed to help you. I don't earn commission through you buying from these sellers. I do realise however that it makes it much easier to simply click and buy rather than having to ask me where I bought what! 

The Results

Whilst coping with a skin condition is never pleasant, especially through pregnancy, I tried my best to stay upbeat and view this as a personal health experiment. In a strange way I think it's important in life that we're reminded never to take anything for granted. I help so many ladies through pregnancy skin worries, it will only help me going forward to empathise from a very personal perspective. 

It took just over two weeks to see this difference, but individual healing timescales are always difficult to predict. The most important thing to remember is that by putting this emphasis on self-care through pregnancy you're nourishing yourself and your unborn little one. 

It's important to reiterate that a skin rash in pregnancy should always be looked at by your doctor or midwife. It's most probably harmless, but conditions such as pemphigoid gestationis and melasma can be life threatening to your baby.