What is Pruritic Folliculitis of Pregnancy?

All you need to know about Pruritic Folliculitis of Pregnancy

Pregnant woman

Some dermatologists regard pruritic folliculitis as a form of acne that arises during pregnancy. Differential diagnoses include bacterial folliculitis, pityriasis folliculitis, and drug- or chemical-induced acneiform eruptions. First described in 1981, it is believed to be more common than previously thought, with the incidence of this disease to be one per 3,000 pregnancies.  

What does Pruritic Folliculitis of Pregnancy Look Like?

The rash consists of several small red bumps that may or may not be filled with pus.

These bumps are usually on the shoulders, upper back, arms, chest, and abdomen. The condition looks like acne. However, the culture of the bumps does not reveal any bacteria. The rash can be very itchy.

When Does it Develop?

Pruritic folliculitis of pregnancy typically develops in the second half of pregnancy. It resolves spontaneously within 2 to 3 weeks after delivery.

What Causes Pruritic Folliculitis of Pregnancy?

The cause of pruritic folliculitis of pregnancy is unknown. Some investigators believe it is caused by hormonal changes. And it doesn't appear to be caused by abnormalities of the immune system.

How is it Treated?

Pruritic folliculitis of pregnancy is typically treated like mild acne. Benzoyl peroxide has been used with some success, but antibiotics are not needed. Oral antihistamines are useful to treat the itching. There are other drugs that may help:

  • Retinoids and antineoplastic agents. Among the drugs used in dermatology, isotretinoin — used to treat acne vulgaris, and antineoplastic agents, such as methotrexate, are two drug types that present a high risk during pregnancy and are contraindicated in pregnancy. There may be less risk with tretinoin, but the risk is still present.
  • Antipruritic agents. Antipruritic medications, such as trimeprazine and doxepin, should be avoided during pregnancy and lactation. Hydroxyzine is classified as a moderate risk in the first trimester of pregnancy and is associated with a risk of congenital abnormality. Hydroxyzine is also not recommended during lactation.
  • Antibiotics. Antibiotics, such as tetracycline and ciprofloxacin, are risky to use during pregnancy and lactation, and should, therefore, be avoided. When antibiotics are necessary during pregnancy, penicillins are considered safer.
  • Analgesics. Analgesics, including acetaminophen, are associated with minimal risk to the fetus or infant. However, there are some nonsteroidal anti-inflammatory agents, such as indomethacin, which are associated with problems in infants and, therefore, are not recommended for use in pregnant women.
  • Topical agents. Topical corticosteroids during pregnancy are considered to present a low risk to the fetus. The FDA says that using these drugs may pose some risks. On the other hand, other topical agents, such as povidone-iodine and podophyllin, are known to possibly put a fetus at risk and are not recommended for use during pregnancy.

The Effects of Pruritic Folliculitis of Pregnancy on the Baby

There are differing reports about the effect of pruritic folliculitis of pregnancy on the baby.

There appears to be an increased risk for premature births and infants who are small for gestational age, as compared with infants from normal pregnancies. Evidence of an increased rate of spontaneous abortions or fetal mortality has not been reported. 


Kroumpouzos G. Specific Dermatoses of Pregnancy: Advances and Controversies: Pruritic Folliculitis of Pregnancy. Medscape. CME Released: 11/24/2010; 

Clinician's Photo Guide to Recognizing and Treating Skin Diseases in Women: Part 2. Pregnancy-Related Dermatoses. Medscape. 

Xia Y, Bray DW. Pregnancy-related pruritic rash. Am Fam Physician. 2007 Oct 1;76(7):1019-20.

Continue Reading