Eczema Knowledge Hub

Pregnancy brings so many changes, some wonderful and some challenging. For many women, those changes also show up on the skin. Eczema is one of the most common skin conditions seen in pregnancy, and it can appear for the first time or flare up after years of being quiet.^[1]

When I was pregnant, our cat scratched me and that tiny scratch triggered eczema that lasted through the rest of my pregnancy. It reminded me just how sensitive skin can become at this time, and how something small can snowball into weeks of irritation. If you've ever found yourself wondering why your skin feels more fragile than usual, you're not alone.

The reason lies in the way pregnancy changes both hormones and the immune system. These shifts can make the skin barrier weaker and more reactive, leading to dryness, itching, and inflammation.^[2] For some women, this means new rashes. For others, it means flare-ups of eczema that were already there.

The good news is that most mainstay treatments are safe in pregnancy. Fragrance-free moisturisers should be the foundation — used liberally and often. Mild topical steroid creams can be used under medical guidance and are generally considered safe due to their limited systemic absorption.^[2] Daily habits — applying moisturiser frequently, taking lukewarm baths rather than hot ones, wearing soft cotton clothing, and avoiding strong fragrances — all help keep the skin calmer.

Specific considerations for pregnancy and breastfeeding:

• Newer non-steroid topical treatments (topical PDE4 inhibitors, such as crisaborole) should be avoided during pregnancy as safety data in pregnancy are currently limited.^[3] If you have been using these, speak to your doctor about alternatives.
• If you are breastfeeding, avoid applying topical steroid creams directly to the nipple and areola area immediately before feeding, and clean the area before breastfeeding.
• Oral corticosteroids (steroid tablets) should not be used long-term in pregnancy due to the risk of complications including gestational diabetes. Only short courses should be used, always under close medical supervision.^[3]
• The general principle is: use the lowest effective dose for the shortest duration necessary — whether for steroid creams or any other treatment during pregnancy.^[3]

If stronger treatments are ever needed, your dermatologist or obstetrician will work with you to balance safety and comfort for both you and your baby.

Living with eczema during pregnancy isn't easy. The itch can keep you awake at night, and the constant discomfort can make an already demanding season feel harder. But it's important to remember: you are not alone, and with the right care, most women manage their eczema safely through pregnancy while protecting their baby's health.