Polymorphic Eruption of Pregnancy Treatment

First-Line Treatment Approach

Apply emollients regularly, especially after bathing, as the basis of therapy for inflammatory skin conditions during pregnancy, to maintain skin barrier function and reduce inflammation, as recommended by the American Academy of Dermatology 1
Wear loose, breathable clothing made from natural fabrics to reduce friction and irritation, as suggested by the American Academy of Dermatology 1
Maintain skin dryness in affected areas, as recommended by the American Academy of Dermatology 1

Prednisolone is 90% inactivated by the placenta, making it the safest systemic corticosteroid if escalation is needed, though this is rarely necessary for PEP, according to the British Association of Dermatologists 2, 3, 4
Avoid betamethasone and dexamethasone as they cross the placenta more readily and could affect the fetus, as warned by the British Association of Dermatologists 2, 3
Avoid prolonged use of high-potency topical corticosteroids during pregnancy, as advised by the American Academy of Dermatology 1

Do not use systemic azole antifungals if fungal infection is suspected, especially in the first trimester - use topical nystatin instead, as recommended by the American Academy of Dermatology 1
Do not prescribe very potent topical corticosteroids for initial management - moderate potency is sufficient and safer, as suggested by the American Academy of Dermatology 1