Treatment of Eczema in Pregnancy

First-Line Approach

Emollients should be applied regularly, especially after bathing, to form the basis of therapy for atopic dermatitis during pregnancy, and a dispersible cream can be used as a soap substitute to cleanse the skin, as recommended by the British Medical Journal 1
Avoiding known irritants and triggers, such as extreme temperatures and irritant clothing, and using cotton clothing instead, can help manage eczema during pregnancy, as suggested by the British Medical Journal 1, 2

The British Medical Journal recommends using the least potent preparation required to keep eczema under control, and stopping topical corticosteroids when the flare resolves, to minimize potential side effects 2
Antihistamines may be useful as a short-term adjuvant to topical treatment during severe pruritic flares, primarily for their sedative properties, as noted by the British Medical Journal 1, 2

For secondary bacterial infection, antibiotics such as flucloxacillin may be necessary, especially for Staphylococcus aureus, as recommended by the British Medical Journal 3
Acyclovir should be given early in the course of herpes simplex infection to effectively manage the condition, as suggested by the British Medical Journal 1

Referral to a dermatologist is recommended when there is diagnostic doubt, failure to respond to maintenance treatment, or need for second-line treatment, as advised by the British Medical Journal 4

Allowing adequate time for explanation and discussion with pregnant patients about treatment options, demonstrating proper application of topical preparations, and providing written information can improve patient outcomes, as recommended by the British Medical Journal 2
Documenting the extent and severity of eczema at each visit can help monitor disease progression and adjust treatment accordingly, as suggested by the British Medical Journal 2

Undertreatment due to fear of topical corticosteroids can be addressed through proper education, and using potent/very potent topical corticosteroids when mild/moderate options would be effective should be avoided, as noted by the British Medical Journal 2
Failure to recognize and treat secondary bacterial or viral infections can cause deterioration in previously stable eczema, and should be addressed promptly, as recommended by the British Medical Journal 1