Itching in pregnancy: when it’s harmless and when it needs checking

Itching is common in pregnancy and usually harmless, but sometimes it can be a sign of a liver condition called intrahepatic cholestasis of pregnancy (ICP, also called obstetric cholestasis). Here’s how to tell when to get help.

Get urgent help if

The NHS says to get urgent medical help if:

your skin is very itchy, for example it keeps you awake at night
the palms of your hands or soles of your feet are itchy
the itching is worse at night

These can be signs of ICP. Call your maternity unit if you have the number. If you can’t reach them, call NHS 111. Don’t wait for your next routine appointment.

What is ICP?

ICP is a liver condition that can cause itching and needs medical treatment. The NHS says that if you have it, a care plan is agreed with you, including extra appointments to monitor you and your baby, and you’ll be offered medicines to treat your liver and reduce the itching. There is a small risk of premature birth, and a small risk of stillbirth if ICP is severe. Most people with ICP make a full recovery and have a healthy birth. Your midwife and doctor may suggest starting labour early to reduce the risk.

The RCOG says ICP usually causes itching without a rash. It is diagnosed with a blood test that checks bile acids and liver function. Tell your midwife or maternity unit about itching early, because the RCOG says itching can be the first sign. If your skin is itchy and the first tests are normal, they may be repeated.

Other itching

See a GP if the itching affects your daily life, doesn’t improve after treatment from a pharmacist or keeps coming back, you have eczema (which can get worse in pregnancy), or you develop a new rash, lump or swelling. A new rash needs a GP check, because ICP itself usually causes itching without a rash.

For everyday itching the NHS suggests:

patting or tapping your skin instead of scratching
cool or warm (not hot) baths or showers, for under 20 minutes
regular unperfumed moisturiser (emollient)
avoiding perfumed soaps, deodorants and moisturisers
keeping your nails short and wearing loose clothes made from natural fibres
limiting spicy food and caffeine

A pharmacist can advise on safe creams and antihistamines in pregnancy. Tell them you’re pregnant.

Itching and stretch marks

NCT says stretch marks might be itchy but aren’t harmful. See stretch marks.

Questions people ask

Is itching all over a sign of ICP?

Not always, but the NHS says to get urgent help if your skin is very itchy, especially on your hands and feet or at night, rather than guessing.

Is it dangerous for my baby?

Most people with ICP have a healthy baby. The NHS says there is a small risk of the baby being born early, and a small risk of stillbirth if ICP is severe. That is why itching is checked quickly and why treatment and monitoring matter.

Can I use anti-itch creams?

Ask a pharmacist, who can advise on safe creams and antihistamines.