I itch but have no rash.

If you are fair skinned you are at higher risk of developing a condition known as cholestasis of pregnancy. It is characterised by itching and/or jaundice. This can be inherited or sometimes is the body's reaction to oestrogen levels. It is a build up of bile salts, which are incompletely cleared by the liver and accumulate in the serum of the blood. There are usually no accompanying skin changes with this condition however unless it is with scratching.

Skin changes are fairly common during pregnancy, many of which may be successfully treated with a 1/2% hydrocortisone cream. However, because the itching began in the 3rd trimester, I would ask your doctor to carry out some liver function tests and a bile salt level.

There are some drugs that help this condition and there is some evidence that there is a slightly increased risk of premature labour and stillbirth in some women with cholestasis in pregnancy. The risk of postpartum haemorrhage may also be increased due to impaired Vitamin K synthesis.

Once your doctor has ruled this out, then view it as a dermatological problem that may be treated locally.

Rarely, this condition could be ‘pruritic urticarial papules and placques of pregnancy’ or PUPP, (‘itchy, skin bumps’) which is a benign dermatological condition of pregnancy. If you don't have a rash, I doubt this could be it. Consult your doctor and ask for this to be investigated further.

Peg