Safe Options for You and Your Baby

Yes, you can and should treat your eczema during this special time. Untreated eczema increases infection risk, disrupts sleep, and impacts your ability to care for your baby. This guide provides dermatologist-approved treatments with the strongest safety data, helping you make informed decisions with your healthcare team. 

How Pregnancy and Breastfeeding Affect Your Eczema 

Pregnancy’s hormonal rollercoaster affects everyone differently. About 50% of women see their eczema improve during pregnancy due to immune system changes, while others experience new or worsening flares. The third trimester and postpartum period often bring the most challenges—between frequent handwashing, sleep deprivation, and stress, your skin barrier takes a beating. 

The good news: Modern dermatology offers multiple safe, effective treatments. You don’t need to “tough it out” when evidence-based options exist. 

Foundation Treatments: Your Daily Defense (100% Safe) 

Moisturizers: Your First Line of Defense 

• What to use: Thick, fragrance-free creams or ointments (CeraVe, Vanicream, Aquaphor) 
• How often: At least twice daily, ideally 3-4 times 
• Pro tip: Apply within 3 minutes after bathing while skin is damp—this traps moisture most effectively 
• Safety: Completely safe throughout pregnancy and breastfeeding 

Dilute Bleach Baths: Fighting Bacteria Naturally 

For recurrent infections or weeping eczema: 

• Recipe: 1/4 cup regular bleach in a full bathtub (1/2 cup for larger tubs) 
• Frequency: 2-3 times weekly, 10-minute soaks 
• Safety note: Well-studied and recommended by the AAD when properly diluted 

Wet Wrap Therapy: Intensive Overnight Relief 

This hospital-tested technique can reduce flares by up to 70% within days: 

1. Apply medications and moisturizer 
2. Cover with damp cotton clothing/gauze 
3. Layer dry clothing on top 
4. Leave overnight or 2-3 hours minimum 

Phototherapy: The Pregnancy Gold Standard 

Narrowband UVB phototherapy is your best non-medication option for moderate-to-severe eczema during pregnancy and breastfeeding. 

• Safety profile: No systemic absorption, decades of safety data 
• Effectiveness: 75% of patients see significant improvement 
• Practical considerations:  
  • Requires 2-3 weekly clinic visits initially 
  • Take 5mg folic acid daily (UV light can deplete folate) 
  • May temporarily darken skin (melasma risk) 
• Avoid: PUVA therapy (contains medication unsafe in pregnancy) 

Topical Medications: What’s Actually Safe? 

Topical Corticosteroids: Still First-Line When Used Correctly 

The evidence is reassuring: A landmark study of 60,000+ pregnant women found no increased risk of adverse outcomes with appropriate topical steroid use. 

Safe approach during pregnancy: 

• Use mild-to-moderate potency (hydrocortisone, triamcinolone) 
• Limit to <30% body surface area 
• Short courses (5-14 days for flares) 
• Avoid Class I super-potent steroids in large amounts 

Breastfeeding guidelines: 

• Apply immediately after nursing 
• Wipe nipple/areola area before next feeding 
• Choose creams over ointments on breast skin 

Non-Steroid Options: Modern Alternatives 

Calcineurin Inhibitors (Tacrolimus/Protopic, Pimecrolimus/Elidel) 

• Minimal systemic absorption (<1%) 
• Safe for facial and eyelid eczema 
• Breastfeeding: Apply after feeding, cleanse before next feeding 
• Preferred for maintenance after steroid course 

Roflumilast (Zoryve): The New Maintenance Star 

• Once-daily application 
• Rapid itch relief (within 24 hours) 
• No steroid side effects 
• Pregnancy: Limited data—discuss risk/benefit with your team 
• Breastfeeding: Can use with precautions (avoid breast area, minimize coverage) 

Crisaborole (Eucrisa) 

• Non-steroid option for mild-moderate eczema 
• Minimal absorption 
• Limited pregnancy/breastfeeding data—case-by-case basis 

Managing Severe Eczema: When You Need More 

Dupilumab (Dupixent): Growing Evidence of Safety 

• Pregnancy: Recent registry data (500+ exposures) show no increased risk of birth defects 
• Breastfeeding: Compatible per LactMed—antibodies unlikely to pass in significant amounts 
• Consider when: Other treatments fail and quality of life is severely impacted 

Systemic Options (Specialist Only) 

• Cyclosporine: May be used short-term in severe cases. Use with caution and only if benefits outweigh risk 
• Absolute no’s: Methotrexate, mycophenolate (cause birth defects) 

Special Focus: Breast and Nipple Eczema 

This common postpartum challenge requires special care: 

1. Moisturize differently: Skip lanolin (common allergen); use pure sunflower oil or mineral oil 
2. Medication timing:  
   • Apply treatments immediately post-feeding 
   • Allow 30+ minutes absorption 
   • Gently cleanse with water before next feeding 
3. Red flags requiring immediate care:  
   • Yellow crusting (likely staph infection) 
   • Spreading redness with fever 
   • Deep, painful cracks 

Your Personalized Treatment Plan Examples 

Mild Facial Eczema (Safe Throughout) 

• Morning: Gentle cleanser → moisturizer 
• Evening: Moisturizer → low-potency hydrocortisone (5-7 days for flares) 
• Maintenance: Calcineurin inhibitor 2-3x weekly 

Moderate Body Eczema (Postpartum) 

• Daily 10-minute lukewarm baths 
• Liberal moisturizer application 3x daily 
• Medium-potency steroid for active patches (7-10 days) 
• Roflumilast for maintenance (with precautions) 

Severe Hand Eczema (Common Postpartum) 

• Protective measures: Cotton gloves under rubber gloves 
• Super-hydrating overnight routine with occlusion 
• Potent topical steroid course (5-7 days max) 
• Phototherapy 2-3x weekly if not responding 

Why KindleeRx Makes Pregnancy/Postpartum Eczema Care Easier 

Managing eczema with a baby is hard enough without juggling dermatology appointments and pharmacy runs. KindleeRx brings board-certified dermatology care directly to you: 

✓ Safe prescribing expertise: Our dermatologists specialize in pregnancy/breastfeeding considerations  
✓ Custom compounds: Get the exact strength and formulation you need—not what’s on the shelf  
✓ Direct delivery: Medications ship from our pharmacy to your door  
✓ Transparent pricing: No insurance hassles, no surprise bills  
✓ Ongoing support: Message your dermatologist as your needs change 

What Makes Us Different for New Parents: 

• Quick consultations: Complete our online assessment during naptime. It takes less than 10 minutes! 
• Pregnancy-specific protocols: Every treatment plan considers your stage in life and safety needs 
• Flexible refills: Adjust your plan as you transition through pregnancy, postpartum, and beyond 

Take Action Today, You Deserve Relief 

Don’t let eczema get in the way of life’s special moments. Start your KindleeRx consultation now and receive your personalized treatment plan within 24 hours. Healthy, comfortable skin helps you feel your best during pregnancy and beyond