Pregnancy is a period of complex endocrinological, immunological, metabolic, and vascular changes. These changes affect the skin and other organs in several ways. More than 90% women experience significant and complex skin changes during pregnancy that may have a significant impact on a womans life.1 Some of the physiological changes during pregnancy occur as a result of the de novo production of numerous protein and steroid hormones by the feto-placental unit as well as by increased activity of the maternal pituitary, thyroid, and adrenal glands.1

Itch is common during pregnancy and can cause considerable distress in pregnant women.2 Eczema is the commonest dermatosis in pregnancy. Only 20-40% of patients have been reported to have a pre-existing history of eczema. Rest of them develop symptoms for the first time during pregnancy.3 Atopic eczema is responsible for a significant proportion of itchy dermatoses in pregnancy.2

Atopic eruption of pregnancy (AEP) starts early in 75% before the third trimester, and tends to recur in subsequent pregnancies. This benign pruritic disorder of pregnancy includes eczematous and/or papular lesions in patients with a personal and/or family history of atopy and/or elevated IgE levels after exclusion of the other dermatoses of pregnancy. Pregnancy-specific immunological changes are implicated in the pathogenesis of AEP. These include reduced cellular immunity and reduced production of Th1 cytokines (IL-2, interferon gamma, IL-12), and dominant humoral immunity and increased secretion of Th2 cytokines (IL-4, IL-10).1

Restoring barrier function is an important aspect of the management of eczema and reduces the need for specific therapy.2 Emollients are moisturizers that make the skin soft and supple while humectants, such as lactate, urea, and glycerine, attract water, thus contributing to water retention within skin.4

Cocoa butter and glycerine are FDA-recognized for having skin protective properties.4 Cocoa has antioxidants and anti-inflammatory activities that have a potential role in the maintenance of skin health while glycerine has been shown to be a suitable alternative to urea/sodium chloride in the treatment of atopic dry skin.5,6

Cocoa butter and glycerine can therefore be used as a potential topical application to soothe dry itchy skin during pregnancy. The preparation can potentially restore barrier function and lock in moisture.

References

1. Vora RV, Gupta R, Mehta MJ, et al. Pregnancy and Skin. J Family Med Prim Care. 2014 Oct-Dec; 3(4): 318–324.
2. Schnopp C, Ring J. Atopic Eczema and Itch in Pregnancy: Therapeutic Considerations. Current Dermatology Reports 2012;1(4):203–8.
3. Weatherhead S, Robson SC, Reynolds NJ. Eczema in pregnancy. BMJ. 2007 Jul 21; 335(7611): 152–154.
4. Correa MCM, Nebus J. Management of Patients with Atopic Dermatitis: The Role of Emollient Therapy. Dermatol Res Pract. 2012; 2012: 836931.
5. Scapagnini G, Davinelli S, Di Renzo L, et al. Cocoa Bioactive Compounds: Significance and Potential for the Maintenance of Skin Health. Nutrients. 2014 Aug; 6(8): 3202–3213.
6. Lodén M, Andersson AC, Anderson C, et al. A double-blind study comparing the effect of glycerin and urea on dry, eczematous skin in atopic patients. Acta Derm Venereol. 2002;82(1):45-7.