What Is a Stress Rash?

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Hives are puffy raised welts that often appear on the skin as a result of an allergic reaction. There are actually a number of different things that can cause people to break out in hives, including anxiety. When this happens, people can develop an itchy rash on the skin known as anxiety hives, also sometimes known as a stress rash.

Most people experience anxiety and stress as a normal part of daily life to some degree. But when you are already feeling stressed out, suddenly developing itchy, irritating hives can make you feel even more anxious.

If you have hives and cannot pinpoint any other cause, anxiety could possibly be the culprit. It is important, however, to determine what might be causing your reaction.

If stress and anxiety are the cause, there are steps you can take to manage your stress response and reduce the likelihood of developing a stress rash.

Symptoms

Stress rashes often appear as hives, also known as welts or wheals, which tend to be:

  • Blotchy
  • Itchy
  • Puffy
  • Red
  • Swollen

They can appear anywhere on the body. While they may initially start as tiny red bumps like a typical rash, stress rashes often become larger welts or patches that become worse after scratching them.

Individual hives can be as large as dinner plates, but smaller hives can also merge together so that they appear to cover a large portion of the body.

Causes

Hives are often the result of an allergic reaction to something in your environment. Stress can trigger a response in the sympathetic nervous system, which leads to the release of histamine. 

Histamine is a compound that is normally produced by the body in response to injury, allergies, and inflammatory reactions, but it can also be triggered by stress.

Some other factors that can lead to hives include:

  • Chemicals
  • Exercise
  • Extreme weather
  • Fabrics
  • Foods
  • Infection
  • Medications
  • Pollen
  • Sunlight
  • Stress
  • Sweat

Common food allergens that might trigger hives include milk, nuts, soy, eggs, seafood, and wheat.

Is It Anxiety or Something Else?

If you are experiencing hives, you should start by assessing your activities over the last few days. Any unusual changes in your routine or exposure to new things might play a role in triggering hives.

Some questions you might ask yourself to help pinpoint the cause include:

  • When did the symptoms start?
  • Have you switched laundry detergents or soaps?
  • Have you eaten anything that you normally don't eat?

If you cannot pinpoint another cause and you have been experiencing a great deal of stress, your symptoms might be a stress rash.

Stress rashes tend to appear most commonly in women during their 30s, 40s, and 50s. People who have had allergic hives in the past are also at a higher risk of experiencing anxiety hives.

Treatment

If you are experiencing a stress rash, it is important to find a way to relieve your immediate symptoms in the short term while also looking for ways to lower your stress over the long term.

Some things you can do that may help:

  • Care for your skin: You can ease some of the uncomfortable physical symptoms of hives by wearing loose-fitting clothing and avoiding hot water. Topical steroids such as hydrocortisone cream and applying cold compresses can also help relieve the itching and irritation caused by the hives.
  • Take an antihistamine: Over-the-counter products such as Benadryl (diphenhydramine), Claritin (loratadine), and Allegra (fexofenadine) can help relieve hives.
  • Use stress management techniques: If you are feeling acute stress, try some fast-acting stress relievers that may help provide some more immediate relief. Deep breathing can be an effective way to calm your body and mind, but other strategies like taking a walk around the block or doing a few minutes of quiet meditation can also help.

If your hives are accompanied by other symptoms of an allergic reaction such as swelling of the face or lips, wheezing, or difficulty breathing, you should seek immediate medical attention. It may be a sign of a serious, possibly life-threatening allergic reaction.

You should also talk to your doctor if your hives worsen or last longer than six weeks. Hives that persist longer than six weeks are considered chronic and may not go away on their own without medical attention.

Prevention

If you are prone to stress rashes, it is important to learn how to identify your triggers and be proactive about preventing hives from happening in the first place. 

If you are experiencing a stress rash, it may be a sign that you need to find a way to better manage the stress and anxiety in your life. It is important to build good stress coping techniques. Some effective tools can include:

Challenge Negative Thoughts

Negative thoughts can cause feelings of anxiety. Learning how to identify and then challenge these negative thoughts can help you replace them with more realistic, positive ones.

Change Your Situation

If there is something in your life that is causing a great deal of anxiety, think about what you can do to change the situation. This might involve delegating some tasks to others, cutting back on your commitments, or setting boundaries with others. 

Try Journaling

Research suggests that expressive writing may be helpful for reducing feelings of anxiety. Consider keeping a journal where you write about things that you are experiencing or some of the things for which you are grateful. 

Consider Professional Treatment

Anxiety can have a serious effect on your life and can become worse over time if left untreated. If you feel like your anxiety is creating significant distress or making it difficult to function normally in your daily life, talk to your doctor. Effective treatments are available that can help you get your anxiety under control.

A Word From Verywell

Anxiety can be difficult to deal with, but experiencing itchy, uncomfortable hives can often make what you are feeling seem even worse. Fortunately, anxiety hives are usually manageable with some self-treatment.

If you are prone to stress rashes, the best way to manage them is to get your anxiety under control. Talk to your doctor about some of the ways you can cope, which may include medication, psychotherapy, or a combination of the two. 

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  1. Cleveland Clinic. Why am I breaking out in hives when I'm stressed? Published March 7, 2019.

  2. Shen L, Yang L, Zhang J, Zhang M. Benefits of expressive writing in reducing test anxiety: A randomized controlled trial in Chinese samplesPLoS One. 2018;13(2):e0191779. doi:10.1371/journal.pone.0191779