How Stress Can Cause a Skin Rash or Hives (and How to Treat Them)

Written by Kara-Marie Hall, RN, BSN, CCRN | Reviewed by Mandy Armitage, MD

Key takeaways:

  • Stress can cause breakouts on your skin, including hives, due to the release of histamine, a chemical in your immune system.
  • Stress can also cause flare-ups if you already live with a skin condition, such as eczema or psoriasis.
  • You can usually treat stress rashes successfully at home, but you may need medical attention.

People respond to the stress of life’s challenges in different ways. These responses can be emotional or physical. The emotional effects of stress include anger, sadness, and anxiety. The physical effects of stress vary as well, but they may take the form of a skin rash or hives

An estimated 20% of people will experience hives at one time or another. However, stress can make hives and other skin problems a more common and frustrating issue. 

Below, we’ll discuss skin rashes and hives and what to do when they’ve been triggered by stress. 

What’s the difference between skin rashes and hives? 

Skin rashes and hives are often mistaken as being the same. However, there are slight differences between these skin-related issues. 

A skin rash is an unusual change in your skin’s color, texture, or appearance due to skin inflammation. This inflammation occurs when your body reacts to an infection, an autoimmune disorder (such as psoriasis), or substances that cause allergic reactions. 

Hives, also known as urticaria, are a type of skin rash that can occur when your immune system releases the chemical histamine in response to an allergen. The appearance of hives can differ from other skin rashes, and hives usually have a recognizable pattern. 

Can stress and anxiety cause you to break out in hives?

Stress and anxiety can cause hives. For this reason, sometimes hives might be called “stress hives” or a “stress rash.”

For example, when you’re under a great deal of stress, your body sends a message to its immune cells, telling them to release powerful chemicals — most notably, histamine. Histamine triggers inflammation and the itchiness associated with hives. 

Stress is only one of several triggers that can cause symptoms like skin rashes or hives. Other causes of skin rashes include: 

  • Food allergens, such as peanuts, shellfish, or spicy foods
  • Pollen, dust, or animal dander
  • Medications
  • Hot or cold temperatures 
  • Irritating chemicals, such as laundry detergents
  • Viral or bacterial infections
  • Autoimmune disorders, such as thyroid disease
  • Insect bites and stings
  • Exercise 

Hives is a common skin condition that affects people of all ages. However, studies have shown that women are more affected by hives than men.

What does a stress rash or stress hives look like?

Stress hives usually appear as swollen bumps called welts or wheals. These bumps can cause redness. However, this redness may not show up easily on dark skin. In darker skin, the bumps may look skin-colored or have subtle redness. 

When pressed against, stress hives become blanchable, meaning they briefly turn white. A welt is generally small — about 1 to 2 centimeters in size — but can combine with other welts to create a larger hive. Stress hives often look oval, round, or ring-like but also can take on irregular shapes. 

Hives are very itchy. You may feel a tingling or burning sensation as if you’ve been bitten by mosquitos. In addition, some welts may disappear only to be replaced by new ones within a few hours. 

Stress can also provoke flare-ups, or a return of symptoms, if you already have another skin condition, such as:

  • Eczema
  • Psoriasis
  • Rosacea
  • Acne
  • Fever blisters

The symptoms of each of these conditions vary. For example, if you’re living with eczema, you may find that you suddenly get more dry, rough, and itchy skin when you’re dealing with a lot of stress. 

Where do stress hives or rashes usually occur on the body?

Stress rashes and hives can occur on any part of your body, but they most frequently show up in the following areas:

  • Face
  • Arms
  • Hands
  • Back
  • Legs
  • Toes

Stress hives or stress rashes are not contagious. But hives can be a sign of a serious problem called angioedema — which happens when inflammation reaches the deeper levels of your skin. In addition to hives, angioedema can cause the following symptoms:  

  • Swelling of the lips, tongue, eyes, and cheeks 
  • Trouble breathing
  • Shortness of breath
  • Wheezing (when breathing sounds like a whistling sound)
  • Dizziness

If you’re experiencing these symptoms, call 911 right away for emergency medical attention.

How can I treat a rash caused by stress and anxiety?

Fortunately, most stress rashes can be treated at home. Here are some tips that may help. 

1) Home and lifestyle remedies

There are several remedies you can try at home to relieve the discomfort from stress hives or rashes. For example: 

  • Apply cool compresses, such as a wet washcloth or ice pack, to the affected area to provide immediate, soothing relief.
  • Take an oatmeal bath to help with itchiness.
  • Avoid triggers that could worsen your rash, such as heat or tight clothes.

2) Over-the-counter medications

Some over-the-counter medications you can pick up at your local pharmacy without a prescription can help with hives. Called antihistamines, these medications block the effects of histamine to stop inflammation. 

Look for these medications at your local pharmacy: 

Be mindful that some antihistamines, like Benadryl, can cause you to feel sleepy or tired. If you have questions, reach out to your healthcare provider. 

3) Stress management

Another effective way to manage stress hives is to lower your stress to prevent them in the first place. Some ways to reduce stress can include: 

  • Practice mindfulness and deep breathing exercises. 
  • Speak to someone you trust about what you’re going through. 
  • Engage in relaxing exercises, such as yoga, tai-chi, or walking.
  • Take breaks from stressful responsibilities

How long do stress rashes and hives typically last?

Stress rashes or hives usually disappear within a few hours or days. It’s important to avoid scratching a rash so that it will heal and not leave behind marks. Sometimes, stress rashes and hives can come back repeatedly for weeks or months. When hives last longer than 6 weeks, it is called “chronic urticaria.” 

If your stress rash or hives last longer than a few days, see your healthcare provider to figure out what could be going on and if you need stronger treatment options. 

The bottom line

Stress is an uncomfortable fact of life and can manifest itself in several ways, including on your skin. Fortunately, when you discover a stress rash or hives, you can make proactive changes to prevent them in the future. These changes include practicing stress reduction techniques like mindfulness and exercise. In the short-term, you can use medications, such as antihistamines, as well as home remedies to get faster relief.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s