Everything You Need to Know About Stress Rashes

By Terez Malka, MD
Medically reviewed checkmarkMedically reviewed
January 25, 2022

According to the American Psychological Association, this past year has been the most stressful in many Americans’ lifetimes, with about 78% of surveyed Americans saying the pandemic is a significant source of stress in their lives.

Stress manifests in different ways on an individual, but for many, it can appear on the skin.

The skin is the largest organ on the human body.

It protects your inner organs from the external environment, but sometimes it can become irritated resulting in a skin rash.

Rashes may be caused by a number of things, including allergies, fungus, viral or bacterial infections, as well as heat.

Stress is also a contributor to rashes and other skin conditions. 

While most common rashes are not considered dangerous, a stress rash may be uncomfortable.

The good news is, a rash may be managed and contained if you understand its cause and symptoms. 

What is a Stress Rash?

A stress rash is an irritation of the skin that may develop when a person is under a significant amount of emotional strain.

Stress may cause hives, also called urticaria, which are most often red, puffy, and itchy.

Sometimes, it may look like bug bites, or raised red bumps.

Stress rash can appear anywhere on the body, may come and go over time, and can be chronic and uncomfortable.

A stress rash is usually the result of an increase of a hormone called cortisol, which is commonly referred to as the “stress” hormone.

An increase of such can generally trigger inflammation throughout the body. 

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Is a stress rash common?

Stress rashes are extremely common and can affect the daily lives of many.

They may be more common in women than men, especially those in their 30s, 40s, and 50s.

They also tend to flare up most often in those already predisposed to allergic hive tendencies, but they can really happen to anyone at any time.

Studies show that there is a strong correlation between high stress situations and common skin conditions amongst all types of individuals.

Stress Rash Causes

Stress rashes are caused by an increase of stress in one’s life or a particular situation.

They may manifest as a rash, but can also contribute to flare ups of existing skin conditions.  

Hives caused by stress

Stress hives happen when stress intensifies inflammation in the body and will often appear as patches of round or oval-shaped, skin-colored or pink and red welts.

They may turn white when you press the center (this response is called “blanching”).

These welts can change over the course of the inflammation and can sometimes be quite itchy.

Some people also experience swelling in places like the lips, eyelids, and other extremities. 

Stress hives can be splotches of individual red hives, or join together in large bumps on your body.

Stress hives can also contribute to irritation of sensitive areas, such as your feet, resulting in uncomfortable, itchy feet

Stress worsening existing conditions

Stress can contribute to flare ups of other skin conditions.

For example, stress is one trigger or flare ups of eczema or atopic dermatitis, resulting in dry, itchy, and flaky skin.

It can also contribute to dyshidrotic eczema, which causes blisters on the hands and feet.  

Stress levels may also trigger flares of skin conditions like psoriasis.

Stress is a common trigger for guttate psoriasis, which may cause small, red spots on children and adults with the condition.

Stress Rash Treatment

While some rashes may go away in a few days, others may take longer and require medication.

There are a number of medications that can be used to treat and manage stress rashes, including over-the-counter medications, as well as prescription medications for more severe cases. 

Over-the-counter options

There are a number of over-the-counter medications that can help block inflammation in your body.

A common option includes over-the-counter antihistamines, like cetirizine (Zyrtec), loratadine (Claritin),  fexofenadine (Allegra), and diphenhydramine (Benadryl).

Another class of drugs that are used with antihistamines are called H2 blockers.

Cimetidine (Tagamet) or famotidine (Pepcid are two common options of this variety.

Some studies show a combination of drugs may be most effective. 

Anti-itch creams like hydrocortisone cream can also help with the itching and inflammation of stress rashes.

Consult your doctor, pharmacist, or medical provider if you have any questions about starting or mixing medications, even if they are available over-the-counter. 

Prescription medications for a stress rash

For severe cases, there are a variety of prescription medications available to manage symptoms.

Prescription antihistamines may be helpful.

Certain drugs can help with an overactive immune system, including oral corticosteroid drugs, such as prednisone, which can reduce swelling, inflammation and itching, but need to be used with caution and as prescribed.

You may also discuss the option of certain anxiety medications, which can help manage stress and triggers for such flare ups. 

When to See a Doctor

Hives may appear as part of a serious allergic reaction known as anaphylaxis.

This requires immediate medical care. Along with a rash, anaphylaxis includes other symptoms such as: trouble breathing, swelling of the lips, eyelids, and tongue, dizziness or lightheadedness, nausea and vomiting, fast heart rate, or a sudden feeling of intense anxiety.

You should speak with a healthcare provider if you believe you are experiencing an allergic reaction, and seek emergency medical care if you start developing symptoms of anaphylaxis.

What Else Could My Rash Be?

While your rash may be a result of stress, there are a number of other conditions that may cause a skin rash.

It is important to seek medical attention if you notice a new rash on your skin. 

Heat rash

A heat rash is a reaction to high temperatures or humid weather.

It often occurs in areas of the skin underneath clothes or those that are very sweaty. 

This rash may present as blisters and red lumps and can be itchy or painful.

Pityriasis rosea

Pityriasis rosea is a rash of large circles and oval spots that may cover your chest, abdomen, and back.

It most commonly affects those between 10 and 35 years old and is sometimes itchy.

This type of rash gets better on its own.

Rosacea

Rosacea causes blushing and flushed look, or visible blood vessels on the face, as well as acne-like lesions and sensitivity.

It commonly affects middle aged women, and while there is no cure, it can be managed with proper medication and skin care.

Contact dermatitis

Contact dermatitis occurs when your skin comes into contact with irritants or has an allergic reaction to something you have touched.

This type of dermatitis causes redness, itching, swelling and/or stinging, and may also cause blistering or an oozy rash.

Contact dermatitis is not contagious and has no relationship to hay fever or seasonal allergies.

Eczema

Although stress may trigger eczema flare-ups, there are a number of other factors including the environment that can contribute to eczema.

Common symptoms include patches of red, itchy, and dry skin.

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Ways to Relieve Stress and Stress Rashes

For people who have hives due to emotional stress, it’s important to practice relaxation techniques that help the body cope with anxiety or other stressful experiences.

There are a variety of ways to manage stress.

Some people find psychotherapy helpful, as well as other forms of meditation and deep breathing.

Mindfulness journaling can be stress relieving, and exercise can also help you manage cortisol levels.

A balance of all these methods can help relieve stress rash symptoms and occurrences.

Frequently Asked Questions

Can anxiety cause rashes?
Yes, anxiety and stress can trigger hives and other forms of rashes on your body.
What do anxiety hives look like?
Hives from stress and anxiety can appear anywhere on your body. They often look like red, pink, or flesh-colored, raised, puffy, splotches. Sometimes, they may look like bug bites, or raised red bumps.
Can stress cause bad rashes?
While most stress rashes will usually resolve on their own, some can be quite itchy and uncomfortable. They may also trigger flare ups of more serious conditions which can lead to fungal or bacterial infections from persistent scratching.
How do you treat a stress rash naturally?
Stress rashes can be treated naturally with cold compresses and over the counter mediations. Stress can also be managed by minimizing stress through psychotherapy, meditation, exercise, and mindfulness practices.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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Terez Malka, MD

Dr. Terez Malka is a board-certified pediatrician and emergency medicine physician.

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