What is a stress rash? How to manage hives caused by anxiety

They’re red, they’re itchy — and they’re coming for you, just when you need them the least.

Hives are a common skin condition, and they typically show up as a red, itchy rash.

Known to doctors as urticaria, hives can be caused by a wide range of factors including spicy-hot foods, heat or cold, skin products, laundry detergents or high levels of stress.

Can stress cause hives?

“While we recognize, as dermatologists, that hives can be caused by stress, it is not our ‘first-explanation,’” Dr. Whitney High, a professor of dermatopathology at the University of Colorado School of Medicine, told CNN.

“If we can’t find any other cause for hives, then it is reasonable to consider stress,” High added.

And a 2018 study found that people with chronic hives were more likely to experience high levels of stress — and their symptoms included more intense itching.

What a stress rash looks like

A stress rash usually appears as raised bumps that look red or pinkish, depending on your skin tone. They can show up anywhere on your body, but are most common on the neck, chest or torso, face and arms. In some people, they’re accompanied by swelling of the lips or eyelids.

Hives can range from tiny dots to large welts, and may form in tightly packed clusters. They’re usually itchy, and in some people they cause a burning or tingling sensation.

People who have been diagnosed with a skin condition such as eczema or psoriasis may find themselves particularly prone to stress-induced skin flare-ups.

How to get rid of stress hives

When you’re under stress, your body responds by releasing cortisol — known as the “stress hormone” — and other compounds including histamines.

“We don’t know how or why the skin responds to your stress hormones, but it’s not a direct relationship,” Dr. Rachel Nazarian, a New York-based dermatologist, told Health. “We may not know exactly why the trigger happens, but we know how to fix it.”

Fortunately, stress hives are usually transient, and will diminish or disappear once the source of stress is alleviated — often within 24 hours.

There are over-the-counter treatments for hives, including oral antihistamines like Benadryl or Zyrtec, or cortisone cream to manage the inflammation that results in itchy, reddish skin.

“There are also some people who require a stronger medication to control the histamine release, so they may want to try a prescription antihistamine or prescription cortisone cream,” Nazarian added.

“Some areas have thinner skin that is easy to treat like your arms or legs. But thicker areas like your hands or feet, an over-the counter-cream doesn’t penetrate as well.”

Experts also suggest removing any irritating factors like heat or tight-fitting clothes around the area of your stress rash. “Heat is known to be an aggravant, as well as pressure,” Nazarian said.

Nazarian and other health experts recommend that people with severe or long-lasting cases of stress hives see a dermatologist or other health care professional for relief.

And, of course, you can help to prevent a stress rash by relieving stress in your life. Try using one or more of the following methods:

• Exercise and sports
• Limit screen time and social media use
• Yoga, tai chi and deep breathing
• Meditation
• Seek out a friend for a walk or other activity
• Listen to music or read a book
• Play an audiobook or podcast