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Stress Rash: Tips for Identification, Treatment, and More

Is this common?

Stress can wreak havoc on your physical and emotional health. You may feel overwhelmed or anxious about the source of your stress. If you’re experiencing physical symptoms like a rash, stress may be amplified.

Everyone deals with stress from time to time, and many people will experience a stress rash at least once. A stress-induced rash generally isn’t cause for concern. It can often be treated at home.

People with preexisting skin conditions, such as psoriasis or rosacea, may find that stress worsens their symptoms. If this happens, stress is considered a trigger.

Here's how to identify and treat stress rash:

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Identification

What does stress rash look like?

Stress rash often takes the form of hives, or welts. Hives can appear anywhere on the body. Areas affected by hives are generally red, raised, and swollen. These blotchy areas can be as small as a pencil tip or as large as a dinner plate.

Sometimes, these patches may connect to form even larger welts. These welts are known as wheals and can range in size from less than a centimeter to giant patches covering large areas of skin.

Hives can also appear as general skin swelling that develops in one place on your body. This section of swelling may disappear and then appear somewhere else.

Areas affected by hives will likely itch. You may also experience a tingling or burning sensation when touching the affected areas.

A single hive generally fades in about 24 hours. But new hives may form as old hives disappear. If you have multiple hives, you may experience these symptoms for about 6 weeks. This is considered a bout of acute hives.

Though less common, your symptoms may persist beyond 6 weeks. If this happens, your hives are considered chronic.

Causes

What causes stress rash?

Hives are often the result of your immune system reacting to an allergen.

The most common food allergens include:

Other notable allergens are pollen, pet dander, and medications such as penicillin.

Hives can also be caused by other factors, like a viral infection, illness, or environmental trigger. Stress is considered to be an environmental trigger.

Other environmental triggers include:

  • hot and cold temperatures
  • sunlight
  • water
  • exercise

When you’re stressed, it isn’t uncommon to experience a flare-up related to an existing skin condition. This is because your body releases extra chemicals, like neuropeptides and neurotransmitters, when you’re stressed. These chemicals can change how your body responds to various functions. This change in response can cause inflammation, sensitivity, and other discomfort to the skin.

Check out: Can stress trigger shingles? »

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Treatment

How to treat stress rash

Sometimes hives go away on their own without treatment. Otherwise, hives can generally be treated at home. The most common treatment for hives is an over-the-counter (OTC) antihistamine. Antihistamines can relieve symptoms like itching.

Common OTC antihistamines include:

You may also find relief by using a cool compress on the affected areas. Soaking in a cool bath or taking a cool shower may also help.

If your symptoms worsen or last longer than 6 weeks, you should consult your doctor. Hives that last beyond 6 weeks are considered chronic and may go away within a year.

Your doctor may prescribe one of the following to treat severe or chronic hives:

  • prescription-strength antihistamines
  • corticosteroids, like prednisone (Deltasone)
  • the antibiotic dapsone (Aczone)
  • the injectable medication omalizumab (Xolair)
  • other medications that fight redness and swelling

If you experience swelling of the lips or face, trouble breathing, or wheezing, you should seek immediate medical attention. These can be life-threatening complications, and you will likely need a shot of epinephrine for treatment.

If your rash is tied to a preexisting condition, such as psoriasis or rosacea, talk with your doctor. They can evaluate your current treatment regimen and may be able to make adjustments if needed.

Other causes

What else could this rash be?

It’s possible to confuse stress rash with other common skin conditions. These include:

Heat rash

If you live or work in hot, humid conditions, you may be experiencing heat rash. This happens when your pores become blocked and sweat is unable to escape.

The most common form of heat rash, miliaria crystallina, causes clear or white bumps. Miliaria rubra can cause red bumps similar to hives.

Unlike hives, heat rash almost always clears up on its own. It typically goes away in less than a week. But consult your doctor if you begin to experience:

Pityriasis rosea

This skin disease is common, and it often goes away on its own. It typically starts with a large patch of red, raised skin. This “mother patch” or “herald patch” may be surrounded by small red bumps, or “daughter patches,” that are typically oval in shape.

It’s unclear what causes the rash, but it’s most common during the spring and fall. It may or may not be itchy.

Pityriasis rosea typically fades without treatment in six to eight weeks. During this time, you can use an OTC anti-itch medication, like diphenhydramine (Benadryl) or cetirizine (Zyrtec) to ease your symptoms.

If your symptoms worsen or persist, consult your doctor. They may be able to prescribe prescription-strength anti-itch medication.

Learn more: Is it psoriasis or pityriasis rosea? »

Rosacea

Rosacea is another common skin condition. Depending on the type, it often causes small, red, sometimes pus-filled bumps to form on the skin. The skin can thicken in these areas. The rash typically covers the cheeks, nose, and forehead. But it can involve other areas of the face. These bumps may appear for weeks to months before disappearing and appearing again at a later time.

Although rosacea can affect anyone, it’s most common in middle-aged women who have fair skin. There’s no cure for rosacea, so treatments focus on management techniques. This includes wearing a broad-spectrum sunscreen and moisturizing frequently.

If you think you’re experiencing rosacea, consult your doctor. They can make a diagnosis and prescribe medication to help reduce redness.

Prescription medications include:

Contact dermatitis

This condition is usually acute and can cause a red, itchy rash to appear on the skin. You may also experience bumps or blisters, swelling, and tenderness. The exact cause of contact dermatitis varies from person to person, though it develops after coming into contact with something that triggers an allergic reaction on your skin.

Common causes include:

  • soaps
  • shampoos
  • cosmetics
  • fragrances
  • jewelry
  • plants, such as poison ivy
  • lotions
  • laundry detergent

Although it’s helpful to identify the exact cause of your contact dermatitis, there are steps you can take to treat this general rash.

This includes:

  • applying anti-itch cream or calamine lotion
  • taking over-the-counter anti-itch medication, such as diphenhydramine (Benadryl)
  • soaking in a cool oatmeal bath
  • avoiding scratching
  • using mild soaps without dyes or perfumes

If your symptoms persist after one to two weeks, consult your doctor. They can make a diagnosis, if needed, and prescribe prescription-strength medication.

Eczema

This chronic condition can also make your skin red and itchy. Although it’s most common in children, it can occur at any age. It generally starts as small, raised bumps. These bumps may leak fluid if scratched. The rash can form thickened areas of skin over a larger area, called plaques.

You may also experience red patches around the:

  • hands
  • feet
  • ankles
  • wrists
  • neck
  • upper chest
  • eyelids
  • face, especially cheeks
  • scalp
  • ears
  • elbow crease
  • back of the knees

You may be able to manage your symptoms by:

  • applying anti-itch cream or calamine lotion
  • taking an anti-itch medication, such as diphenhydramine (Benadryl)
  • moisturizing at least twice daily
  • taking an oatmeal bath
  • using a humidifier

Consult your doctor if your symptoms persist for more than one to two weeks. They can make a diagnosis and prescribe prescription-strength medication.

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When to see your doctor

When to see your doctor

If you’re experiencing bumps that are itchy, inflamed, or filled with fluid, you probably have hives. Hives can often be treated at home or go away on their own without treatment.

If the bumps are hard or filled with something other than fluid, they may be a sign of an underlying medical condition. Hives that occur along with peeling of the skin or blisters can be a sign of a serious allergic reaction. If you develop a rash or hives after taking a medication, you should consult your doctor immediately.

You should also consult your doctor if you have:

  • whole-body rash
  • fever
  • pain
  • blisters that leak yellow or green fluid

If you suspect your rash is the result of a preexisting condition that you’re currently seeking treatment for, you may benefit from a consultation. Your doctor can confirm your suspicions and take appropriate next steps.

Contact your doctor if you suspect the rash is caused by an allergen. Severe allergic reactions may result in a condition called anaphylaxis, which requires immediate medical treatment.

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Outlook

Outlook

Rashes caused by stress may vary in treatment and length. Stress rash caused by hives will likely disappear with time and mild-to-moderate treatments. You may need to see a doctor to treat stress-related skin conditions such as acne, dermatitis, or severe or long-lasting hives. If you have chronic conditions like psoriasis and rosacea, you should work with your doctor to develop an appropriate treatment plan to use in the long term.

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Takeaway

What you can do now

If your rash is caused by stress, this may be a sign to reduce the stressors in your life.

There are many methods to help ease your mind and eliminate stress, including:

Once you find methods that help you relax and reframe your outlook, you may find that your skin condition improves.

In the meantime, use OTC medications as needed to alleviate any inflammation and irritation. If your symptoms persist or if you think they’re the result of an underlying condition, consult your doctor. They can work with you to determine next steps.

Keep reading: 5 ways to reduce stress at home »

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