Any skin irritation caused by physical or mental stress can be called a stress rash. People under lots of pressure often develop hives or notice a pre-existing condition like eczema getting worse. A stress rash may be itchy or cause a tingling sensation and most often affects the face, neck, arms, or chest. Hives usually appear as raised red bumps that vary from large welts to small dots.


The symptoms of a stress rash vary from person to person. However, the most common signs are a rash on the upper body and face, typically itchy, red, and inflamed. It may look similar to an allergic reaction, without an apparent trigger. A stress rash may feel warm to the touch or emit heat; it can also make a person look flushed.

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Causes of Stress Rashes

Whatever the appearance or location of skin irritation, it could be deemed a stress rash if the primary trigger is stress. In addition to hives or worsening eczema flareups, stress rashes can also worsen acne, causing the skin to break out in pimples. Acute emotional distress or chronic worry trigger stress rashes because they adversely affect the immune system and increase levels of stress hormones like cortisol.

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Histamines and Immunes

When a person is stressed out, it triggers an immune response that makes the body release histamine. These hormones are the body's way of fighting off allergens, a process that creates familiar allergy symptoms such as itching, sneezing, and skin inflammation. Stress rash can occur due to too much histamine and is more likely to affect people with autoimmune conditions or allergies. Stress can also harm the immune system, making people more susceptible to allergies and other conditions.

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Stress Rash and Hives

Hives are itchy raised bumps or welts that may appear red. The welts can appear and fade several times until the inflammation runs its course. Hives often develop in clusters and can affect any part of the body.

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Types of Stress Hives

Researchers have identified specific types of stress hives, including cholinergic and dermatographia. Cholinergic hives appear during times of severe emotional stress and are accompanied by raised body temperature. In comparison, dermatographia is common in people who pick or scratch themselves under pressure. Allergy medication may help treat this type of stress rash.

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Stress rashes mostly resolve without treatment. However, they may recur — especially if the cause of the stress is not resolved — and could last up to six weeks. It is crucial to keep from scratching, even though the rash may itch; scratching can worsen symptoms or spread bacteria. A cold compress may help with swelling and itching, while a doctor is likely to recommend an antihistamine. Most importantly, people with stress rashes should examine the stressful triggers in their lives and find ways to mitigate them.

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The best way to prevent a stress rash is to preemptively address the issues that lead to stress. While it's rarely possible to eliminate stress in today's busy world, some things help a person better deal with stressful situations. Research shows that regular exercise, getting enough sleep, having strong social ties, and eating a healthy diet are excellent ways to destress. According to the American Psychological Association, 62 percent of people who walk or exercise say it helps them feel calmer.

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A stress rash can be worse if the skin is moist or warm. Be sure to gently and thoroughly towel dry after showers and keep the area dry throughout the day. Moisturizing is crucial because over-dry skin can worsen conditions like eczema. Use a scent- and oil-free moisturizer once or twice a day.

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There are many studies on the effects of psychological stress on the skin, including stress rash. The results demonstrate a strong relationship between the two and show persistent stress affects the immune and endocrine systems. Studies also show that the skin can be affected by both internal and external factors.

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Ways to Relieve Stress

Meditation, exercise, and healthy eating can all help relieve stress. If a person feels overwhelmed or experiencing anxiety, doctors may suggest speaking to a counselor or psychologist. Work-related stress has countless triggers and, while it can be difficult to identify them. However, when stress manifests in a person, it's crucial to take a step back and assess how to better deal with the things causing worry.

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