Stress can manifest physically in numerous ways, and one such manifestation is a skin condition known as a stress rash, typically presenting as hives or urticaria. According to the American Academy of Dermatology, nearly 20 percent of people will experience hives at some point in their lives. While hives can result from various triggers, including allergies and infections, the Oxford academic journal of Occupational Medicine notes that stress is a recognized factor that can exacerbate skin problems . When hives coincide with periods of high stress, it may be indicative of a stress rash. However, it's crucial to consider other potential causes, as stress can also aggravate pre-existing conditions like herpes simplex. Understanding what is a stress rash involves recognizing the interplay between psychological stressors and physical responses, and seeking appropriate medical evaluation for accurate diagnosis and treatment.
Many people want to know why stress might result in a rash, and the answers to this are not as clear-cut. Stress may affect the body’s immune system, which can have an effect on inflammatory response. The reaction may be similar to what occurs when the body responds to a substance to which it is allergic, but in this instance, stress could be considered the allergen. As stress levels rise, so can inflammation and histamine levels. Essentially, some people may be having an allergic response to stress. This causes the telltale signs of stress rash where bumps, red raised skin, and itchiness may cover the body in small to large amounts.
What Kind of Stress Leads to a Stress Rash?
This idea of stress allergy is an interesting one, since some people clearly don’t have and will likely never get a stress rash. Yet all people undergo stress. Some people’s bodies may simply be better at coping with difficult or anxious times, and others find that slight nervousness can trigger an inflammatory skin response.
Each person reacts differently to the stress of life. There may be physical differences in the way people handle and process anxiety that accounts for the variation in stress rash expression. Many people never develop stress rashes, while some develop them often throughout puberty and beyond. Commonly, the first signs of skin discomfort due to stress come around a significant life event. This can include:
- Life changes, such as weddings, graduations, or relocations
- A loved one dying or moving away
- Family changes such as siblings leaving the house or parents divorcing
- Stressful times of the year, like finals or exam season
Every person is different, and their body reacts to stress uniquely. Even good changes can cause stress, and a stress rash is a physical symptom of the emotional state. Fortunately, these rashes are easy to diagnose and treat.
Stress Rashes and Acne
Unfortunately, those who suffer from rosacea, acne, eczema, or other skin conditions will likely suffer from stress rashes. Although this type of rash is relatively rare in the general population, those who already have skin issues might be more prone to increased hives and acne from stress.
Because stress affects every part of your body, previous diagnoses are likely to get worse. Stress makes indigestion, fatigue, muscle cramps, and other conditions more painful, and skin conditions are no exception. If you struggle with chronic acne, rosacea, or another skin issue, you might be more likely to develop a stress rash.
How to Diagnose a Stress Rash
There could be any number of reasons for an undiagnosed rash. Stress is not the only reason that people develop rashes, nor is it the most common. However, it’s crucial to properly assess your physical health to treat the problem correctly.
Contact Your Primary Care Provider
The first step is to contact a doctor, whether that’s your primary care provider or a dermatologist. Through pictures or an in-person visit, they will be able to help you decide whether your rash is from stress or another reaction.
A medical professional who knows you can help you assess the stress levels in your life, as well as prescribe any medications you might need. They can also set up follow-up appointments with allergists, therapists, and other medical professionals as needed. Once you’ve seen your doctor, you will have a plan in place for your medical care.
Rule Out Other Allergic Reactions
Before you decide that you have a stress rash, you should rule out other allergic reactions. If you assume that it’s stress, the rash won’t go away. Any allergen will continue causing inflammation until it’s completely removed and the irritation treated.
It shouldn't be assumed hives is a result of stress. People should also plan to see a dermatologist if they have recurrent rashes. A doctor can help you rule out common rashes or skin irritants.
Sometimes allergy testing is recommended to determine its cause. In this test, an allergist will expose your skin to multiple common allergens and help you decide what your skin is sensitive to. This kind of test is comprehensive and can help if you can’t find the cause of your rash.
Steps to Treat a Stress Rash
If you’ve ruled out normal allergic reactions or skin conditions and your doctor agrees that you have a stress rash, it’s time to treat it. Treating stress rash can take several directions. The first of these is to promote comfort when a person has an active rash. First line treatment is typically oral antihistamines, which help dull inflammatory response and make the rash go away. This can take a few days to be fully effective.
Of course, the standard method of antihistamines often helps clear up the rash quickly and effectively. However, you want your skin to remain precise.
Follow Prescribed Medications
Of course, the first step to getting better is following the doctor’s orders. If your doctor prescribes antihistamines, you should pick up the prescription and take medicine as prescribed. As with any allergic reaction, the antihistamines should help your rash go down and your skin becomes clearer.
Keep in contact with your doctor and watch the progression of your rash. As it calms down, you can ask your doctor about follow-up care and continued use of medications. However, you will likely not need to use antihistamines any longer.
Learn Stress-Relieving Techniques
Prevention of stress rash is vital, too. A stress rash is brought on by extreme stress, usually in unusual or intense circumstances. If you have a consistent stress response, you might benefit from stress-relieving techniques.
While people can’t always prevent stress, they might be able to find new methods for coping with it, such as: learning relaxation exercises, adopting stress reduction techniques, participating in talk therapy, or finding additional methods to handle high anxiety levels. A licensed therapist can help you control stress and keep your skin clear, no matter how stressful your life is.
Simple breathing exercises or calming, grounding techniques can also help reduce stress at the moment. If you struggle with constant pressure, you might be able to ask your doctor for anxiety medication to reduce your cortisol levels and help your brain manage the stress hormones it produces.
Sometimes people benefit from medication to treat conditions like depression, anxiety, posttraumatic stress disorder, or panic disorder. These could also help dull the body’s response to stress. Given the individual nature of stress response, each person will likely derive a specific plan that best works, and evidence the plan is working would be reduction of stress rashes.
Since many illnesses are manifested by skin rashes, it's also a good idea to get diagnosis of the rash, instead of assuming it's hives.