Stress rashes often appear as raised discolored bumps called hives. They are commonly found on the face, chest, neck, or arms and may itch, burn or tingle.

Everyone deals with stress occasionally, and stress can affect more than just emotional health. It can also cause physical symptoms, such as a rash, that can amplify stress.

A stress-induced rash generally isn’t a major cause for concern, and you can often treat it at home.

Read on to learn how to identify a stress rash and the best way to treat it.

When it’s an emergency

Sometimes, hives can be an emergency. Contact 911 or your local emergency services if you:

  • have swelling of the lips or face
  • have trouble breathing or swallowing
  • are wheezing
  • feel faint or lightheaded
  • have a racing heart

You may need an epinephrine shot for treatment for anaphylaxis, a severe allergic reaction.

If you develop a rash or hives after taking a new medication, you should consult a doctor immediately, as this can also be life threatening.

Stress rashes often take the form of hives (urticaria), also called wheals or welts. Hives can appear anywhere on the body. These blotchy areas can be as small as a pencil tip or as large as a dinner plate.

Areas affected by hives may:

  • be raised above the surface of the skin
  • feel itchy
  • be swollen
  • feel warm to the touch
  • tingle or burn when you touch the affected areas

These patches may connect to form larger welts ranging from less than a centimeter to big patches covering large areas of the skin. What they look like may vary depending on your skin color.

  • In Black or Brown skin, hives may appear as a raised patch that may be the same color as your skin or slightly lighter or darker. This can make them harder to spot.
  • In lighter skin tones, hives usually appear similar to your skin tone or as red or pink discolorations. If there’s a lot of swelling, the hive may look lighter.

Hives may come and go or show up on one part of the body, then resolve and reappear somewhere else. They typically resolve within 2 to 3 hours, but it can take up to 1 day for you to feel full relief.

A single hive generally fades in about 24 hours. But new hives may form as old hives disappear. If you have multiple appearances of hives, you may experience these symptoms for 6 weeks or less.

If your symptoms persist beyond 6 weeks, your hives may be chronic and require additional treatment.

Hives often result from the immune system reacting to an allergen, such as food or pollen. However, they can also result from other factors, including illnesses and environmental triggers.

Stress is considered an environmental trigger.

Stress can come from anywhere, but common triggers for stress rashes include:

  • major life events, such as starting college, getting married, or getting divorced
  • new jobs or challenging promotions
  • an overly ambitious new exercise routine
  • quitting smoking
  • drastic changes to your diet
  • grief
  • anxiety over friends or loved ones going through hard times
  • periods of insomnia

Having certain mental health conditions may also cause stress that can trigger hives. These may include:

  • anxiety
  • depression
  • bipolar disorder
  • somatoform disorder

Stress can cause an existing skin condition to flare up. Stress may cause your body to release extra chemicals, such as neuropeptides and neurotransmitters that affect your body’s responses to stimuli like inflammation, sensitivity, and skin discomfort.

Stress can also increase the production of immune cells, which can potentially lead to an autoimmune reaction.

Sometimes, hives go away on their own without treatment.

Other times, they may respond to at-home treatment, such as over-the-counter (OTC) antihistamines. Antihistamines can relieve symptoms such as itching.

Common OTC treatments can include:

If your symptoms worsen or last longer than 6 weeks, consider making an appointment with a dermatologist. Hives that last this long or longer are considered chronic and may not go away without medical intervention.

For severe or chronic hives, a doctor may recommend:

  • prescription-strength antihistamines
  • corticosteroids, such as prednisone
  • a monoclonal antibody, such as omalizumab (Xolair)
  • cyclosporine, which can be used to treat inflammation
  • montelukast (Singulair) or other allergy medications
  • other medications to reduce discoloration and swelling
  • immunosuppressant medications, though rarely

If you have psoriasis or rosacea, it’s best to talk with a doctor. They can look over your current treatment regimen and may be able to make adjustments if needed.

Some at-home remedies can help relieve a rash and its bothersome symptoms:

  • placing a cool compress on the affected areas
  • taking a lukewarm shower or a soothing oatmeal and milk bath
  • using fragrance- and dye-free lotions
  • staying hydrated and limiting your alcohol and caffeine intake
  • avoiding hot showers or high humidity
  • avoiding tight clothing or anything that rubs on your skin

If the stress in your life triggers a rash, stress management techniques may help you better manage stress and your response to it. You can try:

Reducing stress may also help improve your skin condition.

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

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

  • Heat rash: If you live or work in hot, humid conditions, you may be experiencing a heat rash. It can happen when pores become blocked and sweat is unable to escape.
  • Stress acne: Stress and anxiety can trigger acne, which has symptoms similar to non-stress-related acne.
  • Pityriasis rosea: This common type of rash often goes away on its own. Pityriasis rosea typically starts with a large patch of red, raised skin but isn’t usually itchy.
  • Rosacea: Depending on the type, rosacea often causes small, discolored, and sometimes pus-filled bumps. The skin can thicken in these areas. In some cases, stress can cause rosacea.
  • Contact dermatitis: Contact dermatitis causes an itchy rash on the skin. You may also experience bumps or blisters, swelling, and tenderness.
  • Eczema: A chronic condition, eczema may be triggered by stress and can make your skin discolored and itchy. Although it commonly begins in childhood, eczema can occur at any age.

Stress may worsen your symptoms if you have a preexisting skin condition, such as psoriasis or rosacea. If this occurs, stress is considered a trigger for these conditions.

If you experience itchy, welt-like patches that resolve in several days or with OTC treatment, they’re probably hives.

However, if you’re unsure, it’s best to make an appointment with a doctor. A rash can be a symptom of other health conditions, including an allergy.

If the bumps are hard or filled with pus or something other than clear fluid, they may indicate an underlying medical condition or a serious allergic reaction.

You should also consult a doctor if you have:

  • a rash over your whole body
  • a fever or swollen lymph nodes
  • painful hives
  • blisters that leak yellow or green fluid
  • peeling skin alongside your hives
  • hard or pus-filled bumps
  • hives that involve a mucous membrane, such as the mouth or inside of the nose
  • a rash that doesn’t resolve

Contact a doctor if you suspect the rash is caused by an allergy.

Severe allergic reactions may be life threatening and require immediate medical treatment.

A stress rash with hives will likely disappear with time and mild to moderate treatments.

But stress can also worsen existing skin conditions and they may need additional treatment to resolve.

You may need to see a doctor, such as a dermatologist, to treat stress-related skin conditions, including acne, dermatitis, or severe or long-lasting hives. If you have chronic conditions such as psoriasis and rosacea, a doctor can help you develop an appropriate treatment plan.

If stress is triggering a rash, you may also benefit from taking steps to manage it, such as therapy for stress or mindfulness activities.