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Stress rash: Understanding hives

Woman in white jumper scratches rash on arm
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What are hives?

Itchy skin is something we all experience from time to time. Usually this happens as the result of an allergic reaction or an insect bite, or a side effect of medication. For some people, though, redness and itching of the skin can be a direct symptom of stress. Hives are a common type of skin rash that can occur in up to 1 in 5 people during their lifetime. Learn more about the causes and treatment of hives.

What can cause hives?

Hives (or urticaria) can have various causes – allergic reaction, infection, stress, overexposure to sun or heat.

Different types of hives

Hives can be categorised as:

  • Acute - short term rash, which completely clears within 6 weeks.
  • Chronic - a persistent rash, (which may come and go) for a duration of time longer than 6 weeks. This is less common.

Symptoms of hives

  • Raised, red (or white) patches (known as weals) or spots
  • Round or irregular shaped weals that sometimes join together
  • Itching, stinging and burning
  • High temperature
  • Swelling under the skin
  • Weals that fade, and are then replaced by new weals that can appear on other parts of the body

Image of hives rash on skin

What type of rash is caused by stress?

Hives, or urticaria, is a type of skin rash that can be triggered by stress. It’s quite a distinctive type of rash that causes:

  • Raised, red patches or spots
  • Itching, stinging and burning

The raised, itchy patches of skin (sometimes referred to as “weals”) are often one or two centimetres in diameter.

Why does stress cause hives?

Hives can develop when the immune system releases histamine and other chemicals in response to a “threat” to your body. Sometimes this “threat” might be genuine, like an infection. However, sometimes your immune system releases histamine in response to something completely harmless.

Lots of things can trigger this kind of response from your immune system, including certain foods, cold weather and contact with specific materials and substances. According to the NHS, another trigger is the skin becoming very hot and sweaty, which can be caused by exercise, eating spicy foods or experiencing stress.

How can I manage a stress rash?

There’s not always a need to treat hives, as they often pass quite quickly – in fact, the British Association of Dermatologists advises that hives brought on by sweating tend to pass within one hour.

However, if your symptoms last a while, or if they’re very uncomfortable (e.g. very itchy), you can take over-the-counter antihistamines.

It’s a good idea to see your GP if:

  • The rash doesn’t get better after two days
  • The rash spreads
  • You keep getting hives
  • You have a high temperature
  • You have swelling under the skin
  • Your GP can then assess the symptoms more thoroughly and prescribe any medication that may be required.

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How can I prevent stress hives?

Stress – and the body’s physical response to it – is something we all wish we could control, but that’s not always possible. This means that it’s pretty difficult to prevent hives when you’re in a stressful situation.

If you are prone to stress rashes, it’s a good idea to keep some over-the-counter antihistamines to hand. In any situations where you anticipate a high level of stress or physical exertion you might benefit from taking an antihistamine tablet an hour or two beforehand.

It might be helpful to speak to your GP if you’re regularly feeling extremely stressed – especially if it’s taking a heavy toll on your health. While stress isn’t a diagnosable condition in itself, your GP may be able to suggest some relaxation techniques, refer you for therapy, or sign you off work.

How else can stress affect the skin?

Stress can affect the skin in lots of different ways. Most often, it worsens the symptoms of an existing skin condition like acne, eczema or psoriasis. You can learn more by reading this article on our Online Doctor site: Can stress trigger skin conditions?

How long do hives last?

This depends on the type and cause of the hives. Acute hives might seem to appear from nowhere, with raised weals appearing suddenly. The weals can appear anywhere on the body, and then fade away on their own. Sometimes they will be replaced with fresh weals, giving the sense that the hives are moving around the body. The hives then typically resolve within 24 – 48 hours, but in some cases, they can take several weeks to disappear totally.

Chronic hives are persistent hives that last longer than 6 weeks. This is a rarer condition, which for some people may have itchy, red skin on most days, or it may be intermittent and seem to ‘come and go’.

When should I be worried about hives?

Hives can be a symptom of a serious allergic reaction known as anaphylaxis, which requires emergency medical treatment.

You should call 999 or go straight to A&E if you:

  • Are wheezing and having trouble breathing or talking
  • Have a tight feeling in your chest or throat
  • Have swelling in your mouth, face or throat

Treatment for hives

The main treatment for hives is antihistamines. They are available over the counter from your pharmacist or from a doctor. You can also apply a cool compress to the affected areas and try to avoid scratching. Try loose-fitting, lightweight clothes, especially if the hives are caused by heat or pressure.

Skin rashes can have a variety of causes. If you have a rash that is worrying you, always seek advice from a doctor or your pharmacist. We have a range of products to treat common skin rashes such as eczema, dermatitis, or seborrhoeic dermatitis. For more allergy advice, check out our articles for common causes of allergies, such as mould, plasters, or pets.