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Stress rash: Understanding hives

Woman in white jumper scratches rash on arm
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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 as a side effect of medication. For some people, though, redness and itching of the skin can be a direct symptom of stress.

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:

The raised, itchy patches of skin (sometimes referred to as “weals”) are often one or two centimetres in diameter. However, sometimes they can join together to form larger raised areas.

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

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.

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:

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?

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References

www.nhs.uk/conditions/hives
https://patient.info/skin-conditions/hives-inducible-urticaria#nav-2
www.aad.org/public/diseases/a-z/hives-causes
www.bad.org.uk/pils/urticaria-and-angioedema/
www.mind.org.uk/information-support/types-of-mental-health-problems/stress/treatment-for-stress