Hives are puffy, raised welts that most commonly appear on the skin as a result of an allergic reaction, but there are actually a number of different things that can cause people to break out in hives, including anxiety. When this happens, people can develop an itchy rash on the skin known as an anxiety rash (sometimes called anxiety hives or a stress rash).

Stress is a normal part of daily life. But when that stress goes unchecked, or when it’s actually undiagnosed anxiety, it can come with a host of negative side effects. If you have hives and cannot pinpoint any other cause, anxiety could be the culprit and it’s worth consulting a doctor or mental health professional to confirm.

Symptoms of an Anxiety Rash

Stress rashes often appear as hives, also known as urticaria, which tend to be:

If stress and anxiety are the cause, there are steps you can take to manage your stress response and reduce the likelihood of developing a stress rash.

  • Itchy: The rash can be itchy, or it could burn or sting.Red/blotchy: The welts can also vary in color.Swollen/puffy: The skin will swell in areas, and shapes and edges are obvious. Swelling can also occur underneath the skin, which is called angioedema.

Hives can appear anywhere on the body. However, an anxiety rash on the face, neck, and chest are some of the most common. While they may initially start as tiny red bumps like a typical rash, stress rashes often become larger welts or patches that become worse after scratching them.

Individual hives can be as large as dinner plates, but smaller hives can also merge together so that they appear to cover a large portion of the body.

Causes of an Anxiety Rash

Hives are often the result of an allergic reaction to something in your environment. But emotional stress can cause a rash, too. This is because stress can trigger a response in the sympathetic nervous system, leading to the release of histamine. 

How Long Do Anxiety Rashes Last?

Most anxiety rashes disappear within 24 hours; however, if you’re still seeing hives after a couple of days, it’s recommended that you consult a dermatologist.

Most commonly, hives are a result of one of the following causes:

Histamine is a compound that is normally produced by the body in response to injury, allergies, and inflammatory reactions, but it can also be triggered by stress.

  • Chemicals: Chemicals can irritate your skin or cause an allergic reaction resulting in a rash.Exercise: Exercise can trigger urticaria, but the exact reason for this is not known.Extreme weather: Some people can get hives from being exposed to cold weather, which is a condition called cold urticaria.Fabrics: Some fabrics can cause hives on your skin. Also, some detergents and fabric softeners can cause an allergic or irritant skin response.Foods: Common food allergens that might trigger hives include milk, nuts, soy, eggs, seafood, and wheat.Infection: Viral, bacterial, and parasitic infections can trigger hives and swelling.Medications: Hives may develop as a result of a medication someone is taking, such as aspirin.Pollen: Pollen is a common allergen that can trigger an allergic response, including skin rash.Sunlight: It’s possible to have an allergic reaction to the sun that results in hives in what’s known as solar urticaria.Sweat: Activities that produce perspiration such as exercising and bathing can result in hives known as cholinergic urticaria.

If you’ve ruled out these common causes, it’s possible that stress is a factor.

Stress rashes tend to appear most commonly in women during their 30s, 40s, and 50s. People who have had allergic hives in the past are also at a higher risk of experiencing anxiety hives.

Is It Anxiety or Something Else?

If you are experiencing hives, you should start by assessing your activities over the last few days. Any unusual changes in your routine or exposure to new things might play a role in triggering hives.

Anxiety Rash Treatment

If you are experiencing a stress rash, it’s important to find ways to relieve your immediate symptoms in the short-term while also looking for ways to lower your stress over the long term.

Care for Your Skin

You can ease some of the uncomfortable physical symptoms of hives by wearing loose-fitting clothing and avoiding hot water. Topical steroids such as hydrocortisone cream and applying cold compresses can also help relieve the itching and irritation caused by the hives.

Take an Antihistamine

Over-the-counter products such as Benadryl (diphenhydramine), Claritin (loratadine), and Allegra (fexofenadine) can help relieve hives.

Stress Rash Home Remedies

Some topical treatments such as oatmeal baths or applying aloe vera to a stress rash may help reduce inflammation. However, it’s best to check with a doctor prior to treating your rash at home.

For more severe cases of hives, a doctor may prescribe a corticosteroid such as prednisone.

Use Stress Management Techniques

If you are feeling acute stress, try some fast-acting stress relievers that may help provide some more immediate relief. Deep breathing can be an effective way to calm your body and mind, but other strategies like taking a walk around the block or doing a few minutes of quiet meditation can also help.

You should also talk to a doctor if your hives worsen or last longer than six weeks. Hives that persist longer than six weeks are considered chronic and may not go away on their own without medical attention.

If your hives are accompanied by other symptoms of an allergic reaction such as swelling of the face or lips, wheezing, or difficulty breathing, you should seek immediate medical attention. It may be a sign of a serious, possibly life-threatening allergic reaction.

Preventing Anxiety Rashes

If you are prone to stress rashes, it is important to learn how to identify your triggers and be proactive about preventing stress and stress rash from happening in the first place. 

If you are experiencing a stress rash, it may be a sign that you need to find a way to better manage stress and anxiety. It’s important to build good stress coping techniques.

Challenge Negative Thoughts

Negative thoughts can cause feelings of anxiety. Learning how to identify and then challenge these negative thoughts can help you replace them with more realistic, positive ones.

Change Your Situation

If there is something in your life that is causing a great deal of anxiety, think about what you can do to change the situation. This might involve delegating some tasks to others, cutting back on your commitments, or setting boundaries with others. 

Try Journaling

Research suggests that expressive writing may be helpful for reducing feelings of anxiety. Consider keeping a journal where you write about things that you are experiencing or some of the things for which you are grateful. 

Consider Professional Treatment

Anxiety can have a serious effect on your life and can become worse over time if left untreated. If you feel like your anxiety is creating significant distress or making it difficult to function normally in your daily life, talk to a mental health professional. Effective treatments are available that can help you get your anxiety under control.

A Word From Verywell

Stress and anxiety can be difficult to deal with, and experiencing itchy, uncomfortable hives can make what you are feeling feel even worse. Fortunately, anxiety hives are usually manageable with some self-treatment.

If you are prone to stress rashes, the best way to manage them is to get your anxiety under control. Talk to a doctor about some of the ways you can cope, which may include medication, psychotherapy, or a combination of the two.