Are Stress Hives a Real Thing?

It’s been a rough-and-tumble week, with stress levels rocketing sky-high. And now, out of nowhere, you’re covered in hives — because dealing with splotchy, itchy skin was just what you needed.

So, what’s the deal? Well, as it turns out, stress hives are a real thing. Consider the outbreak a physical manifestation of the turmoil you’re experiencing as your body searches for ways to cope.

Family medicine physician Brian Myers, MD, has some tips to help you calm things down.

How does stress cause hives or a rash?

People tend to think of stress in a mental or emotional context, but it can also bring physical symptoms. Your heart may start racing, for instance, or your stomach may feel a little topsy-turvy.

Those responses reflect your body’s built-in “fight-or-flight” response driven by your autonomic nervous system.

Which brings us to stress rashes and hives.

Your body’s response to stress can include the release of a natural chemical known as histamine. Although this is done as a protective action, the results can have unintended consequences, like hives.

The same process occurs during an allergic reaction, which — not coincidentally — can also bring out hives.

What do stress hives look like?

Hives are raised red welts or splotches that appear on your skin. Typically, they’re small — like the size of a fingertip. But individual hives also can cover an area the size of a dinner plate. (Smaller hives may sometimes merge into huge patches called plaques, too.)

Odds are, you won’t just see hives either: You’ll feel them. Hives can itch, burn and even hurt, says Dr. Myers.

Are some people more prone to hives?

Anyone can get stress hives, but they tend to be more common in women and people assigned female at birth (AFAB). They also seem to most often affect people during their 20s, 30s and 40s.

And if you’ve had allergen-driven hives, you’re more likely to experience stress hives, notes Dr. Myers.

But again, no one is immune. “It can happen to anyone out of the blue,” he says.

How to get rid of stress hives and rashes

The good news? Stress rash often disappears in a day or two. But don’t be surprised if another batch of hives rears up as a replacement — especially if you’re still dealing with your stressors.

Stress hive breakouts may also come and go in waves and can flare up again a few weeks after disappearing.

Dr. Myers offers these suggestions for stress rash treatment:

• Try over-the-counter (OTC) medication. Antihistamines like cetirizine (Zyrtec®), fexofenadine (Allegra®) or loratadine (Claritin®) can block the effect of histamines to clear hives. The medication can be taken orally (by pill) or applied topically (with a gel or cream).
• Avoid certain OTC meds. Aspirin and other nonsteroidal anti-inflammatory (NSAID) medications such as ibuprofen can sometimes help trigger hives.
• Shower smartly. Hot water can fuel and irritate hives, so avoid long and steamy showers. Mild and fragrance-free soaps are recommended, too.
• Dress for success. Tight clothes that rub on your hives can further irritate your skin. It’s best to wear loose-fitting clothes until things calm down.
• Relax. If stress is the likely cause of your hives, try dialing down the tension in your life Yeah, we know — easier said than done. But if you’re up for trying, here are 20 ways to relieve stress. Maybe one will work for you.

Remember, too, that stress isn’t the only possible cause of hives. Something unusual you ate could be behind the rash. Or maybe your skin isn’t agreeing with a new shampoo or laundry detergent. It could be something as simple as the heat outside, too.

“Do some sleuthing,” recommends Dr. Myers. “If you think back over the last few days, you might come up with an explanation and solution.”

If hives last longer than a few days despite treatment efforts, talk to a healthcare provider to see what’s going on. And seek immediate medical attention if hives come with symptoms like swelling of your mouth, tongue or lips, as those are signs of a more serious allergic reaction.

Preventing stress hives

The best way to deal with stress hives is to identify and avoid their triggers, says Dr. Myers. Schedule time in your calendar for some self-care to keep stress levels in check. Ask for help when you need it.

“There’s no downside to stress management,” emphasizes Dr. Myers. “Your whole body will thank you for it.”

But to be on the safe side, it might not be a bad idea to keep antihistamines on hand.