We know that stress can make our pulses race or our heads hurt, but rarely do we think about how it can affect our body’s largest organ—the skin. Each person’s reaction to stress and anxiety differs, but having an allergic reaction that affects the skin is among the responses one can have. When this happens, the body can break out hives and rashes. 

You may experience hives or rashes if you experience anxiety or have an anxiety disorder, such as generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), panic disorders, phobias, or other conditions.

Feeling restless or on edge, worrying excessively, not focusing, or finding it difficult to get to sleep or stay asleep can affect your ability to remain calm. Some people will react to any of these situations by breaking out in hives, something that can happen chronically and beyond their control. We take a look at what factors can lead to these outbreaks and how to treat them when they happen.

What Are Hives?

Per Mayo Clinic, hives is a skin reaction that appears as welts that irritate the skin with mild to intense itching. The reddish welts can be small spots or large blotches. A person with hives can also have angioedema, a condition that can cause swelling in the deeper layers of skin, mainly around the face and lips. 

Angioedema can also occur by itself without hives. A person who has it can have welts appear on the body within minutes or hours, and swelling usually affects the eyes, cheeks, or lips. A person may also experience pain or warmth in those areas.

Both conditions are treated with antihistamine medication and are known to clear up within 24 hours. They also usually don’t leave marks on the skin. If a person’s angioedema is severe, they should seek medical attention. It can be life-threatening if a person’s throat or tongue swells to the point where it blocks their airway.

What Causes Hives?

As GoodRx explains, a stress response can cause the body to release histamine, a chemical in the immune system, and this leads to a breakout of hives. If a person already has other skin conditions, such as eczema or psoriasis, stress can also lead to breakouts as well. The health site also explains the difference between hives and skin rashes.

Skin rashes are not the same as hives. They involve changes in the skin’s appearance due to inflammation. This means a person may notice their skin’s color has changed or that its texture feels different. Infections, autoimmune disorders, such as psoriasis, or certain substances can bring on skin rashes.

Stress can also bring on other skin conditions, such as acne, fever blisters, and rosacea, a skin condition that causes redness in the face.

Treatment for Hives

As noted earlier, you can use antihistamine drugs that help reduce itching. These can be sold to you by prescription or over the counter. Antihistamines such as cetirizine (Zyrtec®), fexofenadine (Allegra®), or loratadine (Claritin®) are available at your local pharmacy. If you seek treatment from a doctor, they may prescribe anti-inflammatory drugs, such as an oral corticosteroid, to help reduce swelling, itching, and redness. Medications that calm an overactive immune system may also be prescribed.

What Is the Link Between Hives and Stress?

does anxiety cause hives

The link between hives and stress hasn’t been established, and researchers continue to study the topic. What they do know that emotional stress can adversely affect the immune system and that the body can react to stressful times by breaking out in skin irritations.

Per HealthCentral, researchers have identified specific kinds of hives that occur when a person is feeling stressed. One type is called cholinergic hives, which can appear when a person’s stress levels raise their body temperature. Dermatographia is a form of stress hives that cause people to pick at their skin when they are feeling stressed. This constant pressure on the skin can cause the body to release histamine and cause hives or welts on the body.

People who already have autoimmune conditions or allergies may also be predisposed to breaking out with hives during stressful times. “This link may have something to do with the fact that the nervous system and the skin are derived from the same embryologic layer, but research is still underway to better understand the correlation,” HealthCentral writes.

How Do You Avoid Hive Outbreaks?

If you have anxiety and break out in hives, this is your body’s stress response, which means you have to identify what triggers your anxiety and what you can do to manage your stress levels. Chronic hive outbreaks can be managed, and depending on the person, it may be challenging to predict when they happen because they can come in waves without you knowing.

However, identifying your stress triggers and having ways to manage them are both helpful and recommended. It will help to keep a journal to record how you’re feeling and situations you may have in your life right now.  After reviewing your account, you can group the external stressors you face and separate them from internal stressors you have.

As Mayo Clinic notes, some external stressors include:

  • Major life changes, such as getting married or divorced, having a child, or dealing with a loved one’s death.
  • Environmental, which can include what we pick up from the settings around us. We can be exposed to noise levels that are too high, rooms that are too light or dark, and other factors in the environment.
  • Unpredictable events that you couldn’t plan for, such as uninvited guests dropping in or facing an increase in your rent or a cut in your pay.

Internal stressors can also bring on hives and other physical reactions to stress. These include:

  • Fear, which can concern just about any area of your life. Take inventory of your fears and work on how to deal with them. Therapy can help reframe how you see situations and manage your response to them.
  • Feeling a lack of control. This is something you will also have to work through and manage.
  • Attitudes, expectations, beliefs, which are all unique to you and shape your life experiences. As Mayo Clinic says, preset thoughts can make us more prone to stress. Evaluating these also could be key to managing stress properly.

Keeping up your diet, exercise, and wellness routine can help your stress response. Getting the proper amount of sleep is critical. Feeling rested can give us the clarity we need to handle stress appropriately or realize that we need to take a timeout and recover.

Not getting enough rest can lead to feeling physically, emotionally, and mentally tired, which can lead to more stress. And more stress can lead to more stress-related hive outbreaks. As HealthCentral notes, itching and pain can intensify when someone isn’t sleeping well.

Therapy Can Help

If you chronically deal with stress or have a diagnosed anxiety disorder, you can work with a mental health professional who can help you learn effective ways to manage your stress levels. There are various psychotherapies that help people with anxiety disorders. You can try cognitive behavioral therapy (CBT), a widely used “talk therapy” that helps people make connections between what they think and how they make decisions based on the behaviors that stem from those thoughts. CBT helps people take a look at themselves and note negative patterns of thinking that can lead to behavior and decisions that do not promote their well-being. It has helped many people find better ways of dealing with their stress.

You also may be recommended for exposure therapy, which encourages people to face the fears they have instead of avoiding them. Identifying your fears and exploring ways to deal with them can help you keep your stress levels in check.

Natural Remedies for Treating Hives, Skin Rashes

In addition to taking medications, a person can treat their hives or skin rashes with home remedies. One key thing to remember is that you don’t want to further irritate your skin. The goal is to calm inflammation. The website Top10HomeRemedies.com recommends natural things you can do to ease hives

It recommends using a cold compress to block the body from producing and releasing more histamine. It is effective to use a cold compress as soon as you realize that a hive outbreak is happening.

  • Baking soda is also recommended to ease inflammation and itching. 
  • Apple cider vinegar is said to relieve inflammation and help regulate the body’s immune system response. 
  • Oatmeal can relieve both the itching and inflammation and help the skin heal. 
  • Ginger’s anti-inflammatory properties make it ideal for easing inflammation and relieving swelling and itching.
  • Aloe vera can also be applied to the affected area of the skin for 15 or so minutes before rinsing it off with lukewarm water. This aids in healing the skin and helps speed up recovery time. You can also drink aloe vera juice in small amounts to help the immune system heal.
  • Turmeric has antioxidant and antihistamine properties that can help you recover from hive outbreaks. It can ease inflammation and swelling. Some people may need to consult with a doctor first before using turmeric, and people who use prescription blood thinners are advised to stay away from it.

You will have to find what works for you when treating hives and skin rashes that are related to stress. Speaking with a physician can help inform you about any outbreaks you may be susceptible to based on your personal medical history. This can help you as you plan a strategy to deal with stressful times and the results of that stress.

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