Anxiety can increase the release of certain chemicals in the body, which can produce physical reactions. This can lead to an itchy skin rash or hives, which may occur anywhere on the body.

An anxiety rash may appear as an itchy rash or as hives on the body. It is due to high levels of anxiety, rather than other causes such as allergies.

Topical treatments or antihistamines may help to relieve symptoms short-term, but long-term treatment will involve coping techniques for managing anxiety and reducing stress. Reducing anxiety can help to treat and prevent anxiety rash.

In this article, we look at symptoms, causes, and potential emotional effects of anxiety rash. We also look at treatment, prevention, and how to tell if a rash is due to anxiety or another cause.

What is an anxiety rash?

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An anxiety rash is an itchy rash that may look similar to hives. It is due to anxiety rather than any other factors, such as certain foods or medications.

Research has found that chronic anxiety increases the sympathetic nervous system response to stress. This response releases histamine, a substance the body usually releases to respond to any injury, inflammation, or allergic reaction. An increased release of histamine may lead to a rash or hives.

Emotional effects of an anxiety rash

Anxiety rash may cause people to feel more anxiety or embarrassment, due to the symptoms or appearance of the rash. Although people may try to hide the rash, covering the rash with makeup, lotions, or tight clothing may worsen the rash.

A rash from stress or anxiety usually resolves in 24 hours, and topical treatments may help to reduce the rash and any uncomfortable symptoms.

Focusing on calming techniques and tools to reduce anxiety may help people feel less anxious, and also help to treat the rash.

Causes

An anxiety rash may affect anyone who experiences anxiety. People may experience anxiety for a number of reasons, which include:

  • Genetics. Research has found people with relatives who have an anxiety disorder may be more likely to also experience anxiety.
  • Environmental factors. Stressful life events, trauma, grief, abuse, or prolonged illness may all contribute to anxiety.

Anxiety rash symptoms

If people have an anxiety rash, they may have the following symptoms:

  • rash feels itchy or irritated
  • small bumps or papules on the skin
  • hives, or raised welts on the skin
  • rash may appear in relation to high levels of anxiety or stress, with no other clear factors
  • rash may resolve in 24 hours

Alongside rash symptoms, people may be experiencing high levels of anxiety or stress. Symptoms of anxiety can include:

  • feeling apprehension or dread around nonthreatening situations
  • feeling jumpy, tense, or on edge
  • feeling restless or irritable
  • anticipating the worst happening, (which mental health professionals call catastrophizing)
  • being watchful for any signs of danger, (which some experts call hypervigilance)

Other physical symptoms of anxiety may include:

  • pounding or racing heart
  • shortness of breath
  • increased sweating
  • tremors and twitches
  • headaches
  • fatigue
  • insomnia
  • upset stomach or digestive issues
  • frequent need to urinate
  • diarrhea

If people experience anxiety symptoms on a consistent basis, they may have an anxiety disorder. Anxiety disorders are common and have a range of highly effective treatment options.

Is it anxiety causing the rash, or something else?

To tell if anxiety is causing a rash, or if it is due to another cause, people can try to eliminate all other possible causes. Other factors that may be causing a rash can include:

  • allergy to certain food or medication
  • contact dermatitis, due to a reaction to ingredients in topical lotions, makeup, bathing products, jewelry, or clothes detergent
  • contact with certain plants, such as poison ivy
  • illness, such as measles or chickenpox
  • skin condition, such as eczema or psoriasis

If people have eliminated all other possible causes, and notice a rash develops in relation to experiencing high levels of anxiety or stress, it may be an anxiety rash.

Treatment

A 2016 case study notes that controlling anxiety may be an effective treatment for anxiety rash. Although medication may also have been a factor, a female who developed a rash in relation to panic attacks found that the rash resolved with improved anxiety control.

Treatment for anxiety may include:

  • Cognitive behavioral therapy (CBT): CBT is the most researched form of psychotherapy to treat anxiety disorders. It helps people to develop strategies to change thought patterns, beliefs, and behaviors that cause anxiety.
  • Exposure response prevention: A type of psychotherapy to treat specific forms of anxiety, such as phobias or social anxiety. It exposes people to the source of their anxiety in order to develop coping strategies and reduce anxiety over time.
  • Medications: Anti-anxiety or antidepressant medications may help to relieve both emotional and physical anxiety symptoms.

Topical treatments may help to relieve symptoms and reduce a rash. Taking an antihistamine may help to control hives. Antihistamine medication works to block the histamine response in the body, which can help to prevent any new hives from forming.

Applying a cold compress or topical steroid, such as hydrocortisone, to a rash may help to relieve itching.

According to The American Institute of Stress, some people may find applying full-fat milk to irritated skin may provide soothing effects, due to the fat content in milk.

When to see a doctor

If a rash worsens or is not responding to treatment, then people should see their doctor.

People can also see their doctor if anxiety is affecting their day-to-day life, or if anxiety and any symptoms are having a negative effect on a person’s well-being.

A doctor may prescribe topical treatments to relieve symptoms and can suggest a treatment plan for managing anxiety.

A rash can sometimes be a sign of a serious infection or severe allergic reaction. People will need to seek help straight away if they have a rash with any of the following symptoms or features:

  • covers most of the body
  • fever
  • appears suddenly and spreads quickly
  • wheezing or difficulty breathing
  • blistering or open sores
  • pain
  • swelling or warmth around rash
  • crusting, a red streak, or yellow or green fluid coming from the rash

Prevention

Managing anxiety may help to prevent anxiety rash. A range of lifestyle changes and coping strategies may help. People may want to try the following techniques to find a combination of tools that work best for them:

  • regular meditation
  • mindfulness activities
  • breathing exercises
  • yoga
  • regular exercise, in particular aerobic exercise
  • understanding personal triggers
  • setting aside a set time to worry before releasing it, to allow more control over each day
  • listening to music
  • eating a nutritious, balanced diet
  • getting regular, quality sleep
  • limiting alcohol and caffeine, which may trigger panic attacks
  • counting to 10 slowly when feeling anxious
  • finding humor and laughing
  • focusing on replacing negative thoughts with positive ones
  • connecting with a local community (find a support network, or volunteer as a break from everyday situations)
  • talking to friends, family, or a healthcare professional if feeling overwhelmed

Summary

Anxiety can cause physical reactions in the body, including a rash or hives.

If the body is in a constant state of “fight, flight, or freeze” mode, it can cause an increase in certain chemicals, such as histamine. This can lead to the development of a rash or hives.

Topical treatments can help to treat the rash in the short-term, while long-term management of anxiety can help to treat and prevent anxiety rash from reoccurring.