Stress rash: Why it happens, and what to do about it

Stress doesn't only affect the mind. For many, it also shows up on the skin. A stress rash, commonly presenting as hives or welts, can appear suddenly and cause both discomfort and distress.

While stress-induced rashes are usually harmless, they can be frustrating, especially when they become chronic or interfere with daily life.

What’s a stress rash?

A stress rash is a skin reaction triggered by emotional or psychological stress. It often presents as hives (also known as urticaria), which are raised, itchy welts or bumps that can be pink, red, or the same colour as your skin.

These stress bumps might tingle, burn, or feel warm to the touch, and they may appear on one part of the body or move around.

The body releases chemicals like histamine in response to stress. Histamine is also released during allergic reactions, which is why hives from stress can look and feel similar to allergic hives. This response causes inflammation and makes blood vessels more permeable, leading to swelling and itchiness.

Stress rashes commonly appear on a stressed-out person’s face, chest, stomach, inner elbows, hands, or legs. But they can appear on different body parts, too.

A single hive can last less than 24 hours, but new ones may appear as others fade. If this cycle continues for six weeks or longer, it’s no longer just simple rashes. It’s called chronic hives.

Stress rash vs other types of rashes

Because stress rashes share symptoms with many other conditions, it’s easy to confuse them. Understanding the differences can help you decide whether it's something you can treat at home or if you need medical advice.

A stress rash tends to be sudden, reactive, and more temporary than chronic skin conditions.

How to get rid of stress rashes?

Stress rash treatment focuses on soothing irritated skin and addressing the underlying stress response. While most cases can be managed at home, persistent or worsening symptoms should be assessed by a healthcare professional.

Natural remedies and self-care

Calming the skin begins with gentle, supportive care. Scratching might offer temporary relief, but it can also worsen symptoms or even lead to broken skin and infection.

Applying a cool compress to the affected area can reduce heat and relieve itchiness. A lukewarm bath infused with colloidal oatmeal or milk may also help soothe inflammation and ease discomfort, particularly when the rash is widespread.

Using fragrance-free moisturisers supports the skin's natural barrier and helps reduce dryness or sensitivity. It’s best to wear soft, loose-fitting clothing that doesn’t rub against irritated skin, especially when hives appear on the chest, inner elbows, or stomach.

Staying well-hydrated and cutting back on caffeine and alcohol can also help manage inflammation internally.

Over-the-counter (OTC) treatments

While over-the-counter products are readily available and can provide symptom relief, it’s important to approach self-medication with care.

Consulting a GP, a pharmacist, or a dermatologist is recommended, especially if symptoms are recurring, widespread, or affecting daily activities.

Antihistamines may help reduce inflammation, itching, and swelling associated with hives from stress. Non-drowsy formulations like cetirizine (Zyrtec), loratadine (Claratyne), or fexofenadine (Telfast) are commonly used, but they may not be suitable for everyone, particularly those with other health conditions or who are taking additional medications.

For localised discomfort, products like calamine lotion or a mild hydrocortisone cream may offer temporary relief. However, these should only be applied to intact skin and in moderation. It’s also advisable to avoid creams and lotions that contain fragrances, alcohol, or synthetic dyes, as these ingredients can irritate sensitive or already-inflamed skin.

If symptoms persist despite using OTC treatments, or if the rash becomes painful or spreads, medical review is essential to rule out other causes and explore further options.

Taking time off and seeking support

If workplace stress is contributing to your symptoms, it may be worth speaking with your GP or mental health professional about the possibility of taking stress leave. In Australia, stress leave can be accessed under personal leave entitlements and is a valid option when stress is impacting your health.

Talk therapy, such as Cognitive Behavioural Therapy (CBT), can be an effective tool for identifying stress triggers and developing healthier coping strategies. Addressing stress through therapy may not only help resolve skin symptoms but also improve sleep, mood, and overall wellbeing.

Employers are increasingly recognising the importance of workplace wellbeing programs. These might include access to employee assistance programs (EAP), flexible working arrangements, or wellness initiatives.

If stress from work is affecting your physical and mental health, consider speaking with HR or your manager about what support may be available.

How to prevent stress rashes?

Preventing a stress rash involves more than just reacting to flare-ups when they occur. It requires ongoing attention to how stress, anxiety, and emotional strain affect the body.

The skin can often be an early warning system, especially when tension builds up over time.

Identify and reduce personal triggers

Understanding your own stress or anxiety triggers is a powerful step toward prevention. Some people, flare-ups are also linked to burnout or depression, both of which can disrupt the immune system and contribute to skin inflammation.

Common triggers include:

• Ongoing pressure at work, especially without adequate breaks or support

• Major life changes, such as moving, grief, or relationship difficulties

• Poor or disrupted sleep patterns

• Chronic worry or unmanaged anxiety

• Feeling overwhelmed or emotionally depleted

Journalling or reflecting on when skin symptoms tend to appear can help pinpoint these triggers early, giving you the chance to respond before the rash develops.

Support your body through daily routines

Incorporating simple, supportive habits into daily life can lower your risk of developing stress-related skin symptoms. Regular physical movement, such as walking, stretching, or swimming, helps regulate mood and reduce the intensity of the body’s stress response. 

Activities that support relaxation, like yoga or guided breathing exercises, can also help calm the nervous system and ease skin sensitivity.

Sleep is another key factor. Restorative sleep supports skin repair and helps balance cortisol levels, a hormone linked to both stress and skin inflammation. A consistent bedtime, reducing screen use before sleep, and a calming evening routine can improve sleep quality over time.

Your diet also plays a role. Anti-inflammatory foods like berries, leafy greens, whole grains, and fatty fish provide nutrients that support skin health and immune function. Drinking enough water and avoiding excessive caffeine or alcohol may also help reduce inflammation and skin dryness.

Set boundaries and seek emotional support

Setting healthy boundaries - at work, in relationships, or with digital devices - can protect your energy and reduce unnecessary emotional strain. If work is contributing to ongoing stress, talk to your psychologist or GP about the possibility of taking a stress leave, which may be appropriate under your entitlements.

For ongoing emotional challenges, support from a psychologist can make a meaningful difference. Talk therapy helps address the root causes of stress, explore coping strategies, and build resilience, which can lead to fewer and less intense skin flare-ups.

Keeping your stress levels in check isn’t just about mental wellbeing. It plays a vital role in protecting your skin from becoming an outlet for emotional overload.

Does mental health therapy really help with stress rash?

Yes, therapy can make a real difference. Talking to a psychologist or mental health professional can help you manage the underlying stress that's contributing to the rash. 

Evidence shows that approaches like Cognitive Behavioural Therapy (CBT) can reduce the intensity and frequency of different dermatological conditions.  Therapy can also help manage coexisting conditions like anxiety, depression, or other mental health conditions, all of which are closely tied to stress reactivity and physical stress symptoms.

Final thoughts

A stress rash is your skin's way of letting you know that something deeper is going on.

While it can be alarming, it's often temporary and manageable. Understanding what triggers your rash, knowing how to get rid of a stress rash, and taking steps to care for your emotional wellbeing can lead to both clearer skin and a calmer mind.

If you're experiencing frequent or ongoing stress-related skin issues, consider speaking with a GP, dermatologist, or psychologist. Remember that taking care of your mental health is an important part of supporting your body, inside and out.