The effects of stress span well beyond emotional health: Acne, hair loss, and weight gain can all be side effects of chronic stress. And beyond worsening existing skin rashes from conditions like psoriasis or eczema, stress can also cause new skin flare-ups and irritations. Here's what skin care experts have to say about stress-induced rashes and how to manage them.
The stress-rash connection.
"Normally, cortisol levels oscillate in response to the circadian rhythm; however, stress can significantly disrupt the cycle," explains dermatologist Keira Barr, M.D. "During periods of increased stress, cortisol levels rise significantly, which can have a major impact on your immune system."
"Cortisol both decreases the barrier function of the skin and increases the sensitivity of nerve fibers in the skin," Villafranco says. "It also activates a local stress response system within the skin, causing mast cells to release histamine and cytokines, which translates to itching, redness, and swelling." One study on 529 medical students found that the more stressed-out members of the cohort were more likely to develop oily, waxy patches or flakes on the scalp and rashes on the face1 because of these mechanisms.
According to Joshua Zeichner, M.D., director of cosmetic and clinical research in the department of dermatology at Mount Sinai Hospital, stress is also associated with the development of hives—the same type of spots that develop when you have an allergic reaction. These raised, blotchy, red welts can vary in size and appear all over the body. Sometimes hives first manifest as general skin swelling in one area and then disappear and reappear elsewhere. Hives are often itchy or have a tingling, burning sensation.
For people with existing skin conditions, stress can also worsen symptoms or cause more flare-ups. One 2013 medical review found that stress seems to exacerbate atopic dermatitis2 by impairing the immune response and skin barrier function, while another 2018 review concluded that it's a big trigger for both the onset and exacerbation of psoriasis3.
Who gets stress-induced rashes?
Stress-related rashes are typically an exacerbation of underlying conditions, says Zeichner. So if you struggle with skin issues like eczema or psoriasis, you're likely already familiar with stress-induced flares. But stress rashes aren't completely limited to people with pre-existing skin issues: "Those prone to allergic reactions can experience hives due to stress alone," Villafranco adds.
Can you tell if a rash is caused by stress?
Stress-induced rashes don't always stand out from non-stress-induced ones, but there are some clues that can help you identify them. "If you're under a great deal of stress and you notice your skin behaving strangely, those two facts are probably related," explains Villafranco. That's particularly true if you're breaking out in hives and can't pin it to environmental triggers, food allergies, or a new medication.
Are stress rashes dangerous?
In most cases, stress rashes aren't a big deal and can be treated at home. One caveat is that any rash that is blistering or spreading rapidly should be checked out—especially if it's accompanied by fever or labored breathing. If you don't have those kinds of symptoms but your rash doesn't seem to be improving with home remedies and you're getting concerned, Zeichner recommends seeking medical care too.
How to prevent and manage stress rashes.
The best way to prevent itchy, uncomfortable stress-induced rashes is to lean on your favorite stress management tools. "You can't prevent stress, but you can train yourself to respond to it more successfully," says Villafranco.
Some helpful strategies for minimizing stress include meditating daily; cutting out caffeine, nicotine, and alcohol if those appear to be triggers for you; and making sleep a top priority. You can also consider adding a supplement like hemp to your routine since the compounds in hemp oil extract have shown to be effective at managing stress4 and supporting quality sleep5 in clinical trials.* Full-spectrum hemp oil also contains antioxidants6 that may help promote healthier, calmer skin.*
If you already have a rash and suspect stress is involved, there are a few ways to find relief: You can apply a cool compress to itchy, inflamed patches or soak in a lukewarm bath or cool shower. Again, if your rashes don't improve with home triage, it might be time to check in with your doctor to see if they can recommend any anti-inflammatory creams or other treatments.
The bottom line.
The stress in our lives has a way of playing out our skin. And while we have limited control over stressors like work, money, and relationships, we can take steps to mitigate how we react to them. By managing our response to stressors that are beyond our control, we can limit their effects on the body, rashes included.
Jessica Timmons has been working as a freelance writer since 2007 and has covered everything from parenting and pregnancy to residential and industrial real estate, cannabis, stand-up paddling, fitness, martial arts, landscaping, home decor, and more. Her work has appeared in Healthline, Pregnancy & Newborn, Modern Parents Messy Kids, and Coffee Crumbs. When she’s not stuck to her laptop, Jessica loves hanging out with her husband and four active kids, drinking really great lattes, and lifting weights. See what she’s up to at her website.