Stress Rash: Eczema, Hives, Or Something Else?

By Corrina Horne |Updated April 6, 2022
CheckedMedically Reviewed By Melinda Santa, LCSW

Despite being a small part of us, we use our hands more than most other parts of our bodies, but they can be taken out of commission by breaks, fractures, burns, blisters, burn blisters, bumps, and other similar skin conditions - some of which can be brought about by stress.

eczema, skin concerns, eczema on hands and skin

Your Body And Stress

Stress affects your body in numerous ways. A single stress response can trigger an immediate reaction involving taut muscles, sweating, a racing heart, and rapid breathing. This response is an important one: it allows your body to react quickly and effectively to a threat. Stress responses can help you run from predators or defend yourself from an attack due to a heightened sensitivity to your surroundings and improved reaction speed.

While stress responses are wonderful things, they can quickly turn against you. When a stress response is prolonged for a single instance or continues over a long period, two things can happen: your body can begin to feel nauseated, overwhelmed, and even dizzy due to the rush of hormones and intense tension radiating through your body, or your body can eventually become parasympathetic dependent, which means that your body naturally settles into its parasympathetic nervous system (think "fight or flight") rather than its natural resting state. Residing in your parasympathetic nervous system in perpetuity can lead to long-term health problems including (but certainly not limited to) high blood pressure, heart failure, breathing difficulties, insomnia, weight gain, and gastric distress.

Eczema

Stress has a significant impact on your skin. When your body releases hormones like cortisol and adrenaline, it also signals your skin to produce more oil. In a single instance, again, this is not problematic; you may want to blot or wash your face more in a stressful situation. When stress is a constant companion, however, oil production can go on overdrive, and existing skin issues like acne can grow exponentially worse. This is why many people notice acne increasing in response to stressful situations. Increased oil production can make it more difficult for your body to rid itself of dirt and grime, which can get trapped in pores and follicles. Removal is also made more difficult by excess oil, so blackheads and whiteheads grow more prevalent.

Inflammatory responses are also common in the skin when stress leaps up. Existing conditions like psoriasis and eczema can be worsened by the presence of stress, causing the spread of the conditions or increased symptoms, such as itching and irritation. Stress can also cause hives, which are typically reserved for allergic responses, and a specific type of eczema, both characterized by itchy, red, and inflamed bumps on the skin.

The addition of stress can also make personal hygiene decline, which can exacerbate acne and other skin problems. The presence of excess oil and acne can make going out difficult, and isolation has been linked to increases in anxiety and depression. Altogether, stress and your skin can make for a potent, unfortunate combination.

Stress Rash Types

Stress bumps on the hands have one of two names: hives, which can be an all-over condition, or Pompholyx (also called Dyshidrotic Eczema), which is typically localized to the hands and feet. Each condition has unique symptoms and signs but is similar enough in appearance that they can sometimes be mistaken for each other.

Hives and pompholyx are both also linked to seasonal allergies so determining the exact cause of the conditions can initially prove difficult; hives are usually associated with an allergic response while pompholyx can arise in response to the type of stress brought about by a stressful situation or the physical stress caused by allergies in the spring and fall.

The term "hives" describes an all-over rash known for its raised red bumps and intense itching. The size of hives varies considerably: some bumps can be as small as the head of an eraser while others might lift to the size of a quarter. Hives may be hard to the touch or soft depending on the severity of the response and can increase in size when scratched too aggressively.

Conversely, pompholyx is characterized by small bumps on the hands and feet, which more closely resemble small blisters than mere bumps. These blisters may or may not be filled with fluid but often cause itching, burning, and even weeping if the surface of the skin is ruptured. If the blisters are ruptured, they can begin to spread and may increase in size, spreading over arms or legs as well. Because these are actual ruptures in the skin, pompholyx bumps can become infected and may require a visit to the doctor.

While hives typically resolve in a matter of hours or, in some cases, several days, pompholyx can persist for weeks at a time and have several stages of healing, including the spread of blisters; ruptures; dry, flaking skin; and the eventual dissipation of dry and cracked skin. Determining which of the conditions is likely to be affecting you may be easier if you keep close track of symptoms, duration, and triggers.

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Physical Effects Of Stress

The effects of stress on your skin may differ from person to person or even season to season. In winter, for instance, when your skin may be more likely to be dry and flaky, you might have more trouble with eczema and similar skin conditions. In the summer, when the skin is already prone to oiliness and acne, you might notice a dramatic increase in the presence of acne. What happens in one stressful situation might not happen in another, which can make pinning down your stress-related skin condition difficult.

Skin conditions due to stress are usually diagnosed by a dermatologist, who can take a detailed list of your symptoms and can observe the exact condition you are experiencing. Some stress-related conditions may require topical or internal treatment in addition to stress-relief efforts. Eczema, for instance, might require a topical cream to alleviate symptoms of redness, itching, and pain in conjunction with regular anti-anxiety efforts with a mental health professional. Hives can benefit from oatmeal baths, topical anti-itch creams, and even specialized soap as well as a mental health intervention.

Unlike some of the most common physical symptoms of anxiety (racing heart, muscle tension, etc.), many of the skin conditions derived from stress morph into conditions that can benefit from actual medical intervention rather than being treated entirely through therapy or counseling. Working with both a psychiatrist or psychologist and a dermatologist can procure the best possible outcome for stress-borne skin conditions.

Unfortunately, stress-induced skin conditions can create a continuous cycle, particularly if flare-ups of skin disorders are readily visible. Many people feel embarrassed by the presence of oily skin, acne, blisters, and hives and may try to isolate themselves or hide their condition until the symptoms have passed. While this is an understandable response, it does create the potential for additional stress to develop, and isolation has been consistently linked to increases in anxiety and depression. Treating stress-induced skin conditions, then, is not merely a matter of vanity, but can help improve symptoms of anxiety.

eczema

Stress interacts with your skin as thoroughly and intensely as any other bodily function and can have a great impact on how your skin functions and looks. Stress can cause flare-ups of eczema and hives, both of which can create pain, itching, and significant distress. These bumps might cause severe discomfort or might merely be unsightly, but both conditions can hurt daily living; the presence of unexplained bumps can be a source of anxiety or embarrassment, particularly if you work in a field requiring your hands or face-to-face interactions.

The effects of stress cannot and should not be underestimated; stress can interrupt and disrupt countless physiological functions, including your skin. Stress-induced bumps may be itchy, painful, and can even contain fluid or pus. Treating these skin conditions topically can temporarily subdue their effects but does not eradicate the issue; instead, stress must be managed and reduced to keep stress-related skin conditions at bay.

If you have stress bumps on your hands or body, the first order of business is likely to be soothing the irritation. This can be done with lotion, anti-itching creams, or even massage, which can all help your skin return to a somewhat normal state. To prevent future breakouts, though, a call or email to a therapist may be in order; a therapist may be able to help sort out some of the causes of stress and can help you find more effective methods of coping with stressful situations.

A recent publication looked at a population that experiences a considerable amount of stress: patients with medical conditions. The authors reviewed 17 studies, from 1990-to 2015, to see if eHealth mindfulness and relaxation techniques – including talking to a therapist – are effective. The publication found that they were: eHealth techniques can have positive effects on general health and psychological well-being,

In addition, the study pointed out that eHealth, such as online therapy, is highly accessible, meaning that you can connect with a therapist in the comfort of your own home as long as you have an internet connection – no stressful commute required. Another advantage is that online therapy tends to be cheaper than traditional therapy, which can reduce potential financial stress. Plenty of folks has already given BetterHelp a chance.

BetterHelp Therapist Reviews

“This was my first time experiencing counseling, and Mr. Santaella immediately hit the nail on the head with the issues I've been dealing with. His suggestions and guidance were really helpful and many things he said to me will stick with me for a very long time. He made me change the way I think about work and my health, both mental and physical, and helped me see the connection between those two.” Read more on Jorge Santaella.

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“Tracy Hollingsworth has played an instrumental role in my constant journey to take good care of myself both mentally and physically. She has a great sense of humor which I love and is extremely creative in her approach to offering strategies for things I struggle with in my life, especially during COVID when EVERYTHING is constantly changing. I struggle with my motivation, mood swings, anxiety, and sometimes my relationships with people. When I feel a ‘mood; coming on I can often use some of the tools Tracy has taught me so that I don't fall deeper into one of my moods that in the past would have destroyed my entire day or even week. I always feel awesome after a session with her no matter how I felt starting the session!” Read more about Tracy Hollingworth.

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Conclusion

Although stress bumps and eczema can be uncomfortable, itchy, and unsightly, there are ways to effectively deal with existing bumps from eczema and prevent the onset of future breakouts.

Managing stress is the best way to handle any form of skin condition brought on by stressors and can be done through diet, activity, skin care, therapy, and medication.

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