Stress Rash: Eczema, Hives, Or Something Else?

Medically reviewed by Andrea Brant, LMHC
Updated May 23, 2024by BetterHelp Editorial Team

We often use our hands more than other parts of our bodies. However, they may be taken out of commission by breaks, fractures, burns, blisters, chronic hives, and other underlying skin conditions.

In some cases, stress may cause a skin rash or bump on our hands. Figuring out what is causing a stress-induced rash may help you relieve itching and pains so that you can get back to work.

Getty/Vadym Pastukh
Is your stress manifesting in physical ways?

Understanding different physical symptoms

Stress, especially chronic stress, may impact our bodies in numerous ways. A single psychological stress response could cause an immediate reaction involving taut muscles, sweating, a racing heart, or trouble breathing. This response often allows your body to react effectively to a threat. Stress responses may 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 can be beneficial, they may also feel counter-productive. For example, when a stress response is prolonged, you may feel nauseous, overwhelmed, or dizzy due to the rush of hormones and intense tension radiating through your body. 

Over time, your body could also become parasympathetic dependent. This term means your body may naturally alert your parasympathetic nervous system (think "fight or flight" mode) rather than stay in a natural resting state. Residing in your parasympathetic nervous system most of the time may lead to long-term health problems, such as high blood pressure.

Acne, eczema, and stress rash

Stress may also have a significant impact on your skin. When your body releases hormones like cortisol and adrenaline, it can signal your skin to produce more oil. At times, this can be beneficial. When stress is a constant companion, oil production may go into overdrive. This excess of oil may cause existing skin conditions like acne to worsen. 

Increased oil production can also make it more difficult for your body to rid itself of dirt and grime, which may get trapped in pores and follicles. Excess oil makes removal more difficult, so black and whiteheads may grow more prevalent.

Inflammatory responses are also common in the skin when stress creeps up. Existing conditions like psoriasis, hay fever, and eczema may be worsened by stress, potentially causing increased symptoms such an itchy rash, burning or tingling sensation, stress acne, skin inflammation, raised skin on fingers, painful blisters, or other skin symptoms. Stress may also cause hives, characterized by itchy, red, and inflamed bumps on the affected skin, often on the hands. 

The addition of stress may make personal hygiene practices difficult, exacerbating acne and other skin problems such as a heat rash. The presence of excess oil and acne may make going out complicated, and isolation has been linked to increases in anxiety and depression

Stress rash types

A stress rash may be called hives, which can be an all-over condition, or pompholyx (also called dyshidrotic eczema or acute palmoplantar eczema), which is typically localized to the hands and feet. Both conditions can have unique symptoms and signs but are similar enough in appearance that they may sometimes be mistaken for each other.

Hives and pompholyx may be linked to seasonal allergies, so determining the exact cause of the conditions can initially prove difficult. However, hives are usually associated with an allergic reaction or response, while pompholyx may arise in response to a stressful situation or physical stress caused by allergies in the spring and fall.


The term "hives" may describe an all-over rash known for its raised red bumps and intense itching. The size of hives can vary considerably. Some lumps may be as small as the head of an eraser, while others might increase to the size of a quarter. 

Hives may be hard to the touch or soft, depending on the severity of the response. They can increase in size when scratched aggressively.

Pompholyx: Burning or tingling sensation

Conversely, pompholyx is often characterized by small bumps on the hands and soles of the feet, resembling small blisters more closely than bumps. These blisters may or may not be filled with fluid. Common symptoms of dyshidrotic eczema include itching, a tingling or burning sensation, and weeping if the skin's surface is ruptured. Allergies, immune system activation, sweaty hands, and stress can all trigger pompholyx. Certain risk factors can make you more prone to having pompholyx, like working with metals or cement or having another type of eczema. 

If the blisters are ruptured, they may increase in size, spreading over arms or legs as well. Because they are ruptures in the skin, pompholyx bumps may develop a bacterial infection and require a doctor visit. However, if you’re wondering, “Is dyshidrotic eczema contagious?” the answer is no. 

Hives typically resolve in a matter of hours or, in severe cases, several days. However, when you develop dyshidrotic eczema (pompholyx), it may persist for weeks at a time and have several stages of healing. These stages include spreading fluid filled blisters, ruptures, flaking skin, and the eventual dissipation of dry and cracked skin. 

Determining which of the conditions is likely to affect you may be easier now that you’ve read a hives and dyshidrotic eczema overview. If you want to get dyshidrotic eczema diagnosed so that you can receive medical treatment from a skin specialist, keep close track of when you first notice blisters, symptoms such as a tingling sensation, the duration of those symptoms, and triggers.


Other factors to consider that might influence a stress rash

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 or similar skin conditions like atopic dermatitis, contact dermatitis, or other eczema types. 

In the summer, when the skin may be prone to oiliness and acne, you might notice a dramatic increase in the presence of acne. The skin's response to one stressful situation might not happen for another, making pinning down your stress-related skin condition potentially difficult.

Skin conditions due to stress are often diagnosed by a dermatologist, who may take a detailed list of your symptoms and observe the exact condition you are experiencing. As a result, if you want to seek medical treatment for dyshidrotic eczema, you’ll likely want to visit a dermatologist. Some stress-related conditions could 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-stress efforts with a mental health professional. Hives may benefit from oatmeal baths, topical anti-itch creams, applying a cold compress, specialized soap, and stress-reduction strategies.

Unlike some of the most common physical symptoms of anxiety (i.e., racing heart, muscle tension, etc.), skin conditions derived from stress may morph into conditions that can benefit from actual medical intervention rather than being treated entirely through therapy or counseling. Working with a psychiatrist or psychologist and a dermatologist simultaneously may procure the best possible outcome to cure and prevent stress rashes or other conditions. A psychiatrist or psychologist will also know which product manufacturers addressed safety for their treatments, before giving you a recommendation, such as which over the counter antihistamines will be best for insect bites.

If left untreated, 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 skin rashes, oily skin, acne, large blisters, and hives and may try to isolate themselves or hide their condition until the symptoms have passed. 

While this can be an understandable response, it may create the potential for additional stress to develop. Treating stress-induced skin conditions may relieve symptoms of anxiety, depression, or loneliness caused by isolation.

Seeking help

Consider soothing the irritation if you have a stress rash on your hands or body. Lotion, anti-itching creams, or massage may help your skin return to a relaxed state. A call or email to a therapist may also be in order to prevent dyshidrotic eczema or future breakouts of other stress-related skin conditions. 

A licensed mental health professional may be able to help sort out some of the causes of stress and help you find more effective methods of coping with stressful situations. Many individuals who find their pain or skin concerns make it hard to leave home may appreciate the easy route to support that online counseling can provide. 

Is your stress manifesting in physical ways?

recent publication looked at a population that experiences considerable stress: patients with medical conditions. The authors reviewed 17 studies from 1990 to 2015 to see if online mindfulness and relaxation techniques (including online therapy) are effective. The publication found that online health techniques can positively affect general and psychological well-being.

Internet-based counseling to reduce stress often has specific advantages for people with skin conditions. If you want to try speaking to a professional about stress-related issues, consider reaching out to a platform like BetterHelp, which has an extensive database of mental health specialists.


Although a stress rash and eczema can be uncomfortable, itchy, and unsightly, there may be ways to effectively deal with these skin conditions and prevent the onset of future breakouts which could affect your skin tone and condition. 

Managing stress may help you handle any form of skin condition brought on by stressors. Various techniques could prove beneficial, including changing your diet, avoiding irritants like certain metals, increasing activity, changing your skin care, going to therapy, and taking medication.

Do you have skin concerns such as minor skin blisters or eczema on your skin, hands, or fingers? It may be stress related. Consider reaching out to a counselor to learn new stress management techniques. 

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