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Hives and Rashes: Main Differences (and How to Treat Them)

In this Air Doctor blog, we show you how to tell the difference between hives and rashes, and how to get rid of them.

People respond to stress in different ways, whether emotional or physical. The latter of which may take on a horribly unpleasant form: stress hives and rashes.

About 20% of people will experience hives at one point or another. However, stress can cause hives and other skin problems to become more frequent. Below we’ll talk about how hives and rashes are different and the best ways to treat them.

How Hives and Rashes Are Different

So, what is the difference between these two itchy fiends?

Well, skin rashes and hives are often mistaken as being one and the same thing. But there actually are slight differences between these skin conditions.


A rash is your body reacting to an infection, autoimmune disorder (like psoriasis), or substances that cause allergic reactions. Rashes all over the body can also occur but it’s more common for them to appear on just one area of the skin.

  • Unusual change in your skin’s color, texture, or appearance usually due to skin inflammation.
  • Dry, moist, bumpy, smooth, cracked, or blistered skin.
  • Skin that’s painful, itchy, or changes color.


Hives, on the other hand, also known as urticaria, are a kind of skin rash that can occur when your immune system releases the chemical histamine in response to an allergen.

  • The appearance of hives can differ from other skin rashes and usually have a recognizable pattern.
  • Hives often appear as raised discolored bumps, and it’s not uncommon to have stress hives on the face as well as the chest, neck, or arms. Hives may itch, burn, or tingle.

Can Stress Cause a Rash?

Yes. Stress and anxiety can cause you to break out in hives and rashes. Hives are sometimes called “stress hives” or even a “stress rash”.

If you’re under a lot of stress, your body sends a message to its immune cells, telling them to release powerful chemicals – histamine – which trigger inflammation and the itchiness associated with hives. But stress is only one of several triggers which can cause symptoms like skin rashes or hives. Rashes from stress often affect people who have underlying skin conditions or allergies.

Other stress hives causes include:

  • Food allergens – like peanuts, shellfish, and even spicy foods.
  • Pollen, dust, or animal dander.
  • Hot or cold temperatures.
  • Medications.
  • Viral or bacterial infections.
  • Irritating chemicals – like laundry detergents.
  • Autoimmune disorders – like thyroid disease.
  • Insect bites and stings.
  • Exercise.

Even without an underlying condition, you can still develop stress hives and rashes. Hives are a common skin condition that affects people of all ages, but studies have shown that women are more affected by hives than men.

Stress can come from anywhere, but common triggers for stress rashes include:

  • Starting college, getting married, or other major life events
  • New jobs or challenging promotions
  • An intensive new exercise routine
  • Quitting smoking or a drastic diet change
  • Death of a loved one or other sources of grief
  • Anxiety over friends or loved ones going through hard times
  • A period of insomnia or poor sleep hygiene

Additionally, a person with a history of anxiety, depression, bipolar disorder, or other mental health conditions can cause chronic stress that leads to hives.

Thankfully, a stress-induced rash generally isn’t cause for concern. It can often be treated easily at home.

Source: Unsplash

The Best Ways to Treat Rashes

You can treat most contact rashes, but it depends on the cause.
Follow these guidelines to help ease your discomfort and speed up the healing process:

  • Avoid using scented soap bars and moisturizers and instead use mild, gentle cleansers and unscented lotions.
  • Use warm water instead of hot water when washing your skin and hair.
  • Avoid rubbing your rash and pat it dry.
  • Let your affected skin breathe. If possible, don’t cover it with clothing.
  • Don’t use new cosmetics or creams which may have triggered the rash.
  • Avoid scratching the rash because it may worsen it and lead to infection.
  • Apply over-the-counter hydrocortisone cream to the affected area if the rash is very itchy and causing discomfort. Calamine lotion can also relieve rashes caused by poison ivy, poison oak, and chickenpox.
  • If you have dandruff with a rash, wash your hair and scalp regularly with dandruff shampoo.

If you do feel like you need to see a doctor – here’s how to prepare for your dermatologist appointment.

The Best Ways to Treat Stress Hives

Sometimes hives will go away on their own without treatment. Otherwise, the condition can generally be treated at home. The most common course of treatment for stress hives is an over-the-counter (OTC) antihistamine – which can relieve symptoms like itching.

But you can treat stress hives through OTC treatments or at-home remedies.

Common OTC treatments for stress hives:

  • diphenhydramine (Benadryl)
  • cetirizine (Zyrtec)
  • fexofenadine (Allegra)
  • loratadine (Claritin)
  • calamine lotion
  • hydrocortisone cream
  • anti-itch creams such as Sarna or CeraVe

Natural at-home remedies for stress hives:

There are plenty of at-home treatments to experiment with, and you probably don’t even have to go to the store.

  • Place a cool compress on the affected areas.
  • Take a lukewarm shower or soothing oatmeal and milk bath
  • Using fragrance- and dye-free lotions
  • Staying hydrated and limit your alcohol and caffeine intake
  • Avoid hot showers or high humidity levels
  • Avoid tight clothing or anything that rubs against your skin

Managing your stress:

An essential factor in combating stress hives and rashes is lowering the stressors in your life. There are many methods to help ease your mind and relieve stress, including:

  • Going to therapy or a support group
  • Practicing meditation or yoga
  • Exercising regularly (in ways that don’t aggravate your hives)
  • Making time for hobbies you enjoy (like baking or going for walks)
  • Eating a balanced diet
  • Getting enough quality sleep

Identifying techniques that help you relax and lower your stress may help your skin condition. In the meantime, try using OTC medications to alleviate inflammation and irritation. If your hives and rashes persist and you think they result from an underlying condition, consult a doctor who can work with you to determine the next steps.

If your symptoms worsen or last longer than six weeks, you should consult a doctor. Hives that last beyond six weeks are considered chronic and may or may not go away on their own within a year.

In the instance of chronic hives, your doctor may prescribe one of the following for treatment:

  • Prescription-strength antihistamines
  • Corticosteroids like prednisone
  • Monoclonal antibody-like omalizumab (Xolair)
  • Cyclosporine – which can treat inflammation

Please note: If you experience swelling of the lips of the face, trouble breathing, or wheezing, you should contact emergency services. These can be life-threatening complications, and you may need an epinephrine shot for anaphylaxis treatment.


Do hives spread by scratching?

Yes. Don’t scratch your skin. Even if the itch is driving you crazy, scratching your hives may cause them to spread, become more inflamed, and even lead to infection.

Should I go to the hospital if I have hives?

It depends. You should inform your doctor if you keep getting hives that last a month or more. You should get medical help immediately if any of these things occur:

  1. You start to get burning or itchy welts in your throat.
  2. You get hives and a dry cough, cold, sweat, nausea, dizziness, or trouble breathing after an insect bite, sting, or new medication. This may be anaphylaxis – an extreme allergic reaction.
  3. You have symptoms of angioedema (this is swelling of the lips, tongue, or throat). You need immediate medical attention so that the swelling doesn’t block the air passage to the lungs.

Can you be hospitalized for a rash?

No. Not unless you are experiencing any potentially life-threatening symptoms. If your rash is recurring or persistent, it may indicate a skin condition or an ongoing allergic reaction. You may not need to go to the ER, but you should make an appointment with your primary care physician to seek medical treatment.


Jenny Cohen Drefler

Jenny Cohen Derfler

Air Dr CEO & Co-Founder

Jenny is the CEO and one of the Co-Founders at Air Doctor. She spent more than 20 years at Intel, most recently as general manager of its manufacturing facility in Israel and before that in various engineering and manufacturing roles in Silicon Valley. Air Doctor is her second startup having previously founded electric vehicle company ElectRoad.