How to Fight Back Stress and Anxiety With Chronic Hives

by Marisa Zeppieri-Caruana Patient Advocate

Each one of us will experience stress at some point in our life. Whether we are dealing with mild daily annoyances or a long season of stress, it can affect us psychologically, emotionally, cognitively, and physically. For some people, emotional stress can act as the trigger for stress hives to erupt - red, itchy raised welts that can appear on any part of the body and can last for up to six weeks or more.

Emotional stress and anxiety can wreak havoc on the immune system, causing it to falter and trigger a hive outbreak. Let’s take a closer look at the connection between anxiety, stress, and hives, and how treatment and lifestyle changes can help you take better control of your health:

Man examining his arm.

The Link Between Stress and Hives

Whether we are dealing with short-term or long-term stress, the side effects from that stressor aren’t solely psychological - physical manifestations of stress can occur too. In some people, it may exhibit in the form of an increased heart rate, tummy troubles, or sudden hair loss, while in others, stress can actually manifest physically in the form of urticaria, or hives.

Woman with hives on her neck.

Histamines and Immune Response

When stress overloads the body, it sets off an immune response causing the body to release histamine. Though this histamine release can happen in anyone, research has shown that stress hives are more likely to occur in people who have autoimmune conditions or those who have had other allergic reactions or allergy-related issues in the past.

Man scratching his scalp.

Forms of Stress Hives

While random raised, itchy, red welts can appear anywhere on the body when someone is experiencing stress hives, did you know there are specific types of stress hives that researchers have identified?

Scratch arm.

Cholinergic Hives and Dermatographia

One form, called cholinergic hives, can appear on the skin during times of acute emotional stress in which there is an elevation in body temperature. Another form of stress hives, known as dermatographia, can occur in people who pick or scratch their skin during times of stress. This constant external stimulus - pressure and friction on the skin - can cause an erroneous histamine release, which creates welts or hives.

Nervous system.

The Vicious Cycle of Stress and Hives

Research has shown that for some people, stress and hives are intrinsically linked, particularly in those who have an autoimmune condition or have other allergy issues and are predisposed to getting hives. This link may have something to do with the fact that the nervous system and the skin are derived from the same embryologic layer, but research is still underway to better understand the correlation.

Woman unable to sleep well.

Emotional, Physical, and Social Impacts

Research has proved that stress can bring about an onset and exacerbation of hives, in addition to finding that emotional stress in particular is linked to itch intensity.

For people with both urticaria and anxiety, a vicious cycle can often occur, with stress and anxiety leading to an outbreak, which then leads to more stress. Feeling physically uncomfortable and not sleeping well due to itching or pain can also increase anxiety and stress levels. This cycle can exert a negative impact on one’s emotional, physical and social functioning, highlighting the importance of stress-reducing and stress management techniques, discussed later in this slideshow.


Medical Treatment and Options

Though hives can be itchy, painful, uncomfortable, frustrating, and may cause increased anxiety in some people, there is hope. Many cases of hives can be successfully managed through the use of antihistamines or a combination of drugs, depending on the cause/trigger and severity of symptoms. If antihistamines alone do not fully provide relief, your physician may add oral corticosteroids to your medication regimen. For more moderate to severe cases of urticaria, epinephrine may be prescribed to extinguish a very severe uncontrollable flare. A biologic drug called omalizumab (Xolair) may also be prescribed as a long term treatment to control severe hives.

Man doing yoga in his living room.

Complimentary Therapies

If you don’t want to focus on pharmaceutical options alone, try combining some complimentary therapies into your treatment plan. For stress hives, options such as deep-breathing and mindfulness exercises, restorative yoga, hypnosis, biofeedback, cognitive behavioral therapy, and acupuncture can be used to help the body relax and decrease stress levels.

Woman writing in a journal.

Lifestyle Changes

Implementing some lifestyle changes may also help you better manage hives. Keeping a daily journal that tracks stressors, temperature changes, food choices and activity can provide insight into trends and triggers that are associated with your hive outbreaks. Also, taking colloidal oatmeal baths can help soothe the skin during an outbreak, and wearing loose, natural fibers will help prevent skin from being further irritated.

Happy woman in a field.

Living a Full Life With Hives

By understanding the link between stress, hives, and anxiety, and implementing both medication options plus complimentary therapies, you can see improvement in hive activity and live your life to the fullest.

Marisa Zeppieri-Caruana
Meet Our Writer
Marisa Zeppieri-Caruana

Marisa Zeppieri-Caruana is an author, journalist, former Mrs. New York, and founder of, a New York-based nonprofit and award-winning website for lupus patients. She is the author of Lupus: Real Life, Real Patients, Real Talk and travels around the U.S. speaking on the topic of autoimmune disease on a regular basis. In her free time, she is an avid baker with a love for food photography and styling. Currently finishing her memoir, Marisa resides in New York with her husband, mom, and rescued terrier, Bogey.