Much like a Rubik's Cube or Countdown Conundrum, stress rash is frustrating, confusing and bound to leave you wanting to throw your metaphorical toys out of the pram. There is no single trigger and it can manifest in myriad ways, from hives to eczema – making a solid medical diagnosis tricky.
It’s always best to get a persistent rash checked out by your GP or a dermatologist
To help us decipher the subject, WH called on two skin experts: Megan Felton, co-founder of expert-led skin consultancy Lion/ne and Dr Alexis Granite, consultant dermatologist at Mallucci London. They're here to reveal everything you need to know about stress rash – so you can calm your skin the F down.
What is stress rash?
'Stress rash is a very confusing term as it can include many different categories of rashes such as hives, that can be attributed to an environmental trigger such as food, stress or weather, or may be related to certain skin conditions like psoriasis, eczema, rosacea, and even acne,' Felton tells WH.
What does stress rash look like?
'Stress increases our innate "fight or flight" response, boosting certain hormones such as cortisol and chemicals such as interleukins within the body, all of which increase inflammation,' adds Dr Granite. 'Inflammation affects our skin, ramping up swelling, redness, and heat, which in turn can cause an itchy, angry rash.'
So, for some, stress can cause hives which is a 'stress-induced rash that appears on the skin as welts,' explains Felton. Alternatively, stress-induced inflammation can exacerbate skin conditions that you’re predisposed to such as cold sores, acne, eczema and psoriasis.
Can you get a rash from anxiety?
You may feel like your stress rash has come – bam! – out of nowhere, but often it can be the result of long-term, low-level chronic stress occurring in our brain and body thanks to work, relationships or even trying to move house (that sh*t's stressful!).
'Excessive or persistent stress may keep our immune system on high alert, which can cause inflammation levels in our body to increase to a point that our skin structure and function will be impacted,' says Felton.
'High levels of stress will generate free radical damage that will harm healthy cells throughout our body. In fact, due to the intrinsic inflammatory cascade, steroids and adrenaline will be produced which will break capillaries and create inflammation. The sensory nerve endings become over stimulated, which will make the skin more reactive and possibly inflamed.'
Alternatively, when triggered by food, sunlight or allergies, our body can stress out in response leading to, in some cases, a stress rash, she notes.
Can your gut health play a role in stress rash?
When it comes to stress rash, Felton believes the gut plays a part. 'We know that stress can disrupt the connection between the brain and the skin, but the gut also plays an important role. The skin, mind, and gut work in synergy... so if one of them is unbalanced it will show and it is very likely to show in the form of inflammation,' she tells WH.
'Our gut microbiome is composed of bacteria, viruses, and fungi which all play a key role in the body. 'They protect us against foreign invasions such as toxins, but most importantly boost and support our immune system. An unbalanced gut flora will not have the ability to fight against the development of autoimmune disorders and inflammation.'
What does this have to do with your skin?
Well, the gut microbiome influences our skin’s microbiome. Our skin microbiome, in a similar fashion, is essential in protecting our skin from harmful substances and free radicals, if unbalanced it will influence the immune system defence mechanisms and trigger skin conditions such as acne, eczema and psoriasis,' Felton explains.
She recommends a course of super strength liquid probiotic Symprove to help get your gut bacteria back into great shape.
How do you immediately treat stress rash?
First of all, 'don’t panic,' says Felton, this will only make things worse. With a stress rash your first port of call should be antihistamines. 'Clarityn and Zirtek are typically the most effective treatment option,' advises Dr Granite.
'Keeping the skin cool and avoiding excessive rubbing of your skin may also help alleviate symptoms.'
It’s tempting to reach for lotions and potions to calm the skin, but Felton advises erring on the side of caution. 'Don’t overwhelm the skin with products. It is tempting, but often makes matters much worse.
'Stick to products that are very gentle—nothing that foams, nothing that tingles— and use as little on your skin as you can (so, cleanser, moisturiser, SPF and that’s it). Also avoid fragrance, exfoliating (acids, peels and scrubs) and masks, even those that promise to calm skin!' she adds.
Avoid make-up, as this will give your skin the chance to breathe. If you really want to wear makeup, look to a loose, natural, mineral makeup.
How do you treat stress rash in the long-term?
The clue is in the name, you need to work on your stress levels. 'I definitely recommend speaking with a counsellor or other healthcare professional if your stress rash is persistent,' says Dr Granite.
'Other stress reducing options that may help include:'
meditation (try the Headspace app)
any type of exercise, from walking and running to dancing and HIIT
Felton adds that sleep is: 'Fundamental in helping to stabilise all of our body’s functions from keeping us creative to lowering the cortisol levels induced by stress.
'Sleep deprivation will have an impact on skin’s hydration, regeneration and nourishment. Most importantly it can also induce inflammation, which can also cause the appearance of certain skin conditions and diseases.'
If you think your gut, rather than your brain could be stressed out then be sure to try a course of probiotics. Plus: nourish your gut with food rich in prebiotics and probiotics to keep your microbiome happy. Yogurt, kefir, kombucha, fermented food are great to boost your gut’s protective role, recommends Felton.
Stress rash still persisting, after you've checked in with your GP and taken their advice? An appointment with Dr Granite at Mallucci London is £250, while the Lion/ne team offers consultations on skincare products from £35.
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