Skin disorders are regularly presented at a salon or clinic where skin management and skincare solutions or offered.  Rashes are a regular phenomenon and can have several origins, however, this article will address new findings with regards to anxiety-related skin rashes.

Studies now confirm that stress and anxiety can increase the release of certain chemicals in the body which then produce physical reactions. This can lead to an itchy skin rash or hives, which may occur anywhere on the body. Learning to manage anxiety can help to treat and prevent anxiety rash.

An anxiety rash may appear as an itchy rash or as hives on the body. It is due to high levels of anxiety, rather than other causes such as allergies. While topical treatments or antihistamines may help to relieve symptoms short-term, long-term treatment will involve coping techniques for managing anxiety and reducing stress. Reducing anxiety can help to treat and prevent anxiety rash, this is why the move towards including stress management strategies are now becoming an important consideration within any skin clinic that aims to provide a comprehensive service in their clients’ wellbeing.

In this article, we look at symptoms, causes, and potential emotional effects of anxiety rash. We also look at treatment, prevention, and how to tell if a rash is due to anxiety or another cause.

What is an anxiety rash?

An anxiety rash is an itchy rash that may look similar to hives and has its origin in anxiety rather than any other factors, such as certain foods or medications.

Research has found that chronic anxiety increases the sympathetic nervous system response to stress. This response releases histamine, a substance the body usually releases to respond to any injury, inflammation, or allergic reaction. An increased release of histamine may lead to a rash or hives.

Emotional effects of an anxiety rash

Anxiety rash may cause people to feel more anxiety or embarrassment, due to the symptoms or appearance of the rash. Although people may try to hide the rash, covering the rash with makeup, lotions, or tight clothing may worsen it. While a rash from stress or anxiety can often be resolved within 24 hours, topical treatments may help to reduce the rash and any uncomfortable symptoms.

Focusing on calming techniques and tools to reduce anxiety may help people feel less anxious and also help to treat the rash. Simple ones you can use in a salon environment include breathing techniques, the use of soothing music and the inhalation of certain essential oils such as neroli, lavender and chamomile – more on proven topical herbs later in this article, but let’s now look at physiological implications.

Causes

An anxiety rash may be caused by two key areas:

  • Genetics: Research has found people with relatives who have an anxiety disorder may be more likely to also experience anxiety.
  • Environmental factors: Stressful life events, trauma, grief, abuse, or prolonged illness may all contribute to anxiety.

What about symptoms?

If people have an anxiety rash, they may have the following symptoms:

  • rash feels itchy or irritated
  • small bumps or papules on the skin
  • hives, or raised welts on the skin
  • rash may appear in relation to high levels of anxiety or stress, with no other clear factors
  • rash may resolve in 24 hours.  If you client tells you that rashes appear and disappear regularly that would be an indication that they regularly suffer from anxiety.

From a psychological perspective, symptoms of anxiety can include:

  • feeling apprehension or dread around nonthreatening situations
  • feeling jumpy, tense, or on edge
  • feeling restless or irritable
  • anticipating the worst happening, (which mental health professionals call catastrophising)
  • being watchful for any signs of danger, (which some experts call hypervigilance)

Other physical symptoms of anxiety may include:

  • Pounding or racing heart
  • Shortness of breath
  • Increased sweating
  • Tremors and twitches
  • Headaches
  • Fatigue
  • Insomnia
  • Upset stomach or digestive issues
  • Frequent need to urinate
  • Diarrhea

If people experience anxiety symptoms on a consistent basis, they may have an anxiety disorder. Anxiety disorders are common and have a range of highly effective treatment options.

Treatment

A 2016 study noted that controlling anxiety may be an effective treatment for anxiety rash. Although medication may also have been a factor, the study the following treatment options for improving anxiety highly effective in controlling the manifestation of rashes:

*Cognitive behavioural therapy (CBT): This is the most researched form of psychotherapy to treat anxiety disorders. It helps people to develop strategies to change thought patterns, beliefs, and behaviours that cause anxiety.

*Exposure response prevention: A type of psychotherapy to treat specific forms of anxiety, such as phobias or social anxiety. It exposes people to the source of their anxiety in order to develop coping strategies and reduce anxiety over time.

*Medications: Anti-anxiety or antidepressant medications may help to relieve both emotional and physical anxiety symptoms.

Herbal Treatments

There is now mounting evidence of how herbal remedies may help to relieve symptoms and reduce a rash. Here are a few well-researched herbal extracts that have an anti-inflammatory effect and in their essential oil form, they can, not only help the skin manifestations, but also help to calm the mind and emotions. Here are just a few scientifically validated herbal extracts:

 German Chamomile: Matricaria recutita L. (German chamomile) is the most known and commonly used medicinal plant. It contains the essential oil (the major components of which are α-bisabolol and its oxides A, B and C, matricin, which is converted to chamazulene by distillation and en-yn-dicycloethers) and flavone derivatives: apigenin, luteolin, and apigenin-7-glucoside.  Extracts of matricaria flower exhibited anti-inflammatory activity by inhibition of prostaglandins and leukotrienes synthesis in vitro. α-Bisabolol and apigenin inhibited cyclooxygenase and 5-lipooxygenase activity, chamazulene inhibited only 5-lipooxygenase.

Marigold – calendula flower: Calendula officinalis L. (marigold) is native to the Mediterranean countries. It has characteristic yellow-orange flower heads. Active ingredients of the calendula flower are triterpene saponins (oleanolic acid glycosides), triterpene alcohols (α-, β-amyrins, faradiol), and flavonoids (quercetin and isorhamnetin).

Anti-inflammatory effects of Calendulae flos are related to the content of flavonoids and triterpene derivatives. Isorhamnetin 3-glycosides isolated from calendula flowers inhibited lipoxygenase. Oleanane-type triterpene glycosides exhibited a marked anti-inflammatory activity in the TPA-induced inflammation. Calendula flower is used for compresses in poorly healing wounds, bruises, rashes, boils and dermatitis.

Aloe vera– (fresh leaves of Aloe vera): Aloe barbadensis Mill. syn. A. vera (L.) Burm. f. (Barbados aloe, cape aloe) is a succulent with bright yellow tubular flowers and thick and fleshy, 30-50 cm long, pea-green leaves (spotted with white when young). Active ingredients in fresh leaves of Aloe vera are carbohydrates (mannose-6-phosphate, acemannan – acetylated-1,4polymer of mannose), glycoproteins, sterols (lupeol, β-sitosterol) and enzymes (bradykinase). Gel is prepared from fresh leaves and it is an antranoid-free preparation. Fresh Aloe Vera Gel significantly reduced acute inflammation in rats (carrageenin-induced paw oedema), although no effect on chronic inflammation was observed. Enzymes, carbohydrates and sterols contribute to anti-inflammatory activity of the aloe gel.

Marshmallow root: Althaea officinalis L. (marshmallow) is native to Europe and is now cultivated in Poland. It has characteristic big leaves, similar to maple-tree leaves, with a sharp apex and indented edge. Active compounds are mucilage polysaccharides – arabinogalactans, galacturonorhamnans, glucans and arabinans. The extract of the marshmallow root stimulates phagocytosis and the release of oxygen radicals and leukotrienes from human neutrophils. Release of cytokines: interleukin-6 and tumour necrosis factor (TNF), from monocytes, by the extracts, demonstrated their potential anti-inflammatory activity. An ointment containing an aqueous marshmallow root extract (20%) reduced irritation.

Oat fruit: Avena sativa L. (oat) is native to the warm Mediterranean region. It is cultivated in moderate regions of Europe, Asia and North America for its yield of grain. I am sure we all know about the anti-inflammatory properties of oatmeal.  Active constituents of oat fruit are mucilage polysaccharides (β-glucan), proteins (glutelin and avenin), and flavonoids.  A colloidal extract of Avena sativa showed anti-inflammatory activity – inhibited liberation of the arachidonic acid from phospholipids and the subsequent metabolism into prostaglandin and leukotrienes.

Avenae fructus is a traditional, herbal medicinal product for the symptomatic treatment of minor skin inflammations, such as skin rashes, sunburn and in healing minor wounds.

Prevention:

Managing anxiety may help to prevent anxiety rash. A range of lifestyle changes and coping strategies may help. People may want to try the following techniques to find a combination of tools that work best for them:

  • regular meditation
  • mindfulness activities
  • breathing exercises
  • regular exercise, in particular aerobic exercise
  • understanding personal triggers
  • setting aside a set time to worry before releasing it, to allow more control over each day
  • listening to music
  • eating a nutritious, balanced diet
  • getting regular, quality sleep
  • limiting alcohol and caffeine, which may trigger panic attacks
  • counting to 10 slowly when feeling anxious
  • finding humour and laughing
  • focusing on replacing negative thoughts with positive ones
  • connecting with a local community (find a support network, or volunteer as a break from everyday situations)
  • talking to friends, family, or a healthcare professional if feeling overwhelmed

Recognising the symptoms of anxiety-related rashes will give you a great opportunity to offer support and evidence-based counsel to your clients as well as reach out to effective ways to help provide them with high-quality care.