Sometimes a breakout can send you into a spiral of stress: Why is this happening to me? Do I need to change my skincare routine? Was it something I ate?

If that sounds familiar, we’re sorry to have to give you one more thing to stress out about: Stress itself can cause breakouts (which then causes more stress, and then—hooray—another breakout!).

So how do you break the cycle? While it’s true that stress is an unavoidable part of life, tweaking the way you handle it (and your skin) can make a big difference in how you feel.

Can stress really cause skin reactions?

You might be wondering if a big work presentation or a hectic move can actually affect your skin, so here’s the truth: Stress really can cause rashes and other types of outbreaks. That’s especially true for people who have allergies or skin conditions like eczema and rosacea, but this can also happen to people who don’t have any underlying conditions.

How? When you get stressed out, your body goes into “fight-or-flight” mode, essentially reacting to your stressors as if they were giant tigers. That means pumping out hormones like cortisol and adrenaline to give you the energy you’d need to avoid becoming tiger food. One of the downsides of those hormones is that they affect your immune system, and some people’s skin is particularly likely to react by becoming inflamed (the scientific way of describing that itchy rash).

What does a stress reaction look like?

A stress rash usually looks like a patch of redness that might have clusters of raised red bumps or welts (a.k.a. hives). The rash might be itchy or tingling, and usually appears on the arms, chest, neck, or face.

How do you get rid of a stress rash?

Dealing with stress is already frustrating enough without having to manage an itchy, painful rash, but the good news is that most stress rashes clear up on their own after a few days. That might not be very soothing if you’re in pain right now, so let’s talk about the best ways to treat a stress reaction.

An ice pack or cold compress can soothe swelling and itch, but be sure not to put ice directly onto your skin (a blanket or sweater can make for a cozy buffer). If that’s not enough, you might want to consider an over-the-counter antihistamine like cetirizine or diphenhydramine or a topical cream that contains corticosteroids, which can reduce inflammation and help your skin heal faster.

And this should probably go without saying, but no matter how much it itches, try not to scratch the rash. Doing so can spread bacteria around and make matters worse.

How do you prevent stress to begin with?

Of course, the best way to prevent your skin from having a stress reaction is to avoid stress, but we all know that’s easier said than done. You’re not always going to be able to remove sources of stress in your life, and some stressful things are just worth the hassle (like a big wedding or a challenging job).

And the science shows that people with skin conditions might be up against additional challenges. According to the National Eczema Association, more than 30% of people with atopic dermatitis have been diagnosed with depression or anxiety (or both). That could be because of the psychological impacts of the condition, like feeling embarrassed or ashamed, or avoiding social events due to self-consciousness. But some scientists think there might also be a biological link between skin health and mental health, because any type of inflammation can make you feel anxious, depressed, or tired.

“The truth is nobody knows exactly why stress makes flare-ups more likely,” says Facet Medical Director Dr. Peter Young. “Stress just isn’t good for your health, and that includes your skin health.”

More research is needed to understand the connection between your skin and your mind, but anyone who lives with eczema knows that stress can lead to outbreaks, which causes more stress, in a cycle that can feel endless.

But here’s the silver lining—there are tons of ways to fight stress, and taking care of yourself has benefits that go far beyond what you look like. Add some of these activities to your routine to make sure you’re treating your mental health like the priority it is:

• Try deep breathing, alone or with the help of a guided meditation app or video
• Exercise regularly (just be sure to shower after you work up a sweat)
• Find a creative outlet like keeping a journal, painting, or knitting
• Get together with friends and family on a regular basis
• Join a support group for people with skin conditions
• Make sure you’re getting enough sleep (moisturize your skin before bed if itching keeps you up)
• Spend a little time outside every day (bonus points if you’re walking or running)
• See if yoga or tai chi helps

If you’re dealing with frequent stress rashes or having trouble getting your stress under control, it might be time to get some expert assistance. A licensed therapist can help you learn strategies for combating stress and focusing on the positive, while a dermatologist can get to the bottom of your skin troubles.

Keep in mind

Stress is an unavoidable part of life, but that doesn’t mean stress rashes have to be. Using an effective over-the-counter treatment can soothe pain and speed up recovery. If stress rashes are a recurring problem for you, talk to a doctor about making a plan to prevent flare-ups as often as you can, and treat the ones you can’t avoid.