Stress bumps on the fingers and hands can be due to dyshidrotic eczema, which appears as itchy blisters on the fingers and palms; shingles, which present as painful, itchy blisters on the fingers and hands; or stress hives that can appear as red, raised bumps on the hands and fingers.
Below, you can find the pictures, symptoms, causes, and treatment options of these skin conditions.
1. Stress hives (urticaria)
Stress bumps on the fingers can appear as raised, discolored bumps known as hives or wheals. These welts can become widespread, affecting not only the fingers and hands but also larger areas of the body.
Causes
Why do these occur? Hives can arise due to various triggers such as certain foods, infections, pollens, molds, and more. Stress is also a common trigger, particularly in individuals who already are susceptible to hives or have an underlying skin condition like eczema or allergies.
Stress can affect hormones or inflammatory components. Emotional stress can also trigger cholinergic urticaria, which is a type of chronic hives.
Common stressors in life include:
- Significant events such as a wedding or exams
- The death of a loved one
- Sleep deprivation
- Work-related stress
- Challenging relationships
Several mental disorders, such as anxiety, depression, and somatoform disorders (including hypochondriasis and body dysmorphic disorder), can lead to emotional stress.
Symptoms
The bumps of stress hives may vary in size and range from small pinpoint hives to larger hives. They are usually oval or round but can also have irregular edges.
They can cause intense itching and burning sensation. Stress can make one itch more than normal.
The color of these bumps can vary. They can be pink, red, skin-colored, or slightly darker than skin. When you press these lesions, you will see clearing or paleness, this is called blanching.
These may resolve in a few hours or days and are called acute hives. When they last longer than 6 weeks, they are called chronic hives.
Treatment
Most stress hives can resolve on their own. In some cases, treatment and remedies may help.
Home remedies
- Manage or reduce stress.
- Cold compress with a cold wet washcloth or an icepack.
- Oatmeal baths can reduce itchiness.
- Wear loose clothes.
- Avoid hot and humid environments.
- Over-the-counter hydrocortisone cream may reduce the symptoms.
- Over-the-counter antihistamines can also alleviate symptoms. These include:
- Loratadine (Claritin).
- Cetirizine (Zyrtec).
- Diphenhydramine (Benadryl).
Note that some antihistamines can cause drowsiness or sleepiness.
Prescription medications
In some cases, your doctor may prescribe medications, which may include:
- Systemic steroids
- Omalizumab (a monoclonal antibody)
- Cyclosporine
- Montelukast
When to see a doctor
If the hives do not resolve within a week, or if they are accompanied by other symptoms such as fever or pain, it’s best to consult a doctor.
In some cases, hives may be associated with angioedema, which is swelling deeper in the skin. It can be fatal if it affects the airways.
Additionally, hives can occasionally be associated with a serious allergic reaction called anaphylaxis. It can lead to systemic symptoms such as abdominal cramps, diarrhea, vomiting, chest tightness, difficulty breathing, dizziness, and confusion. One should go to the hospital immediately if experiencing any of these symptoms.
2. Dyshidrotic eczema
Stress bumps on fingers and hands, which appear as small, itchy blisters, can be due to dyshidrotic eczema.
Dyshidrotic eczema, also known as pompholyx or hand and foot eczema, is a type of eczema that presents as itchy bumps on the fingers, palms, and soles of the feet.
These finger bumps have a characteristic appearance resembling tapioca pudding. It is more commonly seen in adults, especially females.
Causes
The underlying cause is unclear; however, factors such as stress, excessive sweating, hot and humid environments, exposure to metals like nickel, and the use of detergents or hairstyling products can trigger a flare.
It often affects individuals who have a history of allergies, eczema, or a family history of dyshidrotic eczema.
Symptoms
The onset of the rash is usually preceded by sensations of burning or itching. Following this, red bumps filled with clear fluid, or blisters, appear. These can disappear within 2 to 3 weeks, leaving behind dry, red, and peeling skin.
In severe cases, these bumps can interfere with daily activities and may even become secondarily infected.
Diagnosis
Dyshidrotic eczema can often be diagnosed through a clinical examination. If a fungal infection is suspected, your doctor may take a skin sample for further analysis.
Additionally, if an allergy is suspected, your doctor may perform additional tests.
Treatment
- Manage or reduce your stress.
- Keep the area clean and dry.
- Use barrier repair moisturizer.
- Avoid contact with metal jewelry.
- Your doctor may prescribe topical steroids.
- In severe cases, oral steroids, topical calcineurin inhibitors, or phototherapy may be recommended.
- Botulinum toxin injections may help in decreasing sweat, which is one of the factors that can exacerbate the condition.
3. Shingles (Herpes zoster)
Stress can trigger an outbreak of shingles leading to a painful itchy blister rash on the fingers and hands.
Causes
Shingles is a viral infection caused by the Varicella-zoster virus, a type of herpes virus that also causes chickenpox. After a person contracts chickenpox, the virus remains dormant in the body and can reactivate under certain conditions, such as:
- Increased stress levels.
- Being aged 50 years or older.
- A weakened immune system.
- Certain medical conditions like HIV, diabetes, and cancer.
- The use of medications that suppress the immune system.
Symptoms
Shingles usually affects one part of the body on one side, such as the arm and hand on the left side, or just a hand on the left side.
The initial symptoms can include burning, itching, or pain in the affected area, followed by the appearance of red bumps. These bumps eventually form blisters, which may burst, ooze, and subsequently crust over and scab.
Additionally, one may experience systemic symptoms such as:
- General malaise and fatigue
- Fever
- Headache
Complications
A common complication of shingles is postherpetic neuralgia, which is characterized by pain in the affected area even after the rash has cleared.
It’s important to avoid touching your eyes with hands that have come in contact with the shingles rash, as this can cause damage to the eyes.
Shingles is contagious, and the Varicella zoster virus can be spread to anyone who has not been vaccinated against chickenpox or has never had the disease. In these individuals, the virus can cause chickenpox, not shingles.
Direct contact should be avoided with individuals who have a weak immune system, are pregnant, or are small babies.
While shingles usually occur only once, they can recur in some individuals.
Shingles can be prevented by the Shingrix vaccine, which is considered 90% effective. This vaccine is usually administered in two doses.
Diagnosis
Shingles is often diagnosed by examining the lesions. In some cases, your doctor may take a sample from the lesions to test for the virus.
Treatment
Early treatment of shingles with antiviral medications can help in faster healing and decreases the chances of complications. They should ideally be started within 72 hours of the onset of the rash.
These medications include:
- Acyclovir
- Famciclovir
- Valacyclovir
If it is accompanied by severe pain, your doctor may recommend:
- Gabapentin
- Numbing topicals
- Antidepressants like amitriptyline
Differentiating points
Shingles usually leads to painful and itchy blisters on one side of the body, so you will often see them on one hand. On the other hand, dyshidrotic eczema leads to itchy and painful blisters on both hands and may involve the soles of the feet.
Hives usually present as raised red bumps, which are itchy but usually do not hurt. Hives can be localized to the hands or more widespread.
Shingles is a contagious viral infection while hives and dyshidrotic eczema are not contagious.
Prevention
Given that stress is a trigger leading to these bumps, it’s important to manage stress levels. Although this may not be easy, the following measures could be helpful.
- Talk to your loved ones.
- Do relaxing exercises like meditation, and walking.
- Try deep breathing exercises.
- Listen to your favorite songs.
- Take a good rest.
- One can get professional help.
In addition:
- Get vaccinated against chickenpox or shingles if applicable.
- Try to stay healthy by eating well and practicing good hand hygiene.
Summary
Stress bumps on fingers and hands can be due to dyshidrotic eczema, hives, or shingles.
Depending on the cause, the treatment will vary. But all these have one common factor and that is stress. Stress management is an important part of reducing an outbreak of these bumps.
References
- Bansal CJ, Bansal AS. Stress, pseudo allergens, autoimmunity, infection and inflammation in chronic spontaneous urticaria. Allergy Asthma Clin Immunol. 2019 Sep 11;15:56. doi: 10.1186/s13223-019-0372-z. PMID: 31528163; PMCID: PMC6737621.
- Ograczyk-Piotrowska A, Gerlicz-Kowalczuk Z, Pietrzak A, Zalewska-Janowska AM. Stress, itch and quality of life in chronic urticaria females. Postepy Dermatol Alergol. 2018 Apr;35(2):156-160. doi: 10.5114/ada.2018.75237. Epub 2018 Apr 24. PMID: 29760615; PMCID: PMC5949545.
- Bin Saif GA, Alotaibi HM, Alzolibani AA, Almodihesh NA, Albraidi HF, Alotaibi NM, Yosipovitch G. Association of psychological stress with skin symptoms among medical students. Saudi Med J. 2018 Jan;39(1):59-66. doi: 10.15537/smj.2018.1.21231. PMID: 29332110; PMCID: PMC5885122.
- Kayiran MA, Akdeniz N. Diagnosis and treatment of urticaria in primary care. North Clin Istanb. 2019 Feb 14;6(1):93-99. doi: 10.14744/nci.2018.75010. PMID: 31180381; PMCID: PMC6526977.
- Staubach P, Dechene M, Metz M, Magerl M, Siebenhaar F, Weller K, Zezula P, Eckhardt-Henn A, Maurer M. High prevalence of mental disorders and emotional distress in patients with chronic spontaneous urticaria. Acta Derm Venereol. 2011 Sep;91(5):557-61. doi: 10.2340/00015555-1109. PMID: 21597672.
- Dyshidrotic eczema. National Eczema Association.
- Nair PA, Patel BC. Herpes Zoster. [Updated 2022 Sep 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
Disclaimer: This blog post is for information purposes only and does not replace medical advice.