OpenHealth Q&A

Persistent Rash: Seeking Answers

Age 24, assigned female at birth, weighing 98 pounds and standing 5'3" tall. I have a history of significant mental health struggles, including severe depression, anxiety, OCD, and tachycardia. Alongside this, I deal with chronic pain issues that remain without a clear diagnosis. I do not consume alcohol, occasionally smoke or vape, and abstain from cannabis and other recreational substances. My current medication regimen includes 450mg of Wellbutrin XL, 7.5mg of Buspar, and I take 50mg of Hydroxyzine for anxiety as needed. I do not take any vitamins regularly and frequently use Ibuprofen. Approximately one week ago, I noticed a rash emerging on my arms and face. Initially, I suspected it to be poison ivy due to my severe allergic reaction to it, especially since I mowed my lawn, which is infested with poison ivy. However, while one patch tends to improve, new ones appear continuously. The majority of these spots are very itchy, though some do not cause itching at all. There are two additional itchy regions: one beside my ear on my face and another on my abdomen. Last night, the patches on my arm resembled hives more than a conventional rash. I visited MinuteClinic for assistance, but the healthcare providers were puzzled. They ruled out poison ivy since the rash keeps reappearing and changing locations. Unfortunately, I cannot identify any allergens that might be causing this issue. There haven't been any alterations in my laundry detergents, dryer sheets, or personal care products. My diet remains consistent, as I prefer a routine, and nothing I eat appears to contribute to the rash. I live with two indoor cats, and I haven’t detected any fleas this season. The rash worsens at night, becoming itchier and more inflamed when I relax either at my desk or on the couch, but not when I’m in bed; I doubt it's bedbugs since the marks don’t resemble bites. Recently, I've noticed that I might be getting new spots shortly after walking on a nearby trail, although I am careful to avoid touching or disturbing anything while out. To manage the rash, I have been alternating between Benadryl cream and hydrocortisone, along with taking Claritin during the day when needed. I applied oral Benadryl one night when the rash appeared more hive-like, and I have been washing my clothing and bedding more frequently. The practitioner at MinuteClinic prescribed a steroid cream that I will begin using tomorrow; I cannot take oral steroids due to personal health reasons, although the physician initially aimed to prescribe those. I tend to have very sensitive skin—band-aids irritate me due to their adhesive, and many detergents and lotions can cause itchiness—however, none of my body care products have changed recently, neither in the past week nor in the past six months. It's essential to mention that my work involves exposure to various chemicals, including urethane plastic, platinum-cure silicone, acrylics, and liquid leaf metallic paint, which I believe contains copper. I initially thought that these substances could be the cause, but if they were, I would expect my entire body to be affected. The rash seems to avoid areas of my skin that are exposed to chemicals, and I haven't used urethane or silicone in the last week, yet new rashes continue to develop. Years ago, I experienced a similar rash that my doctor labeled a "stress rash," which I recall being quite itchy. It eventually subsided after a few weeks of oatmeal baths and a specific ointment. Currently, I find myself under extreme stress—I'm not able to share too many specifics, but I'm on the verge of a breakdown daily. The relentless challenges of life are taking a toll on my mental health. I’m trying hard to allocate time for relaxation, but I feel constantly anxious and overwhelmed. I’m attempting to keep my worries in check; nonetheless, I can't help but feel uneasy since the doctor was unable to definitively identify the rash. My propensity to overthink these matters has me concerned. Thank you in advance for any insights or advice you might have.

Answers (1)

7/8/2025, 2:40:58 AM

OpenHealth AI

It sounds like you're dealing with a very challenging situation regarding your persistent rash and the associated stress. Given your history and symptoms, we can approach this by focusing on symptom management, stress reduction, and potential triggers.

Main Points:

1. The rash's changing nature and itchiness might be linked to a combination of stress, sensitive skin, and potential environmental factors.
2. Immediate steps can help manage your symptoms while you identify any underlying causes.

Explanation:

Your rash appears to be complex, possibly involving allergic reactions, skin sensitivity, or stress-related responses. Considering your sensitive skin, contact dermatitis could be a possibility, especially since it seems related to certain activities or exposures, even if you haven't identified a clear allergen. The anxious nature of your situation may also contribute to skin flare-ups.

It's good that you've started using a steroid cream and are taking steps to manage the itching with Benadryl and hydrocortisone. Managing the rash and addressing stress are important, as mental health can contribute significantly to skin conditions.

Next Steps:

1. Continue Current Treatments:

   • Use the steroid cream as prescribed. Apply it sparingly on affected areas, ensuring you follow instructions closely.
   • Continue using hydrocortisone cream and Benadryl for relief as needed.

2. Skin Care Adjustments:

   • Stick to gentle, fragrance-free skin care products and look for "hypoallergenic" labels.
   • Avoid potential irritants; consider using cotton clothing to reduce friction.

3. Stress Management:

   • Incorporate relaxing activities into your daily routine, such as deep breathing exercises, meditation, or gentle yoga.
   • Consider setting aside a specific time daily to unwind, reducing your overall stress levels.

4. Track Triggers:

   • Keep a diary to note when new rashes appear and any activities or exposures that may coincide. This may help you identify potential triggers over time.

5. Evaluate Work Environment:

   • If you suspect chemicals could be a factor, discuss safer handling practices with your employer. Consider using protective gear (gloves, masks) to minimize exposure to irritants.

6. Monitor Symptoms:

   • Look for any new patterns or changes in the rash and how they correlate with your activities, environment, or mental state. Be proactive in seeking help if the rash worsens or if you experience additional concerning symptoms.

Conclusion:

It's understandable to feel overwhelmed, but know that you're taking important steps in seeking help. Continue to manage your mental health alongside your physical symptoms, and remember that gradual improvement is possible. Keep a close eye on any changes, and reach out if necessary. You are not alone in this, and I’m here to help as you navigate these challenges.