Hives are a common symptom of COVID-19 that can occur during the day or night. Hives only at night might be from something you’re coming into contact with in the evenings.

COVID-19 can cause hives during the day and night. They often show up early in the infection and may even be the first symptom you notice.

COVID-19 can cause several skin symptoms, including rashes and hives. These symptoms are typically brief, but in some cases, they last for months after the initial infection.

Hives develop when your immune system releases histamine in response to a perceived threat, like an allergen or infection. While hives can occur with infections like COVID-19, they’re more often associated with allergic reactions. You can have an allergy to something you eat, a medication you’re taking, or an irritant that touches your skin.

Keep reading to learn more about hives and their connection to COVID-19, and whether it’s normal for them to appear only at night. Also, learn about treatments for hives and other skin conditions triggered by COVID-19.

Research has identified a link between hives and COVID-19. According to a 2023 literature review, hives are one of the most common skin disorders related to COVID-19.

Researchers examined 63 articles and discovered that hives usually appear with other COVID-19 symptoms, like cough and fever. They last an average of 6.8 days.

Medications used to treat COVID-19 can also trigger hives.

Doctors need to conduct more research into how the coronavirus triggers hives.

Researchers in a 2020 literature review analyzed 46 articles that pooled the details of 998 people who got COVID-19 early in the pandemic. Among this group, 89 people, or 8.9%, developed hives.

Researchers noted that skin conditions are underreported with COVID-19 because they may develop early in the infection before other more identifiable symptoms appear.

It’s normal for hives to come and go. But hives that appear only at night aren’t a symptom typically associated with COVID-19.

If you’re getting hives only at night, it may be because you’re coming into contact with an allergen in the evenings.

Detergents in clothes or bedsheets, lotions, or medications you take before bed could all cause hives at night. Alpha-gal syndrome can also trigger hives at night.

Alpha-gal syndrome is caused by a tick bite. The condition can cause hives or an itchy rash after eating meat or other animal products.

These hives take 2–6 hours to develop, so eating meat for dinner or even taking medications with a gelatin coating (gelatin is an animal product) may make you break out in hives.

Possible causes of hives at night

If you get hives only at night, it may be related to something you’re coming into contact with late in the day. Some possibilities include:

  • detergents used on clothing or sheets
  • lotions or creams applied at night
  • medication taken at night
  • stress
  • pressure from tight clothing, like a belt, or any part of the body under continual pressure
  • changes in temperature, like very cold air or water, sweating, or a hot shower
  • environmental allergens, like dust, mold, pollen, or animal dander

There are several ways that COVID-19 can affect your skin.

The 2023 literature review mentioned above found six main types of rashes. Researchers estimate that skin conditions appear between 4% and 20.4% of the time.

Other rashes that might appear when you have COVID-19 include:

Maculopapular

A maculopather rash is an itchy rash with both flat and raised parts. It often appears on the torso but can develop anywhere on the body. It can appear before or after other COVID-19 symptoms and typically lasts about 8–12 days.

Chilblain-like

Commonly known as “COVID toes,” this chilblain-like condition causes swelling and redness in your toes and, less commonly, your fingers. It’s more common in children and young adults. It usually appears later in the infection.

Vesicular

A vesicular type of rash causes a blister-like appearance. It’s more common in middle-aged adults. It may appear 4–30 days after other symptoms, with an average onset of 14 days. Typically, the rash clears up within 8–10 days.

Petechiae

Petechise is a rash that produces small, pinpoint red, purple, or brown spots beneath the skin on the torso, arms, and legs. It’s not as common with COVID-19 as other rashes, but it can appear after other symptoms.

Livedoid eruptions

This rare symptom produces a blotchy rash that looks like a net. It appears at the same time as other symptoms. On average, it lasts about 9 days.

Hives can be distressing and itchy, but home remedies may help relieve discomfort. Most hives will go away on their own within a few hours, but while they’re visible you can:

  • use an over-the-counter anti-itch cream, like calamine lotion
  • apply a cold compress, like ice cubes wrapped in a towel, on areas that itch
  • take an antihistamine or allergy medication
  • use a fragrance-free moisturizer throughout the day
  • practice self-care and stress-relieving strategies, as stress can trigger hives or make them worse
  • keep a record of flare-ups to try and track the cause
  • wear loose, breathable clothing

Many people experience an occasional outbreak of hives that respond to treatment at home.

If your hives last longer than 6 weeks or repeatedly flare up over this time, you may want to talk with a doctor. The American Academy of Dermatology recommends visiting a board certified dermatologist, allergist, or primary care doctor.

A doctor can help determine what’s causing your hives and make sure nothing serious is going on. If they can’t narrow in on the cause of your hives, your doctor might recommend allergy testing.

COVID-19 can cause several skin reactions, including hives. They usually appear at the beginning of the infection, sometimes before other symptoms develop. Hives from COVID-19 may come and go at any time of the day or night.

Hives that happen only at night are more likely caused by foods or other allergens, like detergents, lotions, or soaps. Things in your environment, like dust, pollen, and pet dander, can also trigger hives.

Most hives respond to over-the-counter treatment, like anti-itch creams, antihistamines, or allergy medications.