These red patches flare up every night, but my doc can’t see me until next month. Any idea what’s happening?

Your core body temperature naturally rises and falls over a 24-hour cycle. In the evening, peripheral blood vessels often dilate slightly as your body prepares for rest. This increased blood flow near the skin’s surface can make redness more visible and intensify inflammation.

### 2. Cortisol Drops

Cortisol is a hormone with anti-inflammatory effects. Levels are highest in the morning and lowest at night. When cortisol drops, inflammatory conditions—like eczema, hives, or rosacea—can become more noticeable.

### 3. Histamine Release

Histamine, the chemical involved in allergic reactions and itching, tends to increase at night. That’s why itching often feels worse when you’re trying to sleep, even if the rash itself hasn’t changed much.

### 4. Fewer Distractions

At night, you’re more aware of your body. No work, fewer noises, dimmer lights—your attention turns inward. A mild sensation during the day can feel much more intense when you’re lying still in bed.

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## What These Red Nighttime Patches *Could* Be

Again, this isn’t a diagnosis—but these are some of the more common explanations doctors consider when patients report red patches that flare up at night.

### 1. Hives (Urticaria)

Hives are one of the most frequent culprits. They often appear as red, raised patches or welts that can change shape or location. They may itch intensely or feel warm.

Key clues:

* Come and go within hours
* Often worse at night
* Can be triggered by heat, pressure, stress, food, or medications
* Sometimes have no clear trigger at all

Chronic hives can persist for weeks or months and still be non-dangerous, though they’re extremely frustrating.

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