Skin Symptoms, Duration, and Treatments for Post-COVID-19 Sequelae

Post-COVID-19 sequelae may include symptoms similar to those of a cold or influenza, such as coughing, shortness of breath, headaches, fatigue, and a feeling of exhaustion. It has also become clear that some people may experience sleep disorders, diarrhea, memory impairment, decreased concentration, and loss of taste.

In some cases, eczema-like rashes may also appear. Rashes and hives that develop after COVID-19 infection may occur not only as a post-COVID-19 sequela but also after receiving a COVID-19 vaccine. We will explain in detail the differences and characteristics between common hives and hives that occur as a post-COVID-19 sequela.

Hives and eczema caused by post-COVID-19 sequelae often develop within 7 days of COVID-19 infection. It has been found that relatively few people develop skin symptoms such as hives or eczema more than 7 days after infection.
In addition, hives and eczema associated with post-COVID-19 sequelae are said to appear as red, raised lesions resembling measles, most often on the trunk and limbs.

The most common skin symptoms occurring as post-COVID-19 sequelae are hives and erythematous rashes. The cause of hives associated with post-COVID-19 sequelae is presumed to be related to activation of T-cell immunity and mast cell degranulation, but the exact cause is not known.

It is also possible that these symptoms are influenced not directly by COVID-19 infection, but by stress after the infection, wearing a mask for long periods, and frequent handwashing and disinfection. Because the causes of hives and eczema associated with post-COVID-19 sequelae are not known, no established treatment is currently available.

Hives are a symptom in which part of the skin suddenly becomes red and raised, but the swelling disappears after a while. Skin disorders that occur as post-COVID-19 sequelae are said to mainly include five types, including hives: erythematous papules, small vesicles, livedo reticularis, and COVID toe.

Erythematous papules are red, mottled bumps that develop across the body. They are skin symptoms that may also occur with other viral infections, including measles and rubella. Small vesicles are small blisters that develop across the body. Livedo reticularis, also known as livedo, causes net-like purple-red or dark purplish-brown patches to appear on both legs. These purpura are caused by bleeding within the skin and are thought to result from inflammation of the blood vessels caused by COVID-19 infection.

COVID toe refers to chilblain-like lesions that develop only on the toes or fingers. COVID toe is relatively mild among these skin symptoms and is seen more commonly in younger people. In addition to these five skin symptoms, varicella-like rashes may occur in some cases, although they are uncommon.

Hives and eczema associated with post-COVID-19 sequelae may continue from the acute phase or may appear after recovery from the acute phase. The severity of hives and eczema may also change over time, and in some cases, the symptoms return after appearing to have subsided.

The average duration until the onset of hives and eczema associated with post-COVID-19 sequelae is approximately 12 days. It is also said that more than half of people feel that their symptoms have improved within 5 months. However, some people continue to experience hives or eczema for more than a year. Therefore, the course and duration until symptoms subside for all post-COVID-19 sequelae, including eczema and hives, vary from person to person.

To prevent hives and eczema associated with post-COVID-19 sequelae, it is first important to avoid COVID-19 infection. Receiving a COVID-19 vaccine does not mean that you cannot become infected. Continue to practice basic COVID-19 prevention measures, such as handwashing and disinfection. You should also continue to avoid the “3 Cs”: closed spaces, crowded places, and close-contact situations.

Wear a mask and maintain an appropriate distance when interacting with others. When dining with others, wear a mask and enjoy conversation except while eating or drinking.

Frequent handwashing and disinfection may also cause skin problems. To protect your skin while taking measures against infection, rinse your hands thoroughly after washing so that no detergent residue remains. If you have washed your hands thoroughly, it is not necessary to apply disinfectant afterward. After washing your hands, applying hand cream or another moisturizer frequently can help protect your hands.

We will explain when to seek medical care and the treatments available if you suspect that you have hives or eczema caused by post-COVID-19 sequelae. At present, the exact cause of skin symptoms associated with post-COVID-19 sequelae and the types of people who are more likely to develop them are not known.

Even people who have never had a skin condition before becoming infected with COVID-19 may develop skin symptoms after infection. Hives and eczema can cause difficult symptoms such as itching and pain, as well as affect appearance, so it may be reassuring to seek medical attention promptly.

If hives or eczema caused by post-COVID-19 sequelae are severe enough to interfere with daily life, or if the symptoms continue for more than 4 weeks, seek medical attention promptly.
The usual department to visit is dermatology, but you may also consult the advice desk of your local government.

At present, no treatment has been established for post-COVID-19 sequelae.
Therefore, when you seek medical care for hives or eczema, symptomatic treatment tailored to each symptom is provided.
In many cases, a topical steroid medication, a standard treatment for hives and eczema, will be prescribed.
If symptoms are severe, an oral steroid medication may also be prescribed.

Hives and eczema caused by post-COVID-19 sequelae may develop not only during the acute phase, but also after vaccination or after symptoms of the infection have resolved. The way symptoms appear and the time until recovery vary.

Since the detailed causes of post-COVID-19 sequelae are not known, medical institutions provide symptomatic treatment.
Although there are individual differences, post-COVID-19 sequelae are said to improve naturally.
However, if symptoms are severe enough to make daily life difficult, or if they continue for more than 4 weeks, do not push yourself—seek medical attention.

LIVELY CLINIC is a clinic specializing in post-COVID-19 sequelae. If you have any concerns about skin symptoms associated with post-COVID-19 sequelae, please feel free to consult us.