What Is the Connection between Alcohol and Hives?

People sometimes develop hives shortly after consuming alcohol as a result of an allergy or sensitivity. Hives are typically red, itchy skin welts that come and go in response to certain irritants either on the skin or in the blood; where alcohol is concerned, the reaction is almost always internal. Sometimes touching alcohol can cause an outbreak, but this is very rare. Most reactions are caused by certain ingredients or components in alcoholic beverages. A condition known as alcohol intolerance is sometimes also to blame, and negative interactions with medications and supplements may also be a cause.

Hives are known medically as urticaria, and are an immune system response to irritants. When an allergen enters the body, the immune system attempts to fight it and flush it out and hives are a standard, if extreme, reaction. The welts can occur anywhere, but are most common on the back, legs, and arms. They typically last for a few hours, but will usually go away on their own once the irritant has been removed.

The human body processes alcohol as a toxin, but normal, healthy people are able to ingest small amounts without experiencing itching, burning, or other skin reactions. Hives are typically a sign that something in the beverage isn’t recognized or accepted by a person’s immune system. Nailing down the precise cause can be difficult without the help of an allergist or other medical professional, but some explanations are more common than others.

Sulfites, which are a class of chemical preservatives, are one of the most common connections between alcohol and hives. Some sulfites occur naturally, but manufacturers often add them to alcoholic beverages, particularly wines, in order to preserve their shelf life and prevent premature spoilage. True sulfite allergies are one cause, but less serious sensitivities can also lead to skin rashes and breakouts. Most of the time, a person who is sensitive or allergic to these additives will experience respiratory problems such as wheezing and shortness of breath in addition to skin irritation.

Unless an alcoholic beverage is specifically marketed as “pure and natural,” manufacturers may have added dyes, flavoring compounds, and other chemicals, whether to improve the overall taste, lengthen longevity, or simply to make the beverage more appealing in the bottle or glass. People who have allergies to specific colorants or additives may think that they are having a reaction to a particular alcohol when in fact the problem might be with something wholly separate that’s been blended in.

A histamine sensitivity is another possible connection. Histamines are naturally-occurring nitrogen compounds that typically help the body’s cells fight allergic reactions, but they can trigger inflammatory responses, too. A reaction to alcohol might indicate an excess of histamines in a person’s system, especially if a rash breaks out each time a person has a drink. Histamines are rarely added into alcoholic beverages, but most wines contain them naturally; some red wines actually have very high levels.

People who don’t process yeast well — or who can’t process it at all — may also get hives, particularly when they drink things like beer that tend to be heavily yeasted. Someone who has a problem with yeast may also have a problem with sugar, yeast’s food source, which can be problematic where alcohol is concerned since many drinks are quite high in concentrated sugars. This can exacerbate negative reactions, making hives more pronounced or more severe.

Some people suffer from alcohol intolerance, a condition that makes them unusually sensitive to the substance to the point where consumption leads to vomiting, diarrhea, or skin rash. Most cases of alcohol intolerance don’t actually produce hives, but a blotchy skin rash that resembles hives is relatively common. People of Asian descent are more likely to experience this phenomenon, but it can happen to almost anyone.

People who mix drugs and drink sometimes develop hives as a side effect of the chemical reaction happening in their bloodstream. Many prescription drugs that interact badly with alcohol or that can cause inflammation when ingested alongside these sorts of beverages often make a note of this on their labels or in their prescription information, but not always. A number of over-the-counter medications for coughs, colds, and headaches also contain compounds that shouldn’t come into contact with alcohol.

People who suffer from hives from other disorders might see the condition get worse when they drink alcohol. This is particularly true of people with certain autoimmune disorders, blood conditions, or even just highly sensitive skin. Alcohol might also exacerbate hives that a person is already getting from an unrelated source like certain foods, pollen, or insect bites. Hives sometimes also erupt from too much exposure to the sun, bacterial or fungal infection, or stress, and in most cases alcohol — which dehydrates the body and weakens the immune system’s response time — only makes things worse.

Treating the connection between alcohol and hives is usually a matter of diagnosing and solving the underlying problem, be it an allergy, a sensitivity, or an interaction. Healthcare experts typically advise patients to refrain from consuming beer, wine, and liquor as a first step. Patients can often experiment to find certain beverages that will work for them, but it may be the case that alcohol in any form is problematic. In these cases, medical professionals may prescribe antihistamine drugs to relieve itching and swelling, or recommend topical creams for short-term relief.