Can Alcohol Cause Hives?

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Hives is an unpleasant, unsightly, itchy, and sometimes painful skin condition caused by an allergic reaction. Alcohol has been known to trigger and worsen skin problems under some circumstances, so if you are a drinker and suffering from hives, alcohol consumption could be a factor. However, even knowing this, alcohol-dependent people may have difficulty stopping drinking because withdrawal symptoms and cravings may be too much to handle without help.

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What Are Hives?

Hives (urticaria) are raised red bumps, welts, or splotches that manifest on the skin’s surface due to an allergic reaction. (1) This response occurs when the immune system is exposed to an allergen, which is “a usually harmless substance capable of triggering a response that starts in the immune system and results in an allergic reaction.” (2)

Hives tend to be itchy but can also cause stinging or burning sensations. They vary in size from a few millimeters to the size of a hand. When hive welts combine to form larger areas, they are called plaques. Most hive outbreaks subside in 24 hours and can persist for several days or weeks in some cases. Acute hives last less than six weeks; chronic hives occur for six weeks or longer and happen at least twice a week. (3)

Determining if Alcohol Is Responsible for Hives

You may need an alcohol allergy test to determine if alcohol is triggering your hives. Although these tests tend to yield negative results, some people may test positive for allergies related to acetaldehyde or acetic acid, toxic byproducts produced from the breakdown of alcohol.

Reasons alcohol could be responsible for causing hives include the appearance of flushed skin or rash following its use or being allergic to an alcohol ingredient. Lastly, having a genetic metabolic dysfunction can also be a risk factor.

Skin Flushing as an Indicator of Alcohol-Related Hives

The flushing of the skin, especially the face, after consuming alcohol could signify you have an allergy and alcohol is causing your hives. This can also be related to another skin condition called rosacea (see below). Consider consulting with a health provider who can review your symptoms and perform a patch test to determine if you have an allergic response to alcohol.

As noted, it is rare to be allergic to ethanol alcohol itself. Instead, alcoholic drinks contain allergenic ingredients, such as yeast, grapes, barley, and hops. For simplicity’s sake, however, we’ll refer to allergies as being due to alcohol rather than listing ingredients and byproducts.

Alcohol & Metabolic Dysfunction

Genetic metabolic dysfunction related to alcohol exposure (also known as alcohol intolerance) is uncommon and most frequently identified in persons of Asian descent. This condition is characterized by the inadequate breakdown of the toxic alcohol byproduct acetaldehyde. (4) Symptoms can result when this toxin accumulates in the body, and this can also trigger the release of histamines that produce inflammation.

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Can Alcohol Worsen Hives & Other Skin Issues?

Alcohol sensitivity can result in an allergic response and exacerbate a pre-existing hives-related condition. In one study involving a 58-year-old male with a history of hives, researchers found levels of the enzyme tryptase, a mark of immune system response, increased with alcohol use. The individual developed hives on the upper arms and chest minutes after drinking, suggesting the alcohol was triggering the reaction. (5)

In another study, the authors “observed a significant increase in tryptase mast cells” in alcohol-fed mice. (6) Research has also found alcohol use can contribute to other skin problems, including psoriasis, eczema, and rosacea.

Alcohol & Rosacea

Rosacea is another chronic condition experienced by people who blush or flush easily that typically begins to manifest around the cheeks and nose. It is characterized by redness and bumpiness that can spread to the forehead, chin, and other nearby areas. Other symptoms include visible blood vessels, breakouts, and red, inflamed eyelids and eyes. Research shows that drinking alcohol can be a significant risk factor for rosacea, and this risk appears to increase with alcohol intake. (7)

Alcohol & Psoriasis

Psoriasis can develop at any point in life and involve various body parts, including arms, torso, scalp, face, genitals, and fingers. Research suggests excessive alcohol use is a risk factor for psoriasis or could aggravate an existing condition. (8) Additionally, alcohol consumption “seems to be greater in psoriasis patients than in the general population.” (9)

Alcohol & Eczema

Eczema is a chronic skin disorder presenting symptoms such as red, dry, itchy, and inflamed patches of skin. Drinking may trigger an eczema flare-up due to its immunosuppressive and dehydrating effects. Also, some drugs used to treat eczema, such as methotrexate, can cause liver damage—much like alcohol. (10) Not only can taking these medications with alcohol increase the risk of liver cirrhosis, but some researchers believe improper liver functioning may cause eczema. (11)

More About Hives

Long-term hives without an apparent cause is known as chronic spontaneous or “idiopathic” urticaria. (NIH) Another form, called physical or “inducible” urticaria, can manifest due to cold, heat, or the sun. Some people react to pressure, vibrations, sweating, or exercise, and typically onset within an hour of exposure.

Acute Hives vs. Chronic Hives

All forms of hives can vary in appearance and can show up anywhere on the body. In addition to red, raised bumps or welts and itchiness, there can be noticeable and painful swelling under the skin around affected areas and in lips, eyes, and throat.

Acute hives tend to be caused by an allergic reaction to something ingested, such as food or medication, or in contact with skin. Chronic hives appear much like acute hives, except they can change size and shape or appear, disappear, and reappear for an extended period. These are not typically related to allergies but are caused by bacteria, viruses, and medical conditions such as lupus. No form of hives is considered permanent or life-threatening.

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Treatment for Hives Caused by Alcohol

Curbing your alcohol use will be the most effective way to eliminate symptoms if you suspect you’ve had allergic reactions or hives due to drinking. However, if you’ve found it challenging to stop drinking despite the adverse effects you’re experiencing, you may have an alcohol use disorder. Seeking an assessment could help determine if you would benefit from professional treatment to overcome alcohol misuse and improve your overall health.

Guardian Recovery offers evidence-based addiction treatment programs to individuals seeking long-lasting recovery. If you are ready to overcome alcohol dependence and improve your overall health and wellness, reach out to us today. We’ll connect you with an experienced Treatment Advisor who will provide you with a free, no-obligation assessment and health benefits check. Contact us to learn more about our comprehensive approach to alcohol use disorders, and begin your recovery journey today.

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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

(1)https://acaai.org/allergies/allergic-conditions/skin-allergy/hives/

(2)https://www.aaaai.org/Tools-for-the-Public/Allergy,-Asthma-Immunology-Glossary/Allergen-Defined

(3)https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Libraries/EL-hives-patient.pdf

(4)https://my.clevelandclinic.org/health/diseases/17659-alcohol-intolerance

(5)https://www.karger.com/Article/Abstract/17995

(6)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3694334/

(7)https://www.aad.org/public/diseases/rosacea/insider/drinking

(8)https://link.springer.com/article/10.1007/s40257-022-00713-z

(9)https://onlinelibrary.wiley.com/doi/full/10.1111/jdv.12164

(10)https://ic.steadyhealth.com/eczema-and-liver-functioning

(11)https://www.ncbi.nlm.nih.gov/books/NBK548219

(12)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4622315/

(13)https://pubmed.ncbi.nlm.nih.gov/32975301

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Reviewed professionally for accuracy by:

Ryan Soave

L.M.H.C.

Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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