Think you might have an alcohol allergy? Here are the symptoms to look out for

woman drinking aperol spritz by the pool
Alcohol allergy – all the signs to look out forOleg Breslavtsev - Getty Images

It's pretty normal to feel ropey the day after drinking alcohol (especially as so many of the most popular hangover cures are actually myths, sorry). Booze can cause us to experience everything from headaches to nausea the morning after, and can also impact on mental health conditions, such as anxiety or depression, too. But what about if you feel funny while you're still mid-drink? Or think your hangovers are abnormally severe? It could be a sign that you actually have an allergy, or an intolerance.

What are the symptoms of an alcohol allergy?

Alcohol can negatively affect us in a number of ways, including over-indulgence, reactions to sulphites or histamines contained in your drink, increasing the likelihood of reactions caused by existing allergies, and triggering the symptoms of asthma. "Reactions to alcohol are unlikely to be caused by a 'true' allergy," explains Holly Shaw, Nurse Advisor at Allergy UK. "A true allergy occurs when a person’s immune system reacts inappropriately to a food or some other agent; [with alcohol] most cases [are a] sensitivity to sulphites and histamine [found in some drinks], which are non-allergic."

Signs to look out for? Shaw says symptoms may affect the skin, breathing and circulatory system. "They may also be accompanied by a red rash, swelling to the eyes, lips, face, breathing difficulties, stomach upset, feeling dizzy or faint due to low blood pressure," she adds. "Allergic conditions may be genetic but, can happen in people with no family history too."

Is going red a sign you're allergic to alcohol?

If your favourite tipple leaves your cheeks burning, then yes – you may well have an alcohol sensitivity or intolerance, says nutritionist Jade Taylor, of Kitchen Home. "Hot flashes can occur when alcohol is consumed and can cause a person’s face to turn red. This indicates that the body is encountering difficulty in digesting the substance." All alcohol contains a substance called ethanol and once consumed, the body works to covert it into other substances, or metabolise it to flush it out.

"Acetaldehyde is a metabolite produced in this process and is very toxic. Usually, the body has no problem metabolising alcohol, especially if a person drinks in moderation, however if they’re alcohol intolerant, they may find it difficult to break down the alcohol and the acetaldehyde will build up instead."

Excessive acetaldehyde can lead to sickness, an irregular heartbeat and the aforementioned facial flushing. Taylor notes that sometimes an alcohol intolerance is the result of genetics. Like Shaw, she says it could also be that you’re experiencing a reaction to histamines (which can make you feel short of breath) or sulphites, found in some booze (a doctor can decide if allergy testing is needed). Until then, the best advice? If a certain drink (or several) doesn’t agree with you, then steer clear. Sorry.

How does an allergic reaction to alcohol differ from a bad hangover?

The symptoms of drinking alcohol and an allergic reaction to alcohol are quite different, Shaw explains: "Over-indulgence of alcohol may lead to an altered conscious state, and/or stomach upsets like vomiting and nausea. Alcoholic drinks containing histamine, such as beers, ciders or brown liquors, can also trigger symptoms that may be confused with an allergy, such as sneezing, a runny nose, breathing difficulties, tummy upsets, and headaches." She adds that alcohol may also mask the symptoms of a true allergic reaction to a food if they are consumed together. "There is an increased risk of a more severe food-induced allergic reaction, possibly due to increased absorption of the food or accidental ingestion."

close up of two female friends enjoying drinks in a bar
Marko Geber - Getty Images

Is there a link between having alcohol allergies and eczema?

"Alcohol may in some people aggregate skin conditions like urticaria (hives)," says Nurse Shaw. "You may develop a red rash and/or itchy red raised bumps after consuming alcohol. Some people have a tendency to become red and flushed whilst drinking alcohol, but this is not an allergic reaction."

What about asthma?

Some people with asthma find that their breathing is affected when they drink alcohol. The nurse explains that this is due to the presence of sulphites, which preserve many alcoholic drinks. "For some people with sensitive airways, such as asthmatics, consuming sulphites in alcohol may cause wheezing," she explains. "The amount of sulphites contained in alcohol will vary between products, but sulphur dioxide is one of the fourteen major food allergens that are required by law to be included on labels."

Can you be tested for an alcohol allergy? Are there treatments?

If you’re concerned that you have an allergy, your GP will be able to help. "There are many possible reasons that alcohol may cause unpleasant symptoms that are not allergic in nature," says Shaw. "Your doctor will decide if allergy testing is needed or if the problem is non-allergic (for example histamine intolerance or sulphite sensitivity testing will not be useful here)."

The best treatment of allergies is to avoid the substance that triggers a reaction wherever possible. "This includes looking at ingredient/content labels of food and drink," explains the nurse. "If you are wanting to avoid alcohol, also be cautious of foods that may have alcohol added, for example in a marinade or sauce."

So, to recap, according to Shaw, symptoms of an alcohol allergy or intolerance may include:

  • Skin changes like a red rash

  • Swelling to the eyes, lips, and face

  • Breathing difficulties

  • Stomach upset

  • Feeling dizzy or faint

  • Sickness

close up of a woman's face with red flushed or rashy cheeks
Wirestock - Getty Images

What are the possible causes of alcohol allergy?

As mentioned, a true allergy to alcohol is extremely rare, though cases of skin reactions have happened. More commonly, symptoms are caused by an intolerance to alcohol, or to the food on which the drink is based (like grapes for wine or grains for whisky), or to another substance in the drink, according to Allergy UK.

An intolerance may arise when the body is lacking an enzyme that is needed to properly digest and eliminate a food or substance (or in this case, the alcohol itself). If the alcohol molecule cannot be effectively dealt with by the body, it can cause unusual symptoms to occur. For more information on causes, visit the charity's website page or call its helpline on 01322 619898.

This article is not intended to be a substitute for professional medical advice or diagnosis. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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