Alcohol and hives

Hives are raised, itchy welts that can change shape or move around. A reaction may relate to the drink itself, an ingredient, food eaten alongside it, a medicine or another exposure.

Alcohol can widen blood vessels and may make existing hives look redder or feel itchier. Beer, wine and mixed drinks contain different grains, fruits, yeasts, preservatives and flavourings, so the trigger may not be ethanol.

Urticaria presents with temporary welts, whereas a mark that remains fixed, bruises, blisters or scales may be another rash. Deeper swelling of the lips, eyelids or other tissues is called angioedema and changes the urgency of assessment.

Stop drinking, move to a cool place, wear loose clothing and avoid hot showers. Take photographs and record the beverage, mixer, meal and medicines used that day, including pain relievers.

A pharmacist can advise whether an oral antihistamine is suitable and whether it interacts with your medicines. Avoid driving if a product makes you drowsy, and do not use alcohol to wash down medication.

Call emergency services for tongue or throat swelling, trouble breathing, wheezing, faintness, confusion or rapidly worsening symptoms. Use a prescribed adrenaline auto-injector according to your emergency plan if you have one.

Seek a routine clinical review when episodes recur, the trigger is unclear, welts keep returning, or individual marks are painful or leave bruising. Bring photographs because the skin may look normal by the appointment.

Ask whether the rash is urticaria, whether any medicine or drink ingredient is suspect, what antihistamine plan is appropriate, and whether you need allergy assessment or an emergency action plan. Describe any swelling, breathing symptoms and previous episodes.