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Q. Why do red hives appear in different parts of my body after drinking alcohol?

Answered by
Dr. Ajeet Kumar Lohana
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Jul 03, 2020 and last reviewed on: Apr 26, 2021

Hello doctor,

I am a male aged 24 years with an overall healthy history. However, I have noticed in the recent past a bunch of red hives on (swollen red-colored, not-painful) different parts of the body (knees, legs, cheek, arms) appearing after drinking beer or wine. This happened now twice in a row, which makes me concerned. I have been an active social drinker for the last three years (occasionally also indulging in binge drinking), but I never faced any sign of alcohol intolerance. This is sudden and quite surprising, for a bit of family history, and my father has alcohol intolerance, but that has never been an issue for me, at least, as of now. What would you recommend in this situation? I am worried if this is a sign of something serious, or should I get my liver tested? The red hive in the cheeks is of fairly big size, and it is embarrassing. Typically, would it go on its own if I stop drinking? I usually do not drink anything other than beer or wine that, too, not more than twice a week.

Thank you in advance.

#

Hello,

Welcome to icliniq.com.

I am sorry, but the picture you uploaded (attachments removed to protect the patient's identity) seems a little bit taken far away, not giving me a full description of what it is. Yes, you should get your liver function tests. This will help us to detect any subtle damage to the liver. In chronic drinkers, small blood vessel enlargement can occur in the skin named spider angioma. They are not really painful and vary in size from a tooth pin tip to 1 cm. They are harmless and will not cause you harm. But if you have not been an over-drinker, then it is fine. If yes, try to cut down the amount.

The other possibility is some insect bite. Most of us usually could not figure out at the initial stage, but they are a common cause for such skin hives. They tend to be itchy otherwise. Lastly, a cross-reaction of alcohol has been seen with certain drugs, one of which is Disulfiram. The common medication to cause this is Cephalosporin, an antibiotic, Sulphonylureas, Metronidazole, both antibiotics, and some others. But the hives you mention may be just a part of the whole syndrome, which comprises throbbing pain in the head, skin reaction, sweating, nausea, vomiting, and abdominal pain.

So first of all, just take a close picture of the lesion, take as many pictures as you can and upload them. And see if you could recall and figure out the relevance of your symptoms with any of the above-mentioned possibilities, particularly the use of any antibiotic medication or insect bites. We will discuss the treatment once we establish the diagnosis.


The Probable causes:

Spider angioma.
Disulfiram reaction.
Insect bite.
Mastocytosis.

Regarding follow up:

See with the maximum pictures of the lesion and relevant information.


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