Alcohol and Eczema: Does Drinking Trigger Flares?

Alcohol and eczema flares (increases in symptoms) have not been confidently linked by research. However, there are anecdotal reports that some people with eczema experience flares after drinking and see an improvement when avoiding alcohol.

Some studies of nummular (discoid) eczema have found an association between alcohol consumption and a flare. The American Academy of Dermatology lists heavy alcohol drinking as a possible cause of a flare of nummular eczema.

Alcohol, Eczema, and the Immune System

Alcohol, the immune system, and the skin interact with one another.

Some reasons researchers suspect a link between drinking alcohol and experiencing eczema symptoms include:

• Histamines: The immune system produces compounds called histamines in response to an allergy or injury. They are also released when breaking down alcohol. When histamines are triggered inflammation, itching, redness, and/or discoloration can result.
• Dehydration: Dehydration from alcohol doesn't just mean morning thirst, it can also lead to loss of moisture in the skin. When already dry skin loses more moisture it tends to get itchy, causing a cycle in those with eczema.
• Slow skin healing: The skin protects against harmful environmental factors, like pathogens that cause infections. Alcohol has been proven to disrupt the skin barrier. An eczema-compromised skin barrier may be slower to heal and at increased risk of infection.
  

Other Skin Conditions Triggered by Alcohol

Eczema isn't the only skin condition that appears to be triggered by drinking. Psoriasis and rosacea have been linked to alcohol use, as well as porphyria cutanea tarda.

Psoriasis studies show that the amount and frequency of drinking may be related to the severity and onset of the condition.

Alcohol intake, specifically liquor and white wine, has been associated with an increased risk of rosacea in women.

More research is needed to understand how alcohol can impact these skin conditions, but studies show that the body responds to each in similar ways: increased susceptibility to infections, stimulation of immune cells, and inflammatory responses.

Alcohol and Eczema Medication Interactions

It's always risky to mix alcohol with medications. Drinking while taking medication can change the effectiveness of the medication and tax the liver, among other dangerous effects.

Here are some specific alcohol-eczema medication interactions to be aware of:

• Antihistamines: Antihistamines can prevent eczema flares. Mixing these medications with alcohol can cause sleepiness and impaired focus.
• Antibiotics: Antibiotics are prescribed to treat or prevent skin infections. Drinking can limit their effectiveness and lead to other side effects.
• Corticosteroids: Corticosteroids are used for a short period to suppress the immune system and get an eczema flare under control. Since alcohol and corticosteroids both suppress the immune system, they put you at high risk of infection and illness.
• Biologic drugs: Some people with eczema regularly take medications to improve their immune system function. There isn't much research on how biologics interact with alcohol. People are often advised to steer clear of alcohol.

Eczema and Alcohol: Does What You Drink Matter?

It's not uncommon to have both eczema and food allergies (or sensitivities). A 2017 study found that a large percentage of people with eczema have some form of food allergy.

Those with eczema may have an intolerance to a naturally occurring component in alcohol called histamines. Alcohol is broken down by the body into acetaldehyde, which can stimulate the release of histamines.

Histamines are responsible for cueing allergic reactions in the body (like inflammation in the skin). That's why some people with histamine intolerance will get a "red wine headache." Others, especially those with existing skin conditions, may experience an increase in itchy skin.

If you notice itching after drinking, consider switching to a mocktail or low-histamine alcohol, such as vodka. Avoid red wine, beer, and aged liquor, which have high levels of histamines. Histamines are also found in foods and drinks that have been fermented.

Tracking Your Triggers

Keeping track of your daily habits, food, and stress can help you narrow down the impact each has on your eczema. When it comes to determining your reaction to alcohol, try using a food and drink journal to track when flairs occur.

Consider keeping a close eye on other ingredients in drinks, such as mixers, fruits, or flavorings, too. You may be reacting to a different food source rather than, or in addition to, alcohol.

Drink Responsibly

Being aware of how much and how often you drink is important. There is mounting research linking chronic skin conditions with alcohol misuse.

A 2021 study found an alcohol use disorder (AUD) in 23% of people with eczema and 28% of people with psoriasis. About 10% of the general public misuses alcohol.

Some studies highlight how eczema and other chronic skin conditions can affect mental health. Others note the connection between liver function, the skin, and eczema.

Bottom line, finding strategies to limit or halt alcohol consumption may help improve eczema flares in some cases. This may include adding stress-reducing or confidence-boosting exercises, seeing a therapist, or just being more mindful of when and why drinking seems beneficial.

Summary

There is no direct research linking alcohol consumption to eczema flares or new cases of eczema. However, medical observations and personal anecdotes are encouraging more research.

Experts may not fully understand why eczema gets worse after alcohol consumption, but they know how alcohol and the body interact.

Food sensitivities, dehydration, histamine intolerance, and overall low liver function are all factors in alcohol-induced eczema flares. Track alcohol intake and find what works for you.