Last night you had a few drinks, but immediately felt stuffy and congested, maybe a flushed red face and runny nose. And today your sinuses are acting up. Yet others with you were totally fine. Does this scenario sound familiar?

Everyone’s blood vessels dilate after drinking alcohol. This is normal and it’s why you typically feel warm after a drink or two. Drinking alcohol can also lead to some nasal congestion, but this clears up quickly in most people.

However, for some others the symptoms are more extreme and don’t clear up quickly. These people are experiencing what are called “alcohol-induced nasal symptoms”. These symptoms can include nasal congestion or blockage, flushed red face, hives, itchiness, a runny nose, sneezing, cough, and sometimes even nausea and diarrhea. In persons who already have sinus problems and sinus inflammation, these symptoms make the sinuses feel worse.

Why some people have more extreme reactions to alcohol

There are several explanations for what is going on. For some people, the symptoms are due to alcohol intolerance or alcohol hypersensitivity. This is not a true allergy, but a sensitivity to alcohol. Another group of people have allergies to some of the ingredients in the liquor, such as tannins, sulfites, and histamines. And finally, some people have a genetic reason for developing these symptoms after consuming alcohol.

A few studies conducted in Europe and Australia have looked at what percentage of people have alcohol-induced nasal symptoms. They found that 3.4% to 7.6% of persons of European descent report symptoms. About twice as many women as men report symptoms from consuming alcohol. While all alcoholic beverages can trigger symptoms, people report that red wine causes the most symptoms. 

The studies also found that individuals with allergic and non-allergic rhinitis, nasal polyps, and respiratory conditions (e.g., asthma, chronic obstructive pulmonary disease or COPD, emphysema, chronic bronchitis) are more prone to these symptoms. Nasal blockage is the most common symptom, followed by flushed skin, nasal discharge (runny nose), and itching.

It has been known for a long time that people with asthma are more sensitive to alcohol. One study found that over 40% of people with asthma report allergic-type symptoms (e.g., nasal symptoms, itching, face swelling), and that up to 35% report that alcohol worsens their asthma.

Interestingly, several studies found that persons who have nasal symptoms from alcohol also have similar symptoms to other things, such as hot or spicy food and strong-smelling scents. But not really to tree pollen (hay fever).

About 36% of people of East Asian (e.g., Chinese, Japanese, or Korean) descent have a genetic impaired ability to metabolize alcohol, but this can also occur in non-Asians. Even after drinking a small amount of alcohol, they typically experience facial flushing, a rapid heart rate, and nasal and sinus congestion. This is sometimes referred to as alcohol flushing response or alcohol flush reaction. 

Sinus infections and alcohol

Persons who suffer from frequent sinus infections or chronic sinusitis may feel that drinking alcohol worsens their sinus problems. Many of them have also been diagnosed with allergic or non-allergic rhinitis (also called vasomotor rhinitis), and studies find that a greater percentage of individuals with nonallergic or allergic rhinitis report alcohol-induced nasal symptoms. For example, a recent study found that persons with allergic rhinitis may feel more clogged and congested after drinking alcohol than people without allergic rhinitis.

Also, blood vessels in the nose normally dilate after drinking alcohol. Persons with a sinus infection will be more bothered by this, and have worsening of sinus symptoms, because they are already inflamed from the sinus infection.

Having certain chronic respiratory conditions is associated with a greater likelihood of symptoms after consuming alcohol. One study comparing 5 different groups found that the greatest prevalence of persons reporting nasal and bronchial symptoms after consuming alcohol were in persons with NERD (Nonerosive Reflux Disease), followed by persons with chronic sinusitis with nasal polyps. It was less frequent in persons with chronic sinusitis without nasal polyps, and those with allergic rhinitis, and the least in healthy individuals without any of these conditions.

How to avoid alcohol-induced nasal symptoms

Studies find that individuals experiencing all sorts of nasal and skin (e.g., hives, flushing) symptoms still continue to drink alcohol. However, they may avoid alcohol that has given them the most problems in the past (perhaps red wine). Many people also report that taking an allergy medication before drinking alcohol helps minimize symptoms.

However, if sinus symptoms still develop or worsen in the days after drinking alcohol, then can take Lanto Sinus for sinus relief.

Cheers!