Wine Articles and Reports

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Why Red Wine Causes Headaches and Facial Flushing In Some People

Article written by: J. Pallotta - July 2026

ight to moderate consumption of red wine can cause headaches and facial flushing in some individuals. These symptoms often occur more quickly and more frequently after drinking red wine than after consuming white wine, beer, or distilled spirits.

When the liver metabolizes ethanol (the chemical name for alcohol), it converts it into acetate through a two-step process. The first step involves converting ethanol into acetaldehyde, a highly toxic compound. When large amounts of alcohol are consumed, acetaldehyde can accumulate in the body. This substance is approximately 20 times more toxic than ethanol and is classified as a carcinogen. Acetaldehyde is largely responsible for many common hangover symptoms, including nausea, sweating, facial flushing, and headaches. The second step involves the conversion of acetaldehyde into acetate by an enzyme known as aldehyde dehydrogenase (ALDH2). If acetaldehyde is not efficiently converted into acetate by ALDH2, it can accumulate in the body and bloodstream, leading to headaches and facial flushing in susceptible individuals.

Traditionally, red wine headaches have been attributed to specific components of red wine, including tannins, sulfites, histamines, and alcohol itself. According to the Cleveland Clinic, these components may contribute to symptoms in certain individuals:

  • Tannins: Naturally occurring compounds found in grape skins, seeds, and stems. Tannins contribute to a wine's flavor, astringency, and aging potential. They may narrow blood vessels and stimulate serotonin release, potentially triggering headaches in people who are prone to migraines.

  • Sulfites: Although often blamed for wine-related headaches, sulfites are unlikely to be the primary cause for most people. Sulfites can trigger asthma symptoms or hives in sensitive individuals, but their role in headaches remains controversial.

  • Histamines: Red wine generally contains higher levels of histamines than white wine because it is fermented with grape skins. Histamines can contribute to inflammation, nasal congestion, and headaches in sensitive individuals.

  • Quercetin: A flavonoid found in abundance in red wine. Research suggests that quercetin may inhibit enzymes involved in breaking down acetaldehyde. As acetaldehyde accumulates in the bloodstream, it can contribute to headaches, facial flushing, and nausea.

  • Alcohol itself: Ethanol dilates blood vessels in the brain and can activate inflammatory pathways in the trigeminal nerve system, potentially causing throbbing headaches. In some cases, this effect may occur within 30 minutes of excessive alcohol consumption.

While these compounds may contribute to headaches in susceptible individuals, there has been limited evidence to support the theory that they are the primary cause of red wine headaches. More recent research has focused on the significantly higher concentration of flavonoids found in red wine. Red wine typically contains flavonoid levels that are up to ten times higher than those found in white wine.

These flavonoids may interfere with the conversion of acetaldehyde into acetate in the liver. As acetaldehyde accumulates in the body and bloodstream, it may trigger headaches and facial flushing, even after relatively small amounts of red wine are consumed.

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Research papers published in 2023 by the Scientific Reports journal and Harvard Health identified a flavonoid called quercetin as a leading candidate in the development of red wine headaches. Quercetin is one of thousands of flavonoids naturally present in foods such as onions, capers, cabbage, coriander, cranberries, green tea, apples, and grapes.

Researchers examined several compounds in wine known to inhibit ALDH2 and found that quercetin-3-glucuronide was the most potent inhibitor. This compound inhibited ALDH2 nearly three times more effectively than the other flavonoids tested. The findings suggest that when red wine is consumed, the liver converts quercetin into quercetin-3-glucuronide, which may impair the breakdown of acetaldehyde. The resulting accumulation of acetaldehyde may be responsible for headaches and facial flushing experienced by some wine drinkers.

It is important to note that quercetin concentrations vary among wines. Fermentation methods and aging practices can significantly influence quercetin levels. In addition, vineyard practices such as pruning and trellising can increase sun exposure, which may stimulate greater quercetin production in grapes.

Some studies have suggested that premium wines may contain higher concentrations of quercetin than lower-priced wines due to differences in vineyard management and winemaking techniques.

Conclusion

People vary considerably in their sensitivity to the many compounds found in food and wine. While several components of red wine may contribute to headaches or facial flushing in susceptible individuals, current research suggests that quercetin may play a significant role. By inhibiting the conversion of acetaldehyde into acetate, quercetin may allow acetaldehyde to accumulate in the bloodstream, resulting in headaches, nausea, and facial flushing.

Because the enzymes involved in quercetin metabolism differ from person to person, not everyone experiences these symptoms after drinking red wine. This variation may help explain why some individuals can enjoy red wine without issue, while others develop headaches or facial flushing after only a small amount.