You’re enjoying a glass of wine with dinner when the throbbing starts. You know what that means: A wine headache is about to ruin the rest of your evening.

Wine often takes the blame for headache pain. The pain is very real, but scientific evidence for the reasons behind this phenomenon is lacking.

Let’s take a closer look at a wine headache, if there’s a way to avoid it, and what to do when a wine headache strikes.

Among alcoholic beverages, wine has quite the reputation as a headache trigger, particularly red wine. That first twinge of a headache can occur within a sip or two, or it may show up several hours later.

Alcohol can dilate blood vessels in your brain, which can cause a headache. Red wine, in particular, has long been known as a migraine trigger.

But even among those who identify red wine as a trigger, it doesn’t hold true every time. It’s likely that migraine attacks involve several contributing factors.

There are many theories, but no clear evidence as to why wine gives some people a headache.

Here are some possible theories regarding wine headaches.

Histamine

Grape skins contain histamine. White wine is made without the grape skin, so it has a lower histamine content than red wine, which is made from the whole grape. A histamine sensitivity could make you more susceptible to a headache.

Keep in mind that some other foods contain more histamine than alcoholic drinks. These include:

  • aged cheese
  • eggplant, sauerkraut, spinach
  • fish
  • sausage, salami

Tannins

Grape skins also contain plant chemicals called tannins, which help give wine its flavor. Tannins also prompt your body to release serotonin, which may cause headaches in some people. Red wines have more tannins than white wines.

Tannins are found in a variety of foods, including tea, dark chocolate, and some berries and nuts.

Tannins are thought to trigger migraines even in people who take preventive treatments.

Sulfites

Sulfites are sometimes blamed for wine headaches. Sulfites are compounds that help preserve red and white wine. If you’re sensitive to sulfites, you’re more likely to experience breathing problems than headaches, though.

Higher amounts of sulfites can also be found in:

  • certain fruits and dried fruits
  • chips
  • pickles
  • raisins
  • soy sauce

Wine is often acknowledged as the most common drink to provoke a headache, but any type of alcohol can do it. There’s no “safe” alcoholic drink, and you don’t have to have a primary headache disorder to be affected.

Your headache triggers are uniquely yours. To add to the confusion, even known headache triggers aren’t universally reliable.

Developing a headache may depend on a variety of contributing factors, such as:

  • other ingredients in the alcoholic drink
  • foods you’ve eaten
  • having an empty stomach when you drink
  • your stress levels
  • your level of fatigue

Of course, drinking any type of alcohol to excess can lead to a hangover headache. But that type of headache is caused by the amount of alcohol you drink, rather than what you drink.

At the first inkling of a wine headache, it’s a good idea to put your wine glass down, and to consider one or more of the following strategies.

  • Drink plenty of water.
  • Have a caffeinated beverage.
  • Use a cool compress or ice pack on the pain.
  • Lie down in a dark room.

You might find relief from a wine headache with over-the-counter (OTC) pain relievers such as:

OTC pain relievers are generally safe, but mixing them with alcohol can be dangerous in some cases, particularly if you:

If you take OTC or prescription headache medicines, follow the label instructions and warnings regarding interactions with alcohol.

If you’ve identified wine as a common headache trigger, your best bet might be to avoid drinking wine. That could mean no more reds, no more whites, or no more wine at all.

On the other hand, if your headaches are bearable and you’re willing to risk it, you may want to experiment with different types of wine. You may be able to separate the offending wines from those that don’t trigger a headache.

Wines are made with a variety of grapes, preservatives, and other ingredients, so keep track as you go. Choose high quality wines and only drink a small amount until you’re sure how that wine affects you.

Other ways to prevent a wine headache

Other strategies that may help prevent a wine headache include the following:

  • Avoid drinking wine if you’re not feeling well or if you feel stressed or upset.
  • Avoid drinking wine on an empty stomach.
  • Drink a full glass of water before drinking wine.
  • If you’re going to have a second glass of wine, be sure to wait at least an hour, and drink a full glass of water before the second glass of wine.
  • Sip your wine slowly.
  • Don’t mix wine with other alcoholic drinks.
  • Stop at the first sign of head pain.
Healthline

Any type of alcohol can lead to a headache, especially if you overindulge.

If you drink alcohol, the recommended daily consumption is one standard drink per day for women and two standard drinks per day for men. For wine, a standard drink is considered to be 5 ounces of wine at 12 percent alcohol volume.

A wine headache is not uncommon, but the reasons for it are unclear. It may take the perfect storm of factors to trigger a headache.

If you get a wine headache often, it doesn’t necessarily mean you need to avoid wine forever.

Experimenting with different types of wines may help you isolate those that tend to trigger a headache from those you can savor. Drinking slowly and limiting how much you drink may help fend off a headache, too.

If you get bad headaches regardless of what type of wine you drink or how much, you may want to consider a different type of beverage.

Be sure to see your doctor if your wine headache is sudden, severe, or is accompanied by other symptoms you haven’t had before.