What Alcohol Consumption does to your Skin
From a few drinks to many, alcohol’s effects on the skin can be evident with even casual drinking. (Photo credit: paukrus)
Alcohol is very prevalent in our society — consumption ranges from a glass of wine with dinner to serious alcohol dependencies. Depending on where you get your information, alcoholism affects from 10 to 20% of the American population — a pretty substantial number of people. Most of us are familiar with the side effects of excessive drinking on our bodies but drinking has serious effects on your skin. Some of these effects can be seen with mild alcohol consumption, while some occur with alcoholism and liver damage.
What Can Happen Within a Few Hours of Drinking
urticaria: raised, red, and itchy
Within a few hours of alcohol consumption, an allergic reaction such as urticaria can occur. Even the smallest amount of alcohol can cause an allergic reaction in a susceptible person. Regular alcohol consumption also worsens the symptoms of existing skin conditions e.g. seborrheic dermatitis (SD), eczema, psoriasis and psoriatic arthritis, and even acne.
Facial Spider Veins
Dilation of Blood Vessels, probably the most well known effect, seen even in infrequent drinkers, is a flushed face. In time dilation of blood vessels can become permanent, leading to formation of spider veins. These affect mainly the face, chest, abdomen, arms, and hands.
The reason for dilation is twofold: alcohol directly affects the blood vessels, but in the long run, liver damage leads to cirrhosis and portal hypertension. The portal circulation is a network of blood vessels that feed the liver, and when blood pressure increases in these vessels, resistance to blood flow in them increases, which shunts blood flow to collateral blood vessels, which then dilate.
Another stigma of long term alcoholism and liver damage is red palms (palmar erythema). Of course it makes sense that rosacea, a disease worsened by dilation of blood vessels, would be exacerbated by alcohol consumption and alcoholism.
What Else Can Happen From the Liver Damage
Liver damage can do more than just cause red palms too.
It causes a raise in bilirubin levels, leading to jaundice (yellow skin), as bilirubin has an affinity for elastin, which is abundant in the skin (it is also quite abundant in the sclera, which is why the eye whites turn yellow).
Bile stagnation accompanying liver failure causes itching (pruritus). There are no actual skin manifestations apparent, but rather itching leads to problematic scratch marks, skin thickening, infection, and skin discoloration.
A type of photosensitivity that is associated with liver damage in alcoholism is called porphyria cutanea tarda. PCT develops due to a decrease in the activity of an enzyme in the heme biosynthesis pathway (called uroporphyrinogen decarboxylase), which leads to accumulation of porphyrins in the skin. Porphyrins act like UV magnets. Sun exposed skin becomes fragile, blistered, crusted, and scarred.
What Can Happen Over Time From Prolonged Drinking
Alcoholism is also known to be associated with hyperpigmentation, especially around the eyes, around the mouth, and darkening of freckles.
Look older faster (photoshopped)
Alcohol causes skin to become dry. Alcohol (like coffee, by the way!) is a diuretic. This might not be a problem with infrequent drinking, but regular, long term consumption of alcohol dries the skin, especially if water drinking is not consciously regulated. Alcohol also accelerates skin aging: at age 30, an alcoholic would look quite older than a 30 year old non-alcoholic.
Due to a combination of various nutritional deficiencies and impaired immunity, an alcoholic is also at an increased risk of skin infections, such as tinea pedis, or oral candidiasis.
Alcohol consumption causes various vitamin deficiencies, leading to many skin manifestations such as dry, thick skin (vit A), inflamed mouth angles (vit B2 and 6), or impaired wound healing (vit C)
Clubbing
Nail changes that are associated with alcoholism but not specific to it include clubbing, white bands (Muehrcke nails) or whitening of the majority of the nail (Terry nails).
Alcoholism is associated with many forms of cancer, among which is an increased risk of basal and squamous cell carcinoma. This increased risk may be due to an immunosuppressive effect, as well as nutritional deficiencies that are related to alcohol consumption.
Bottom Line
Alcoholism is a big obstacle to overcome. I realize there are many more things to worry about beyond the skin skin, but here is hoping that this list of skin manifestations will perhaps push someone in the right direction to save their lives, bodies, and skin, and put the minds of the ones they love at ease. Good luck always.
Sources:
SW. Liu et al. The Effects of Alcohol and Drug Abuse on the Skin. Clinics in Dermatology 2010; 28 (4): 391-9.
AM. Tobin et al. Prevalence of Psoriasis in Patients with Alcoholic Liver Disease. Clinical and Experimetal Dermatolgoy 2009; 34 (6): 698-701.
A Jensen et al. Intake of Alcohol may Modifay Risk of Non-Melanoma Skin Cancer: Results of a Large Danish Prospective Cohort Study. Journal of Investigative Dermatology 2012; advanced publication online 14 June 2012.
About Author
Dr. Hanan Taha, M.D. got her MD from Kuwait University in 2002, and obtained a masters degree in Dermatology in 2010 from the University of Alexandria. She has experience in various cosmetic procedures, such as hair removal, facial rejuvenation, skin tightening, cellulite treatment, and management of stretch marks. Hanan’s passion for dermatology started on her very first day of rounds, and after being undecided for years on which direction to go, she decided to become a dermatologist. A strong believer in patient education as grounds for a healthy living, she strives to thoroughly explain her patients their skin problems or concerns and the proposed treatment plan. She also runs a blog in Arabic dedicated to spreading the knowledge about dermatology and cosmetic dermatology in a simple, concise manner (elbashra.com). Elbashra (البشرة) is the Arabic word for “the skin.”
View all Dr. Hanan Taha, M.D. posts.(7) Readers Comments
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Lucas
Alcohol abuse is indeed a serious matter. But is occasional drinking also a problem?
Although a common trigger for rosacea, it doesn’t seem to be a problem for me. Weirdly, I become very pale when I drink. Unless I’m exposed to a trigger (like a close, airless, sultry room), in which case my skin becomes very reactive.
Dr. Hanan Taha, M.D.
Hello @Lucas
Short term effects would be related to the immediate effects alcohol has on the body and brain, from lack of good judgement to redness to dehydration. I find it interesting that you turn pale even with your rosacea, but some people do turn pale with drinking, which might be attributed to dehydration. Remember to drink plenty of water!
Thank you for stopping by.
Lucas
Hey,
Dehydration does make sense, since my skin feels kind of dry/tight when I drink. I’ll try drinking more water.
Thanks!
Hillary G.
Hi Lucas –
I drink a lot of coffee and tea (black), do you know if that could negatively affect my skin?
Hillary
Lucas
I took a long time to see your comment Hillary G. Sorry about that.
I guess you’re asking me because you also suffer from rosacea. I’m no expert, but I can tell you my personal experience. When I drank a lot of coffee or tea, like 4 cups a day or more, I did seem to react to it, even if it wasn’t hot, especially if there was another trigger present. I cut back drastically, to NO caffeine for a few months and then re-introduced caffeinated beverages, but only about 1-2 cups of coffee a day (maybe more tea since it has less caffeine). I have no problems with it now, but I have to say I also changed a lot of other things, skincare and diet related, so, not exactly scientific.
What I found interesting about how coffee affected me when I was drinking a lot and regularly is that it didn’t turn my face red right away, it actually took a few hours (4-6) to significantly affect my rosacea. I realized that one day when my face didn’t turn red a particular day, at a time when it always did. Perhaps try not to change anything in your routine (skincare, lifestyle, diet, etc.) and drink some coffee and watch how you respond. If you think there is any connection, remove it for a while, and watch if you still have any symptoms. If not, try introducing it back. If the symptoms return, it’s very likely you can’t tolerate it.
Also, I can tell you that concentrated caffeine, like in energy drinks/pills/powders affects me VERY badly. It makes me really red, burning, tight-feeling and takes a long time to go away. So I don’t recommend trying any of that.
Remember that triggers vary greatly with rosacea, so perhaps what makes you react negatively, doesn’t do the same for me or everyone else.
If you weren’t asking me because you also suffer from rosacea, then I’m sorry for the useless speech. I guess it’s good for skin in general, since it has antioxidant activity. Someone could do a post about this and set the record straight.
Best!
Jacqueline
Hi Dr Taha,
Thank you for the great site.
May I ask to know about the link between alcohol and hyperpigmentation and dark circles? I am not familiar with it.
I know dehydration can cause temporary darkening around the eyes. And that that area can be linked to kidney health.
Thank you.
Jacqueline
Dr. Hanan Taha, M.D.
@Jacqueline
Hello there, and thank you for your kind words. Dark circles are expected as a result of a combination of liver damage, poor nutrition and dehydration that are associated with alcoholism. Also, Here is a paragraph from the first study mentioned in “sources” above:
“Alcoholics with liver disease may demonstrate hyperpigmentation and erythema, particularly on the legs. Accentuation of freckling, areolar pigmentation, and perioral and periorbital pigmentation may also be seen. The exact mechanisms for hyperpigmentation are not known but may be related to excess melanin in the melanosomes. Hyperpigmentation associated with hemochromatosis can also be seen. Alcohol facilitates the absorption of iron and therefore plays a role in acquired hemochromatosis. Hemochromatosis classically presents as generalized hyperpigmentation, with concomitant cirrhosis and diabetes mellitus. This associated hyperpigmentation is generalized brown to slate-gray, with accentuation in the sun-exposed areas. The skin may also be dry and scaly.”