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You Are What You Drink: The Harmful Effects of Alcohol on Your Skin

It should come as no surprise that what we put into our bodies can impact how we look on the outside. In a recent Mail Online article, the author challenged one women to give up drinking her regular intake of alcohol as a means of evaluating the impact on her skin. After four weeks, the results were rather obvious from the images. Should this be a surprise? In fact we know that not only does alcohol use worsen normal, healthy skin, but is well known to exacerbate common skin diseases such as psoriasis and sometimes rosacea. So what are the harmful effects of alcohol on our skin?

1. Puffer Flusher: Facial flushing is probably the most common skin sign of drinking alcohol, as intake causes the blood vessels in the skin to dilate even with moderate intake, increasing blood flow. Over time, dilation of blood vessels can become permanent, leading to the formation ectasia (ie spider veins). These affect mainly the face, chest, abdomen, arms, and hands. The permanent dilation can be caused by not only the direct effect of alcohol on the blood vessels, but in some cases due to liver damage from long term overindulgence. Furthermore, damage to these small blood vessels can cause them to be leaky, allowing for fluid to enter soft tissue like the skin, giving a puffy swollen appearance. Those of asian decent are at even greater risk for this as up to 40% of northeastern Asians have a mutation in an enzyme that metabolizes alcohol (acetaldehyde dehydrogenase (ALDH2)), and experience flushing and elevated heart rate after drinking even minimal amounts of alcohol.

2. Arid: Alcohol is a known diuretic (meaning it makes you pee more) and actually prevents your body from extracting water from urine in the kidneys. This means alcohol can dehydrate you, and dry skin can appear ashy or lusterless. Dry skin is also the number one cause of itch (think of eczema) , and does a poor job protecting us from the elements and dangerous bacteria and viruses.

3. Liquid diet? Not only does alcohol not offer any nutritional value, it can adversely affect your mineral/vitamin levels by causing a depletion in healthy nutrients that aid in carrying oxygen throughout your body. Importantly, alcohol can have a huge negative impact on your vitamin A, B3, and C levels, all which are very important antioxidants for your skin, and it is vital in the regeneration of new cells.

4. What the heck is that? Alcohol consumption can also impair the immune system in addition to disrupting the barrier function of the skin. Both bacterial and fungal skin infections are common in those who drink frequently and excessively. There is come evidence suggesting that this immune suppression can also increase the risk of skin cancer, though associated risky behaviors such as smoking and unprotected sun exposure may be confounding factors.

Should You Give Up Drinking? No!

So am I suggesting prohibition (like in Boardwalk Empire, but not as exciting)? Absolutely not.

Alcohol intake in moderation in combination with appropriate water and food intake is ideal. In fact, resveratrol, an antioxidant in red grapes, has been shown to have numerous beneficial features, especially for skin aging, and you can get all you need in a single glass of red wine. It’s all about balance. If you drink, do so in moderation. Eat a balanced diet. Drink plenty of water. Protect yourself from the sun with sunblock containing SPF30 + broad spectrum. Don’t smoke. Easier said than done, but maybe not as seen in this Mail Online challenge.

1.Margaritas

High levels of sugar and alcohol which causes inflammation resulting in sensitivity, breakouts, redness and cell damage. Combine this with the high levels of salt which causes water retention making our faces appear puffy and swollen.

2.Cocktails

All cocktails contain high levels of sugar whether that’s with syrups, fruit juices or actual sugar.

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3.Red wine

It’s a vasodilator which causes blood vessels to expand creating redness, plus it releases histamine which again causes redness and flushing. Totally avoid red wine if you struggle with rosacea.

4.White wine

Contains sulphites which can irritate the skin, plus it has high levels of sugar.

5.Vodka and Red Bull

Vodka is probably the least damaging spirit you can drink, but combining it with an energy drink makes this a terrible choice for your skin. The high levels of chemicals, caffeine and sugar in Red Bull causes inflammation and irritation, plus your sleep will be inhibited.

Getty Images

According to nutritional therapist Lola Ross:

1. Baileys

There are 5g (1tsp) of sugar in a 25ml glass of Baileys, plus additives and dairy cream that’s full of skin cell hardening saturated fats.

2. Espresso martini

The combination of alcohol and caffeine is a hard core blood sugar disruptor and stimulates stress hormones – not good for skin health.

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3. Rum and coke

Rum has a high sugar and alcohol content. Mixing with coke will top up the sugar levels and even if you opt for a sugar-free coke, you’ll swap the sugar for liver-stressing additives that reducing healthy liver detoxification instead.

4. Prosecco

The much loved fizz has a fair bit of sugar and is also often filled with preservatives and additives. What’s worse is, as it’s so easy to drink, we tend to drink a lot of it.

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5. Pre-mixed cocktails

Easy and often cheap, premixed cocktails such as Bucks Fizz or Bellini’s are usually full of added sugar and preservatives and colourings.

How quickly does alcohol affect your skin?

‘You’ll notice the short-term effects immediately’, says Bolder. ’24 hours after one night of excessive drinking (three drinks or more) your skin will appear dull, slack, lined and those who suffer from acne and rosacea will see flare ups.’

How long does it take to reverse the effects of alcohol?

‘In relation to skin health, some people might see benefits after 3 days of abstaining from alcohol, which gives the liver time to excrete alcohol, sugars and its other ingredients,’ says Ross.

So whether responsible or not, you don’t have to abstain from the fizz completely. Huzzah!

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What can you do to help hungover skin?

‘If you’ve been hitting it hard for an extended period (hello Christmas!) then you need to give your body a helping hand and incorporate retinols (vitamin A) in your skincare to encourage the cell regeneration process which you’ve inhibited by drinking alcohol,’ says Bolder.

Granactive Retinoid 2% Emulsion The Ordinary cultbeauty.co.uk £8.00 Luna Sleeping Night Oil Sunday Riley cultbeauty.co.uk £45.00 Retinol Youth Renewal Serum Murad feelunique.com £60.00 Dreamy Skin Retinyl Oil Disciple cultbeauty.co.uk £35.00

‘Combat hungover skin by using lovely plant-based oils like Time Bomb Youth Juice Secret Oil and products containing mega moisturisers like hyaluronic acid,’ says Bolder. ‘Encourage the process by drinking at least two litres of water a day and adding in lemon to kick start the liver’s detoxification process.’

Is there anything good for your skin in alcohol?

Optimistic we know, but surely it’s not all bad news? Alas, according to Bolder there’s not much hope with this one:

‘I know some people claim that red wine contains antioxidants which are good for your skin but the alcohol and sugar content alone outweigh any benefits that they may have on our skin.’

Party pooper.

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Here’s how cutting out alcohol can affect your skin

  • Alcohol can have some negative impacts on your skin.
  • It can cause puffiness and acne.
  • After cutting out alcohol, your skin should improve over time.

No matter how fun alcohol may be, it can be bad for your health, especially if you over-indulge. Your Margarita Mondays and Thirsty Thursdays may seem like fun, but having one too many shots can do some major damage to your health, and in this particular case, your skin.

While many of us focus on the negative effects alcohol has on the liver, we tend to forget about its impact on your body’s biggest organ — your skin. INSIDER spoke to a few skin-care professionals to get the scoop on alcohol’s major effects on the skin, and what happens to your complexion when you cut it out.

It causes dehydration.

One of the biggest effects alcohol has on your skin is dehydration, according to Tess Mauricio, MD, FAAD and CEO of MBeautyClinic.com.

“It dehydrates the skin and will cause your wrinkles and pores to be more visible,” Dr. Mauricio told INSIDER. “Your skin will lose it’s natural plumpness and healthy glow.”

Alcohol can heighten your risk of rosacea.

Certain alcohols can increase your risk. Sarah Schmalbruch/INSIDER If you identify as a woman, you may want to lay off the pinot grigio: the American Academy of Dermatology (AAD) reports that alcohol consumption, specifically white wine and liquor, increases the risk of rosacea in women.

However, if you’re still craving a drink (in moderation), Dr. Debra Jaliman, board-certified NYC dermatologist, assistant professor of Dermatology Icahn School of Medicine at Mount Sinai and author of the book, “Skin Rules: Trade Secrets from a Top New York Dermatologist,” noted that clear liquor like vodka won’t increase your risk of rosacea.

It can cause inflammation.

“Everyone knows the sun is the number-one ager for the skin, but most people don’t realize that the second major cause of skin aging is inflammation — any way we can avoid inflammation will be better for our skin,” Joshua Ross, celebrity aesthetician and owner of SkinLab, told INSIDER. “What alcohol does is bring the blood up to the tissue causing inflammation so that’s why it’s harmful to the skin. That can manifest in blotchiness, redness, ruddiness, and dehydration.”

You could be depriving yourself of nutrients.

Although certain alcoholic beverages like red wine are known to have some health benefits, consuming alcohol in excess is never a healthy choice. Filling your body with the empty calories and sugars that many of your happy hour drinks are filled with can actually lead to malnutrition, which can have an obvious impact on your complexion.

“Alcohol is a toxin with little nutrient value and can contribute to poorer liver function, reduced immunity, hormone disruption, cell damage and insulin issues all impacting on the quality, appearance and aging of your skin,” said Sonya Dakar, celebrity esthetician and founder/CEO of Sonya Dakar skin care and Skin Clinic. “Alcohol is also a diuretic, so you can lose plenty of skin cell-loving water from the body quite rapidly, leaving your skin dehydrated and dull. I can always tell who is a drinker when I look at their skin and see puffy under eyes, red skin, or a red nose, pasty skin and even broken capillaries.”

A lot happens to your skin when you cut out alcohol.

Now that we know all of the things alcohol can do to your skin, it’s time to hit the road to recovery. Here’s what will happen to your skin once you cut out the rosé for good:

After one hour, your body works overtime to cut out the excess toxins.

After an hour from your last drink, Dakar said that your body begins to work overtime to clear your skin (and the rest of your body) from the excess toxin you just ingested.

“Your body will enter a detox mode to clear the alcohol from your bloodstream and prevent alcohol poisoning,” she said. “As you drink your last drink, your liver starts working overtime.

She also said that your pancreas also starts producing extra insulin due to shock.

After one day, your skin will still be dehydrated.

You may want some extra hydration. Mark Dadswell/Getty Images For those of you who have from rosacea, we have good news: Dr. Jaliman stated that within a 24-hour period, your skin will see a bit of an improvement when it comes to your symptoms. With that being said, Joshua Ross noted that your skin has a long way to go before it fully bounces back, and will still be recovering from its own type of hangover.

“One day after drinking, your skin will be dehydrated and blotchy,” Ross said.

A week after your last drink is when your skin really starts to see improvement.

After your seven-day stretch of sobriety, Dakar said that your skin will begin to have a dewy, healthier look and a youthful glow due to restored hydration.

However, you may want to keep your cleansers and spot treatments at hand: Ross stated that while your skin’s lipid barrier will begin to heal itself from inflammation, your pores may start to “purge” — which means more breakouts as your skin pushes all of the toxins and clogging materials out of the pores and onto the surface of your skin.

After one month, your skin may have significant changes.

After a month of staying margarita-free, your skin will likely be significantly healthier-looking. According to both Ross and Dr. Mauricio, your skin will have less swelling, a more even tone, and a more hydrated look. Bonus: Dr. Mauricio also said that you may experience some weight loss too.

One year later, your skin should have an overall healthier appearance.

Your skin will definitely reap from the benefits of going sober for good: according to Dr. Mauricio, since your liver will be significantly repaired from the damages of alcohol by this point, your skin will have an overall healthier appearance and naturally radiant look.

“Over one year of not drinking alcohol, your liver will be healthier and better at detoxifying your body,” she said. “The healthier you are, the more beautiful your skin looks, so our skin will be more healthy and glowing.”

For more great stories, head to INSIDER’s homepage.

Photo: VikaValter/Getty Images

Does your face look slightly puffier and redder than normal? Do you see dry patches? Are your eyes bluish-red? Congratulations, you had a great night out! And according to celebrity aestheticians Joanna Vargas and Joanna Czech, your face is exhibiting the physical signs of a hangover.

“When people are hungover, they are experiencing inflammation,” explains Vargas, and that often manifests in the non-pretty signs mentioned above. But not to worry: Your hangover face can be fixed more easily than your pounding headache. Here are the best hangover beauty tips from a dermatologist, some celebrity aestheticians, and a makeup artist, so you can put the physical effects of last night behind you. Read these while lying down, or have a kind friend with a quiet voice read them to you in a low whisper.

Try to Get Up

Start by first removing your makeup from the night before. If operating the sink seems like too much of an effort, use a micellar water like Bioderma or a cleansing cream that doesn’t require water. You can do both of these from bed.

If you can make it to the sink, celebrity makeup artist Suzy Gerstein, whose clients have included Leighton Meester, recommends using a creamy cleanser with a richer texture. “They are brilliant because they feel like silk and have a balm-like feel, which can be removed with water or lotion and tissued off, leaving all the skin-plumping ingredients behind.”

Vargas, a Sofia Coppola favorite, then suggests exfoliating to bring glow back to the skin, and dermatologist Elizabeth Tanzi seconds using a gentle exfoliating wash to “wake up the skin” and get the blood moving.

Touch Your Face a Lot

All the experts agree that the key to reducing puffiness is to massage your face. If Gerstein has a client come in hungover, she’ll do a facial massage to boost circulation and encourage lymphatic drainage. The same goes for Vargas and Czech, who already do lymphatic drainage as part of their facials. Here’s how.

Make Your Face Drink Water

Tone, mist, and mask. Gerstein creates a hydrating mixture combining a serum (her choice is Kypris’s Antioxidant Dew) with an essence (Beauty Elixir II), using a damp makeup sponge to apply it all over the face. She follows it up with an eye mask. Czech, whose client roster includes single-named stars like Sting, suggests using a balancing toner, followed by a mist and mask.

If you have the energy to DIY your own mask, Vargas suggests one with yogurt and honey because yogurt “reduces the effect of inflammation on the skin, while the honey hydrates.” It can also be good to sleep in a hydrating sleep mask, adds Czech — provided you can remember to put one on the night before. Otherwise, sheet masks work, too.

Ice Yourself

Take the ice cubes out of the freezer and rub them over your mask, suggests Czech. She likes doing this to minimize puffiness and swelling. Tanzi also suggests using cold teaspoons to de-puff around the eye area. As a bonus, the old-as-dirt beauty trick with chamomile tea really works. Czech recommends steeping tea bags in hot water, letting them cool, and then putting one on each eye for ten minutes to look refreshed and de-puffed.

Take a Bath

Showering will probably seem like too much cardio at this point. Czech recommends decompressing by soaking in an Epsom salt bath with lukewarm or tepid water. “It improves circulation for the whole body,” she says. Try not to fall asleep in the bath.

No Glitter

Although you’ll want to use an illuminating tinted moisturizer, which can help your skin look more luminous, avoid shimmery eye shadow. Gerstein explains, “Shimmery shadow can irritate sensitive eyes and draw attention to their puffiness.”

Put Some Color On

If your skin is looking sallow, adding a bright color will perk up the skin and your face, much like the smell of a hot breakfast sandwich does to your spirits. Gerstein recommends a cream blush and tinted lip balm. “Avoid powders on dry skin, as they can look dull and splotchy.”

Avoid Too Much Concealer

“It may seem counterintuitive but extra full-coverage concealer under the eyes can only make puffy eyes look worse,” says Gerstein. She suggests using a moisturizing foundation, lightly using color-corrective concealer, and defining brows — a great way to draw attention away from dark circles. YouTube makeup sensation Wayne Goss turned me on to Bobbi Brown’s Tinted Eye Corrector in this video, and it’s still the first thing I reach for when someone remarks that I look “sleepy.”

Now put on your sunglasses, open the fridge, and get started on part two of your cure. Or go lie down on the couch and wait till the dreadfulness stops. You do you.

Bioderma Sensibio H2O Micellar Water

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TATCHA The Rice Polish Foaming Enzyme Powder

The gentle exfoliator loved by Meghan Markle that lightly sloughs off dead skin, refreshes, and makes it supersoft.

LAURA MERCIER Tinted Moisturizer SPF 20 – Illuminating

The infamous tinted moisturizer with a hint of radiance that brightens up sallow skin and evens out blotchiness.

Dr Teal’s Epsom Salt

It will soothe the aches in your body and improve circulation, and generally make you feel better about moving.

BOBBI BROWN Under Eye Corrector

A corrector that goes beneath your moisturizer, to knock out and deflect the purply-black color of under-eye circles.

STILA Convertible Color

A cream blush that comes in many face-warming, brightening colors that blends and diffuses easily into the skin with a few pats.

Olio E Osso Balm

A sheer tinted balm that will soothe your parched lips and give them a pretty wash of color.

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Beauty sleep is not a myth. While you rest, your skin is resting too, recharging and recuperating from a day’s worth of activity. Your body produces collagen to keep your skin healthy, smooth and youthful. The hormone cortisol is reduced in your body. And your body is restored through cellular regeneration.

Quality sleep for the recommended eight hours a night is paramount to good health, and skin is no exception. Read on to learn exactly what happens to your skin when you hit the pillow each night and how you could be doing damage to your complexion by missing out on the benefits of quality sleep.

Your Body Is Restored

After a long day, sometimes there’s nothing more satisfying than laying your head down on a soft, comfortable pillow and drifting off to sleep. But while you dream, your body is hard at work restoring itself and preparing for the day ahead.

There are several stages of sleep, but according to the National Sleep Foundation, the most important stages for your body and skin’s restoration are the third and fourth stages of the NREM (is this an acronym? Can you define it?) cycle. This deep sleep relaxes your muscles and is responsible for increasing blood flow, repairing and growing tissue and restoring energy.

Your Skin is Enriched With Collagen

Collagen is the not-so-secret secret to flawless, youthful skin. According to Medical News Today, it’s the most abundant protein in our bodies and it’s responsible for holding it (what is “it”?) all together. It’s in our bones, our muscles and, yes, in our skin.

Collagen forms the structure of skin, which keeps it looking fresh, firm and young. After the age of 30, collagen production naturally declines, causing unwanted wrinkles to develop. This is when sleep becomes even more important. During the third and fourth restorative cycles of sleep, the body produces collagen, replenishing our stores and keeping skin smooth and supple. Lack of sleep and the presence of stress can negatively impact collagen production, according to a study published in Medical Hypotheses, because they deprive your body of a chance to naturally restore itself.

Your Cortisol Levels are Being Reduced

You might have heard of the stress hormone cortisol in relation to weight management, but it also impacts the integrity of your skin. It may be linked to skin’s oil production, which when spiked can cause flare ups of acne. Some autoimmune disorders that affect skin, like alopecia and vitiligo, can be brought on by elevated stress levels as well.

Sleep reduces cortisol levels, which can help stave off stress-related skin issues. One study published in the Journal of Psychiatry and Neuroscience examined levels of cortisol and growth hormone in sleep-deprived participants. Even though average cortisol levels didn’t spike during 40 hours of sleep deprivation, the typical nocturnal pattern was disturbed. Levels jumped about one hour earlier than normal during sleep following sleep deprivation and an hour later once a normal sleep pattern was resumed. Not getting enough sleep can disrupt your body’s natural ability to manage its cortisol.

Your Skin Gets To Rest Too

When you sleep, your mind is at ease and the troubles of your day can melt away into the softness of your pillow. For skin, sleep has the same effect. Snuggled safely in your sheets, your skin is offered respite from the harsh elements it battles all day long. It gets a break from fighting off the sun’s harmful UV rays and combating damaging free radicals.

If you wear makeup, removing it before you go to sleep gives skin a chance to breathe. Sleeping in makeup can be damaging to skin. “Sleeping in makeup can be detrimental to the skin’s health”, Dr. James C. Marotta, a facial plastic surgeon and skincare expert, told Good Housekeeping. “This is especially true because skin repairs itself at night while you sleep, so makeup can clog your pores and not allow the skin to breathe”.

Dr. Marotta claims that this can cause uneven skin tone, dryness, redness, acne and deeper wrinkles. Take your makeup off before bed, slip into comfortable, quality bed linens and let your body do the rest. When you wake up, you’ll feel refreshed and your skin will be ready to face the day.

Cutaneous adverse effects of alcohol

Introduction

Excessive alcohol (ethanol) intake or alcohol abuse can result in many health problems and is implicated as a cause or aggravating factor for several skin conditions.

What is alcohol abuse?

Alcohol abuse has been defined as recurrent alcohol use where it impacts on work, school or home, or to the point it is physically dangerous, gets you into trouble with the law, or continues despite the problems it has created.

Health problems due to alcohol

Alcohol intoxication

Effects of alcohol intoxication include:

  • Heart: slow heart rate or irregular rhythm, low blood pressure
  • CNS: headache, confusion, memory loss, disorientation, poor coordination, emotional lability
  • Gastrointestinal: nausea and vomiting
  • Respiratory: asthma, slow or heavy breathing.

Chronic alcohol abuse

Effects of chronic alcohol abuse include:

  • Heart: high blood pressure, heart failure, irregular heart rhythm
  • Haemostasis: clotting is impaired with reduced survival and aggregation of platelets and reduced thromboplastin
  • Endocrine: low testosterone levels with loss of libido, testicular atrophy, impaired fertility and reduced facial hair, high oestrogen levels with gynaecomastia, change in fat distribution and loss of body hair
  • Oesophagus: ulcer, varices, cancer
  • Liver: hepatitis, cirrhosis, gall stones
  • CNS: dementia, poor coordination, Wernicke Korsakoff syndrome (Vitamin B1 deficiency) associated with psychiatric and visual disturbances
  • Immune system: direct toxic effect on bone marrow, reduced number and function of T-cells, reduced survival of immunoglobulins.

Infographic below shows effects of alcohol on the body (provided by Healthline).

Vascular effects of alcohol

Facial redness

One of the earliest signs of alcohol abuse is a persistently red face due to enlarged blood vessels (telangiectasia). This appears because regulation of vascular control in the brain fails with sustained alcohol intake.

Flushing

Transient flushing is also a common side effect of alcohol, particularly in heavy drinkers. It is due to acetaldehyde, the main breakdown product of alcohol. Acetaldehyde is thought to cause flushing by stimulating release of histamine.

Up to 40% of northeastern Asians experience flushing and elevated heart rate after drinking even minimal amounts of alcohol, due to accumulation of acetaldehyde. This is because of a mutation in acetaldehyde dehydrogenase (ALDH2), the enzyme that converts acetaldehyde to acetate.

Vascular effects of alcohol

Skin changes due to liver disease

Spider telangiectasis

Spider telangiectasis is given that name because of its appearance. Blood vessels (the spider legs) radiate out in all directions from a central blood vessel (its body). Like other blood vessels, spider angiomas blanch when pressure is applied. They may pulsate. They are most frequently found on the face, v of the neck, chest, arms, hands and abdomen.

Large numbers of spider telangiectases are associated with liver cirrhosis (scarring of the liver) due to elevated oestrogen levels. A study of 82 patients with liver cirrhosis showed significantly higher numbers of spider telangiectases in alcoholic cirrhotic patients than non-alcoholic cirrhotic patients, indicating there may be an additional effect such as vasodilation to account for this difference.

Small numbers of spider telangiectases are seen in healthy children and adults. They are more common in women, especially during pregnancy, as they are influenced by the female hormone, oestrogen.

Palmar erythema

Chronic alcoholic liver disease may lead to reddening of palmar skin. This is also thought to be due to oestrogen, as it sometimes observed during normal pregnancy.

Caput medusa

High pressure within the venous system in the liver leads to high pressure in the venous system elsewhere in the body including the veins around the umbilicus (belly button). When these veins are dilated the appearance has been likened to ‘caput medusa’ (head of Medusa), referring to Greek mythology where a once beautiful woman was cursed and her hair turned into snakes.

Jaundice

The skin and sclera of the eyes often turn yellow in patients with alcoholic liver disease. The colour, known as jaundice, is due to bilirubin, a product broken down from haem derived from red blood cells. The metabolism of bilirubin is impaired in acute and chronic liver disease. Jaundice lessens as liver function improves.

Hyperpigmentation

Skin darkening (hyperpigmentation) around the eyes, mouth and on the legs may be associated with chronic liver disease. The reason this occurs is unclear.

Generalised pruritus

Generalised skin itching (pruritus) may occur due to the build up of poorly metabolised substances that stimulate nerve endings in the skin. These substances may include bile salts, histamine, corticosteroids and opioids.

Nail changes

Nail changes associated, but not specific to alcohol-related liver disease include:

  • Clubbing: the nail bulges out instead of dipping in slightly before it meets the skin at the root of the nail, resembling a club. The angle between the nail plate and proximal nail fold is called the Lovibond angle and is normally less than 180° (indicating a dip and rise where the nail and skin meet).
  • Koilonychia: the opposite of nail clubbing. Instead of bulging out, the nail plate is flat or sunken in (concave or spoon-shaped). This finding is often related to iron deficiency.
  • Terry nails: two-thirds of the nail is white and the last 2mm is pink. This may be due to reduced capillary blood flow in the nail bed.
  • Muehrcke nails: white bands running parallel to the lunula (moon of the nail) with normal pink nail between the bands. This sign may be due to low protein in the blood (hypoalbuminemia).
  • Red lunula: change in colour of the moon of the nail to red, possibly due to increased blood flow and vasodilation
Nail changes sometimes associated with liver disease

Porphyria cutanea tarda

Porphyria cutanea tarda (PCT) results in photosensitivity, skin fragility, blistering, erosions, crusts, milia, scleroderma and increased hair growth (hypertrichosis) on sun-exposed sites such as face and hands.

Alcohol is the most common cause of acquired or type 1 PCT in susceptible individuals and is associated with chronic liver disease. Porphyrins build up because of deficiency in uroporphyrinogen decarboxylase (UROD), an enzyme important in the sythesis of the blood protein haem.

Other factors that may trigger type 1 PCT include oestrogen, iron and viral infections (especially hepatitis C). Familial or type 2 PCT is due to genetic deficiency in UROD.

Skin cancer

Along with increasing the risk of liver, pancreatic and breast cancer, alcohol increases the risk of skin cancer including squamous cell carcinoma, basal cell carcinoma, and melanoma. Alcohol is also associated with an increased risk of oral cancer.

The reasons why excessive alcohol consumption may cause cancer include:

  • Alcohol suppresses the immune system and impairs adequate nutrition, reducing the body’s natural defense against skin cancer.
  • Its main metabolite, acetaldehyde, is a carcinogen (cancer causing chemical). Acetaldehyde produces reactive free radicals and damages DNA.
  • The effects of ultraviolet radiation may be enhanced by photosensitising byproducts of alcohol.
  • Alcohol abuse is associated in many people with tobacco smoking.
Skin cancers

Nutritional deficiency

Nutritional deficiency can develop when alcohol replaces normal food in the diet and the digestive tract and liver do not digest and process food the way they should resulting in malabsorption. With little calorie or protein intake the skin becomes dry and loses elasticity.

Vitamins are essential to maintain healthy looking skin:

  • Vitamin A deficiency results in xerosis (dry skin) and follicular hyperkeratosis (rough follicles).
  • Vitamin B1 (thiamine) deficiency results in waxy skin and a red thickened tongue.
  • Vitamin B2 (riboflavin) deficiency presents with angular cheilitis (cracked corners of the mouth), atrophic glossitis (inflamed tongue) and a rash on the face that resembles seborrhoeic dermatitis.
  • Pellagra is a deficiency of niacin (vitamin B3) and presents with the three ‘d’s: diarrhoea; dementia and dermatitis on sun-exposed areas. Cheilitis and glossitis are also a feature.
  • Vitamin C deficiency (scurvy) results in swollen gums, follicular hyperkeratosis and corkscrew hairs.
  • Zinc deficiency causes a condition known as acquired acrodermatitis enteropathica with dermatitis around the mouth, hands, feet and anus.
Signs of vitamin deficiency

Oral changes due to chronic alcohol use

Changes found in the mouth often relate to nutritional deficiency or poor oral hygiene. These include:

  • Dry lips (cheilitis)
  • Inflamed swollen gums/gingiva (gingivitis)
  • Tooth decay (caries)
  • Beefy red smooth tongue associated with Vitamin B deficiency
  • Hairy tongue associated with overgrowth of bacteria

In addition, swelling of the parotid gland may be a result of chronic alcohol use.

Oral changes associated with chronic alcohol use

Skin conditions affected or caused by alcohol

All of these skin conditions may occur without any history of alcohol abuse.

Rosacea

Alcohol induces vasodilation and facial flushing in people who have rosacea. However, alcohol is not the cause of the skin disease in most people.

Although the classic ‘drinker’s nose’ (rhinophyma) was thought to be related to excess alcohol consumption, it has never been proven. In a case-control study of 175 people with rosacea and 145 people with normal skin, there was no significant difference in alcohol consumption between the two groups.

Psoriasis

High intake of alcohol is a risk factor for new onset of psoriasis. The distribution of psoriasis has been observed to be particularly prominent on the fingers and hands of heavy drinkers. People who have psoriasis and drink more than 80g of alcohol per week have been found to have more severe treatment-resistant psoriasis, including erythrodermic psoriasis. The reasons for the association may be relative immune suppression induced by alcohol and/or that it induces proinflammatory cytokines.

Heavy drinking reduces options for treatment of psoriasis, as some medicines are contraindicated if the drinking has led to liver disease (methotrexate) or to high levels of triglyceride (acitretin). Patients with psoriasis and high alcohol intake are also more likely to suffer from depression.

Seborrhoeic dermatitis

Seborrhoeic dermatitis has been observed to be more frequent in heavy drinkers.

Nummular dermatitis

Nummular or discoid dermatitis occurs more frequently in alcohol abusers, particularly in those with abnormal liver function tests.

Skin infections

Skin infections occur more frequently in patients who drink alcohol excessively due to impairment of the immune system, nutritional deficiency and increased trauma. These include:

Bacterial skin infections that may lead to septicaemia (spread to the blood):

  • Group A and G streptococcus
  • Staphylococcus aureus
  • Corynebacteria resulting in erythrasma and pitted keratolysis

Fungal skin infectionsare common but rarely cause sepsis. They include:

  • tinea infection
  • onychomycosis
  • pityriasis versicolor

Tuberculosis is also seen more frequently in alcoholics. Skin involvement is called cutaneous tuberculosis.

Skin infections sometimes associated with heavy alcohol use

Urticaria

Urticaria (hives) may occur within minutes to hours of drinking alcohol and is sometimes due to allergic reaction. Flushing and overheating after drinking alcohol may also indicate cholinergic urticaria. This is a physical type of urticaria is brought on my heat, exercise or stress.

Sensitivity to alcohol

Alcohol can give rise to allergic or allergy-like symptoms. Along with urticaria (see above), patients may develop low blood pressure, diarrhoea, shortness of breath and low heart rate (anaphylaxis). Even tiny amounts of alcohol may induce urticaria in people who have had a severe reaction previously, although allergy testing is often negative.

Some apparent allergic reactions to alcohol are due to inherited defects in alcohol metabolising enzymes or allergy to other contents of the drink such as colouring agents, preservatives or flavouring.

Interactions of alcohol with dermatological medications

Some medicines used to treat dermatological disorders should not be taken with alcohol. Examples include:

  • Metronidazole: provokes unpleasant symptoms including flushing, palpitations, sweating, dizziness, headache, nausea and vomiting
  • Sedating antihistamines: increased drowsiness and dizziness, impaired driving
  • Tricyclic antidepressants: increased drowsiness and dizziness, impaired driving

When you drink red wine, does your face mirror that ruby glow? Or do your cheeks redden only when you’re drinking cocktails?

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“Your face may flush from alcohol for two reasons: because of an enzyme deficiency or because of rosacea. Both are tied to your ethnicity,” explains dermatologist Alok Vij, MD.

  1. Enzyme deficiency. Many Asian populations have a deficiency in alcohol dehydrogenase, the enzyme that breaks alcohol down. “Alcohol is toxic to cells, and when it gets into the cells of your blood vessels, it makes them dilate,” he says. “This reddens the skin and can make you feel warm.” Without enough of this enzyme, alcohol reaches toxic levels much earlier in your cells.
  1. Rosacea. Fair-skinned people of Northern European backgrounds who flush when they drink may have some degree of rosacea. “This very common skin condition is marked by vasomotor instability or hyperactivity,” explains Dr. Vij. “That means lots of things can dilate your blood vessels: alcohol, chocolate, hot beverages and spicy foods — basically, all the good things in life.”

Does flushing from alcohol raise cancer risks?

Because alcohol is a cellular toxin, anyone who drinks excessively increases their risk for oral cancer and esophageal cancer.

“Alcohol most frequently passes through these sites,” explains Dr. Vij. “Toxicity and DNA damage can build up in cells and, eventually, a cancer can form.”

But recent studies report that those who get an alcohol flush because of an enzyme deficiency are also at heightened risk of digestive, liver and respiratory cancers.

They are more vulnerable to alcohol’s toxicity as it is processed and later eliminated in:

  • The GI tract, especially the stomach, where alcohol is absorbed.
  • The liver, where alcohol is sent after it is absorbed by the stomach.
  • The lungs, where alcohol in the blood is released in the breath.

Is rosacea linked to cancer in any way?

“We don’t think of rosacea as a precancerous disease,” Dr. Vij says. “The biggest problems rosacea causes are a bulbous nose, like W.C. Fields had, and eye inflammation.”

(It was rosacea — not alcoholism — that made the storied comedian’s nose look large, red and bumpy, because of an overgrowth of the sebaceous glands, he adds.)

In addition, rosacea can make your eyes feel itchy, dry and chronically irritated. These eye symptoms can be managed with anti-inflammatory medication. “We typically prescribe oral antibiotics like doxycycline or minocycline, often at lower doses than are required to kill bacteria,” says Dr. Vij.

Are some types of alcohol more likely to cause flushing?

So if your face flushes, are specific kinds of alcohol to blame?

“It’s really patient-specific. Some people with rosacea flush more with red wine; others flush more with hard liquor,” says Dr. Vij.

If you have rosacea and keep track of what happens when you drink, you’ll find your triggers, he says.

Can facial flushing be prevented?

If an alcohol flush makes you feel self-conscious when you drink, certain treatments can help, says Dr. Vij:

  • Topical medications. Medicines like Mirvaso® (brimonidine), can block blood vessels in your skin from dilating.
  • Laser treatments. A series of laser treatments can shrink the superficial blood vessels in your skin. “You usually need three to 10 treatments to get the full effect, but it can last for years, and prevent broken blood vessels in the later stages of rosacea,” he says.

Because the medications and laser treatments are considered cosmetic, however, they are not covered by insurance.

“If flushing bothers you, and you know alcohol is a trigger, the easiest and most cost-effective solution is to avoid it,” says Dr. Vij.

Every mirror-conscious binge drinker has noticed a correlation between his thirstier nights and obnoxious pimples a day or two later. That and a general sense of the skin having turned into parchment overnight—dry to the point of scaly.

So, what exactly is happening to the skin when you drink so much? Why is the body processing alcohol differently than it would water, leaving you dehydrated and red in the face? We had these questions, so we called in the help of a pro: Dr. Amy Spizuoco of Greenwich Village Dermatology in NYC. Here’s how Spizuoco breaks down alcohol’s affects on your skin:

Toxic Byproducts

First, the body metabolizes the alcohol from an enzyme in the liver, which releases a byproduct called acetaldehyde. This byproduct is toxic to body tissues. In turn, body tissues and skin are dehydrated, which Spizuoco says cause premature aging of the skin (like wrinkles). Dry skin is also a stepping stone to post-bingeing breakouts.

The alcohol is meanwhile causing inflammation to bodily tissue, “releasing a histamine that dilates the blood’s capillaries, so that the net effect is redness of the skin.” Spizuoco warns that, when compounded over several years, this redness can be permanent.

And that’s not it!

“Alcohol dilates the pores of the skin, leading to blackheads and whiteheads,” says Spizuoco. “And if is not properly treated, it can go on to cause inflamed skin papules (lesion-like bumps) and cystic acne.” In the long term, this ages the skin and can cause permanent scarring.

Also, and we knew this already, alcohol consumption impairs your sleep and the dehydration compromises the regenerative cycle your body enters while you rest. “This decreases normal cellular turnover and leads to an unhealthy, dull complexion,” Spizuoco says.

Side Note: Caffeine Can Be Bad Too

Alcohol isn’t the only dehydrator. Caffeine has similar effects on the body. It is also metabolized in the liver, then acts as a diuretic (hence that familiar urge to use the restroom after drinking coffee). Diuretics also dehydrate the body tissues and skin, which in turn leads to wrinkles and premature aging. Caffeine can stress the liver just as aggressively as alcohol, when consumed in such large and frequent quantities.

Which Kind of Alcohol is Least Bad for the Skin?

From the alcohol menu, Spizuoco says that beer may be the most offensive to the skin. “Beer has more additives, such as salts and sugars, which will add more stress on the liver to metabolize, as well as be overly dehydrating,” she says. Similarly, dark liquors have more additives than clear ones. The least harmful to you (note that we aren’t saying “the best for you”) is probably red wine, says Spizuoco. This is because reds contain resveratrol, which acts as an antioxidant for the tissues and skin, and helps rid the body of harmful free radicals.

How to Drink and Minimize Strain to the Skin

If you want a pro-skin strategy for your nights out, Spizuoco suggests alternating between a serving of alcohol and a glass of water. Chase one with the other. “This can minimize harmful effects of alcohol on the skin by hydrating the tissues and skin.” She also stresses that eating full meals prior or while drinking will deter the side effects, since some of the alcohol will pass instead through the gastrointestinal system along with the food, so that the two are metabolized in tandem (and thus, side effects aren’t as potent).

What Does a Hangover Feel Like?

Jump To Section

  • Hangover Symptoms
  • What Causes a Hangover?
  • Hangover Cures
  • How long does a hangover last?

Almost everyone who drinks alcohol has had the unpleasant experience of “the morning after.” According to the Alcohol Hangover Research Group, technically, hangover symptoms develop when an individual’s BAC (blood alcohol concentration) drops substantially, and the symptoms peak when the individual’s BAC is near zero. According to Scientific American, it is estimated that nearly three-quarters of individuals who use alcohol will experience some hangover effects at one time or another.

Hangover Symptoms

According to a review in the journal Alcohol and Alcoholism, controlled studies have listed the following symptoms of a hangover:

  • Impaired cognitive functioning
  • Drowsiness as a result of the effect of alcohol on REM sleep
  • Feelings of general malaise
  • Headache, nausea, stomach ache, and other flulike symptoms
  • Feeling dizzy or faint
  • Extreme thirst, most likely due to the diuretic effects of alcohol
  • Extreme fatigue
  • Other autonomic nervous system symptoms, such as racing heart, jitteriness, and perspiration
  • Potential symptoms of alcohol withdrawal in individuals with serious alcohol use disorders
  • Numerous individual reactions

Have you been drinking?

My skin hurts if I consume alcohol

Some of it does an some of it doesn’t at all. I have taken many tests over the years, nothing is ever concluded from them because my blood labs are always perfect. Except this time I knew enough to see a trend in my RBC’s to pick out a b deficiency. The the mast cell symptoms, I do not have any skin lesions or irritations, I don’t have high cholesterol. I have had an endoscopy and colonoscopy and both came up clean except for a few polyps in the esophagus and transverse colon. Generally these are my general symptoms, can you tell me if you think there is a fit?
Symptoms I have had for years
Severe Fatigue and muscle weakness
Weight gain, (possibly due to the fatigue and sugar cravings to seek energy)
Restless Leg at night
Heart feels like its racing, can become breathless with very little exertion.
Lightheaded and low blood pressure 90/58 , low body temp 97.8 average
Irritable
Sensitive to cold
Weak immune system, despite good diet and many supplements
Inability to concentrate
Numbness and tingling in my left toe, right knee
Joint/muscle aches and pain
Abdominal/intestinal pain, bloating, constipation
NEWER symptoms
Pressure in my neck and head especially at temples and behind the eyes, followed by severe
Irregular periods, when I do get them they are extremely heavy
Headaches – massage, chiropractic or pain meds can get rid of.
Pain around left ovary at ovulation and menstruation
Hair loss and eyelashes, especially on the inner edges.
Canker sores and sores in my mouth
Skin breakouts and bumps/sores all over in my head
Recent hives allergic reaction to antibiotics after a surgery (Keflex)

Alcohol and dry skin

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