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The effects of alcohol on the skin

Ethyl alcohol is the most consumed psychoactive substance in the world, in addition to being the most used as a starting substance for the youngest.

When we drink alcohol, ethanol is absorbed in small amounts in the mouth and esophagus. Then in moderate amounts in the stomach and large intestine, with greater absorption in the small intestine. Once absorbed, it passes into the bloodstream until it reaches the liver. Where it is metabolized in order to break it down and eliminate it from the body. This ethanol in the blood and the metabolites formed in the liver produce toxic effects of alcohol on the body, also affecting the skin. Frequent and prolonged intake of this substance causes both acute and chronic adverse effects of alcohol on health (nutritional, neurological, hepatic, and teratogenic).

Surely you know someone who, after a night of ‘ drinking ‘, pimples, redness, or dry skin appear. This is because the skin is an organ in which the effect of alcohol consumption is quite visible. In addition, it is not necessary to consume excessive amounts of alcohol to notice a resentment in the skin, but low doses can have a negative impact on this organ.

Consequences on the skin

Chronic adverse effects of alcohol

  • It decreases appetite and prevents the proper absorption of nutrients provided by the diet (because it affects the mucosa of the digestive system). In this way, a nutritional deficit is created, affecting the entire body and, consequently, the skin.
  • It is an anxiolytic, mood-stimulating, and sedative substance. Along with the large amounts of sugars present in these beverages, hormonal imbalances are created. Furthermore, it inhibits gluconeogenesis and can cause insulin resistance or increased androgen secretion, causing hirsutism or acne.
  • As we have already mentioned before, the liver is the organ in charge of metabolizing ethanol. Thus, the liver must work more than usual, releasing more toxins than normal and causing the appearance of pimples, blackheads, and pimples.
  • A large number of simple sugars present in alcoholic beverages can cause fluid retention, which can trigger inflammation both in the body and in the face, standing out in the eye area, and appearing as dark circles or bags.

‘Alcohol Flush Reaction

This is a reaction to alcohol that causes redness, spots, and swelling on the face, shoulders, neck, back, and other parts of the body. These reactions appear due to the accumulation of acetaldehyde (a byproduct of alcohol metabolism) due to the deficiency of the enzyme acetaldehyde dehydrogenase 2 (ALDH2) in the body, which means that the liver is not able to metabolize more alcohol.

Spider Angiomas

They are the most common telangiectasia associated with liver diseases due to alcohol abuse. It appears clinically as a central bright red papule surrounded by radiating vessels and erythema. These angiomas have been associated with an increased risk of bleeding from esophageal varices. Patients with alcoholic cirrhosis have a greater predisposition to develop spider angiomas than patients with cirrhosis caused by other factors.

Palmar Erythema

This is a side effect of cirrhosis induced by alcohol abuse that occurs symmetrically on the palms of the hands and soles of the feet. It is usually asymptomatic and presents an erythematous and violaceous appearance.


Another symptom of liver damage and cirrhosis or hepatitis is caused by alcohol abuse. It appears when bilirubin reaches serum levels of 2.5 to 3.0 mg/dL or higher. It occurs on the underside of the tongue, the white of the eye, and the skin with a yellow coloration.

Caput Medusae

This is a vascular complication that appears in people with cirrhosis and liver failure. It presents in the abdomen as congested blood vessels that protrude.


It can appear all over the body, especially on the palms of the hands and the soles of the feet. Its presentation varies, from mild to severe and transient to chronic, and causes tingling or irritation of the skin, causing the desire to scratch the area.

Dupuytren’s Contracture

This is a palpable, painless nodule on the ring finger (metacarpophalangeal joint) caused by fibrotic changes. This can lead to a reduced range of motion in the joints. There is another similar condition called Peyronie’s Disease, also associated with excessive alcohol consumption, which results from fibrous scar tissue forming on the penis and causes curved and painful erections.

Pigmentary Alterations

Those people with chronic liver disease caused by alcohol can develop grayish hyperpigmented spots. Areolar pigmentation has also been observed in patients with secondary hypogonadism.


Due to alcohol consumption, edematous and erythematous plaques may develop on the upper trunk and extremities.

Skin Cancer

Alcohol consumption increases the risk of cancer since a strong relationship has been observed between alcohol consumption and neoplasms of the oropharynx.  larynx, esophagus, liver, colon, rectum, breast, and skin cancers of the melanoma type. Some studies have concluded that alcohol consumption may reduce protection. Offered by the skin by decreasing the concentration of carotenoids. Reducing the skin’s ability to neutralize UV-induced free radical damage, resulting in sunburn and increased risk of skin cancer.


A chronic inflammatory skin disease that affects 2-5% of the Western population and is characterized by the appearance of itchy, red, scaly patches on the skin. Alcohol intake can aggravate skin lesions or enhance their onset.

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