How To Spot an “Alcoholic Face”

Ever wake up with a red or puffy face after a night of drinking? It may not be a coincidence. In fact, an “alcoholic face” encompasses a range of physical changes — telltale signs of chronic alcohol consumption. Even if we follow a 10-step skincare routine, eat an anti-inflammatory diet, and make sure to put on sunscreen every day, excessive drinking can appear on our face.

The physical changes that indicate chronic alcohol consumption are more than skin-deep; they often reflect underlying health issues. Let’s delve into the science behind the “alcoholic face” and learn its key indicators. By becoming more aware of these signs, we can better understand the detrimental impact of alcohol on our body and take proactive steps towards healthier living. 

What Is an “Alcoholic Face”?

“Alcoholic face” is a term that’s used to describe specific facial characteristics commonly seen in those who drink regularly or excessively. While many of us may wake up looking tired or slightly puffy from a late night out drinking, “alcoholic face” refers to noticeable changes in our appearance that occur over time due to alcohol’s effects on our body.

These physical changes don’t occur superficially. They occur internally due to the way acetaldehyde, the toxic compound found in alcohol, affects our body. Acetaldehyde can impact different functions of our body — leading to visible effects, some of which show on our face.

• Vasodilation. A buildup of acetaldehyde can cause our blood vessels to expand. This leads to increased blood flow, which explains why reddening or flushing of the face frequently occurs after drinking. Excessive drinking can also damage our capillaries (delicate blood vessels), resulting in lasting redness and visible spider veins.
• Impacted liver function. Our liver bears the brunt of alcohol damage, as it’s the main organ responsible for breaking down toxins. Impaired liver function can lead to a buildup of harmful substances, including bilirubin, a chemical that, when accumulated in our blood, can cause yellowing of the skin, known as jaundice.
• Decreased nutrient levels. Acetaldehyde in alcohol disrupts our gut bacteria balance, decreasing nutrient absorption. Additionally, our liver utilizes B vitamins to aid with alcohol metabolization, taking them away from other areas of the body. Vitamin and nutrient deficiencies can lead to dullness and discoloration of the skin.

“Alcoholic face” encompasses a wide range of physical effects. Let’s get a better idea of the indicators to look out for.

Recognizing Facial Effects of Alcohol: Bloated Face, Redness, and More

Have you ever woken up after a night out and noticed a new pimple that seemed to pop up out of nowhere? While alcohol can cause short-term facial effects such as irritated skin and an overall tired appearance, “alcoholic face” typically includes more permanent facial changes.

• Redness and flushing. Persistent redness, also known as rosacea, can occur due to broken capillaries and spider veins. This differs from short-term redness or flushing that may occur when we’re hot or our skin is irritated. 
• Puffiness and swelling. Alcohol misuse can cause chronic inflammation, leading to a puffy face. Alcohol also increases fluid retention, which not only leads to high blood pressure but also persistent bloating. While regular swelling may include a slightly rounded face that may subside after a morning ice-rolling session, swelling from alcohol misuse also causes swollen eyelids and under-eye bags that persist. 
• Changes in skin texture. We may be keeping up with our lengthy skincare routine, but changes in skin texture can start from the inside. Dehydration and nutrient deficiency can cause rough patches and dry skin.
• Discoloration. Yellowing of the skin from jaundice and dark circles under the eyes from lack of sleep are common skin tone changes associated with excessive drinking.
• Visible blood vessels. Along with damaged capillaries, drinking causes the veins and blood vessels on our face to be more prominent. This is known as telangiectasia, which occurs when our small blood vessels dilate. 
• Signs of aging. Fine lines, sagging skin, and other signs of aging are common, as drinking can decrease elasticity in our skin and deplete skin hydration. 

Identifying facial signs of alcohol misuse is a primary step in understanding how alcohol affects our overall appearance. However, the impact of alcohol extends beyond what meets the eye. Let’s learn about other physical signs of alcohol misuse to understand just how comprehensive alcohol’s effects can be.

Other Physical Signs of Alcohol Misuse

Alcohol’s effects on the body are far-reaching, with many physical signs that extend beyond facial changes. Recognizing these other physical indicators helps us better identify alcohol misuse:

• Redness of the palms. Palmar erythema is a condition characterized by reddening of the palms that can be caused by liver damage. This is what gives someone “alcoholic hands.”
• Tremors and shakiness. “Alcohol shakes” is a common symptom of alcohol withdrawal. When alcohol’s depressant effects wear off, our nervous system activity may spike and overwhelm our brain. Mixed-up messaging in our brain can lead to tremors and shakes. 
• Weight changes. Excessive drinking is commonly associated with weight gain due to excess calories from alcohol and poor eating habits that may accompany drinking. On the flip side, some of us may experience weight loss from malnutrition caused by alcohol. Significant weight changes can have serious implications whether it’s weight gain or loss. 
• Bruising and slow healing. Alcohol and bruising often go hand in hand. Maybe we ran into the coffee table or took a tumble after losing balance during a night out. Chronic alcohol consumption also damages our bone marrow, which produces blood cells. This leads to increased bruising and prolonged healing of cuts and bruises.

While physical signs of alcohol misuse are telling, they’re only part of the story. Our behavior and psychological state can add to our physical appearance. For example, stress and lack of sleep can contribute to dark circles, and anxiety can result in wrinkles and other signs of aging. Understanding behavioral and psychological factors gives us a more complete picture of alcohol's impact. However, these signs can sometimes manifest differently between genders. What are some of the unique differences?

How To Spot an Alcoholic Male or Female

While there are no specific differences between “alcoholic face” in females and males, alcohol impacts females and males differently — making physical signs of misuse, such as “alcoholic face,” more common in women.

Since women are generally smaller than men, they typically have a lower fluid volume, causing alcohol to be less diluted in the blood compared to men. Women also have less alcohol dehydrogenase, which is an enzyme that helps break down alcohol. This means that women may experience greater harm from alcohol when drinking the same amount as men. Progression of alcohol use disorder (AUD) is also reported to be quicker in women than men. This explains why, although there are no differences between male and female “alcoholic face,” symptoms are more prominent and commonly observed in women. 

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) also reports that women are less likely to seek treatment for AUD than men. This can lead to delayed intervention and exacerbated physical effects. While there may be subtle gender differences in unhealthy drinking habits, alcohol is detrimental to all of us.

Understanding these gender differences can help us better identify more nuanced changes. Aside from taking care of our overall appearance, why is it beneficial for us to recognize facial signs of alcohol misuse?

Importance of Identifying “Alcoholic Face”

Have you ever sat at your computer all day without a break, and when you finally call it quits, the eye strain and migraine start kicking in? Physical signs are a way that our body tells us something’s wrong.

Sometimes we may not realize we have a negative relationship with alcohol, or we may simply brush it off. Especially if we’re what’s known as a “functional alcoholic” (or functioning or high-functioning alcoholic) — a person who is able to maintain other aspects of their life despite struggling with alcohol. Functional alcoholic signs are sometimes difficult to identify, meaning that alcohol misuse is left untreated until things get worse. Physical signs of alcohol misuse, including “alcoholic face,” can help us and others determine whether we may be struggling, increasing our chances of initiating treatment. 

Intervention, especially early on, has many benefits. Treatment and support can increase our chances of recovery and reduce long-term health effects. “Alcoholic face” might not be something that all of us face when struggling with alcohol misuse, but it’s a common experience. How can we avoid it?

Preventing “Alcoholic Face”

“Our face tells all,” as the saying goes. However, working on our appearance starts from the inside. We can implement these four strategies to improve our overall health — benefiting our outward appearance.

• Recognize the signs. Detecting early signs of alcohol misuse such as persistent thoughts of drinking, having difficulties stopping, and putting other priorities on the back burner can help us take steps to address the issue before long-term health effects and physical signs appear.
• Quit or cut back. There may be a root cause of our drinking, but by limiting or eliminating the substance that’s causing harm, we can minimize the consequences while we’re working to address the root issue. Have an accountability buddy to help us stick to our goals or seek professional treatment if additional support is needed to help quit or cut back.
• Prioritize nutrition. Facial changes from alcohol misuse don’t just occur superficially. They are a direct result of alcohol’s effects on our cells and organs. Since alcohol can deplete essential vitamins and nutrients (which affect our outward appearance), prioritizing our nutrition through a balanced diet and proper hydration can help combat physical symptoms. 
• Maintain liver health. Our liver is a mighty organ that breaks down harmful substances in our body — contributing to our appearance and overall health. Maintaining good liver health through participating in daily exercise, eating a balanced diet, and limiting toxic substances helps us improve our appearance from the inside out.

These preventative measures can help us maintain a healthier appearance and promote overall well-being. 

Facing the Facts

Learning how to spot an “alcoholic face” is more than recognizing surface-level changes. It’s about being aware of underlying health issues from excessive drinking that manifest through physical signs. This awareness not only helps us limit negative health effects, but also underscores the importance of a more mindful approach to alcohol consumption. When we pay attention to these physical indicators, we take charge our health and well-being — promoting a healthier and more vibrant appearance.