What Does an Alcoholic Face Look Like?

Does heavy drinking really cause noticeable changes to a person’s appearance? Is alcoholic face real? And if it is, what does it look like?

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What Is Alcoholic Face?

Alcoholic face is an informal term that encompasses a variety of facial changes that some people develop as a result of heavy, long-term alcohol consumption.

Characteristics of alcoholic face can include:

Reddening of the skin, especially on the nose and cheeks
Yellowing of the skin and the whites of the eyes
Grey, dry, and flaky skin
Visible blood vessels (spider veins)
Bumps, pimples, and other signs of acne or psoriasis
Puffiness or bloating of the face
Premature wrinkles, bags under the eyes, and sagging skin

Is Alcoholic Face Proof of Alcoholism?

Before we get any further into today’s post, we need to clarify something: You cannot tell if someone is (or isn’t) an alcoholic simply by looking at them.

Alcohol use disorder, which is the clinical term for alcoholism, is a complex disease that can look quite different from one person to the next. Sometimes, this disease causes obvious physical, psychological, and behavioral signs. But in other cases, people are able to keep the symptoms and effects of the disorder secret, even from those who are closest to them.

So, as we discuss alcoholic face throughout today’s post, please remember that it is not proof that someone is addicted to alcohol. In the same vein, the lack of alcoholic face is not evidence that a person doesn’t have a drinking problem.

What Causes Alcoholic Face?

As suggested in the previous section, the term “alcoholic face” is a bit of a misnomer for a few reasons:

Most of the characteristics of alcoholic face can occur in people who only drink moderately or not at all.
While heavy drinking can contribute to the signs of alcoholic face, you don’t have to be addicted to develop them.

Having established that, let’s take a look at the potential causes of the more prominent features of alcoholic face:

Reddening of the skin

If a person’s face always gets red when they drink, they may have a condition called alcoholic flush reaction. This is an inherited genetic abnormality that hampers the body’s ability to metabolize alcohol.

As part of the metabolization process, alcohol is briefly converted into a toxic substance called acetaldehyde. In a healthy body, the acetaldehyde only exists for a brief period, after which it is quickly broken down in several non-toxic molecules.

The genetic variation that causes alcoholic flush reaction disrupts this process and causes a buildup of acetaldehyde. One of the symptoms of this buildup is a reddening of the skin on the face. Since acetaldehyde is a carcinogen, people who have this condition and continue to drink may have an elevated risk of several types of cancer.

In addition to the genetic variation, certain prescription medications can also cause facial flushing if a person drinks while they have the drugs in their system.

Yellowing of the skin and eyes

The yellowing of the skin and the sclera (the part of the eye that is typically white) is called jaundice, and it is a sign that a person’s liver is not functioning properly. If a person with a history of heavy drinking develops jaundice, that could indicate that they have progressed to an advanced stage of alcohol-associated liver disease.

As described by the Cleveland Clinic, damage inflicted on the liver by alcohol usually occurs in three phases:

Steatosis involves a buildup of excess fat, which is why this phase used to be referred to as fatty liver. At this phase a person may not have any symptoms, and the fat buildup can likely be reversed if they stop drinking before the condition progresses any further.
The second phase, alcohol-induced hepatitis, is characterized by inflammation due to the continued fat buildup. If this inflammation persists and becomes more severe, a person may develop jaundice and other more obvious symptoms, such as abdominal pain, nausea, and unintentional weight loss.
If a person with alcohol-induced hepatitis continues to drink, their condition may progress to cirrhosis. Someone who reaches this phase will have incurred permanent scarring in their liver. Untreated cirrhosis can lead to liver failure, at which point the only remaining treatment option is transplant.

Jaundice can also be caused by factors unrelated to alcohol use, such as viral infections, genetic irregularities, tumors, and some prescription medications.

Puffiness and bloating

Alcohol is a diuretic, which means it promotes fluid loss via increased urination. For people who only drink moderately and infrequently, alcohol’s diuretic effects are unlikely to have a lasting impact on their body. But if they regularly drink heavily, their body may begin to retain fluid in an effort to offset the alcohol-induced fluid losses.

Fluid retention can cause bloating throughout the body, but facial puffiness is often the first outwardly noticeable sign.

Pimples, dryness, and premature aging

In addition to triggering excessive fluid retention, alcohol’s diuretic effects can also cause dehydration. Dehydration, in turn, can cause many signs of premature aging, such as discoloration, flakiness, sagging, and wrinkles.

Alcohol use isn’t a direct cause of pimples or acne, but it can contribute to these problems via indirect influences such as:

Alcohol can impair immune functioning and cause hormonal imbalances, both of which can lead to or worsen acne or psoriasis.
Heavy drinkers often have unhealthy diets, and poor nutrition can be a factor in skin breakouts.
Excessive alcohol use is also associated with lack of exercise, tobacco use, poor sleep habits, and other concerns that have been linked to skin damage.

Is Alcoholic Face Dangerous?

Most symptoms of alcoholic face aren’t dangerous on their own. However, as discussed in the previous sections, they can be signs of serious, potentially life-threatening health concerns.

Often, as with alcohol-associated liver disease, facial symptoms can be evidence of advanced damage. In other cases, they may serve as warnings that your alcohol use has put you on the precipice of irreversible harm.

Regardless of what your body has already gone through, ending your alcohol use can be an essential first step on your path toward improved health. If you’re unable to stop drinking, even though you understand the consequences of continuing to do so, it may be time to get professional medical detox.

Untreated alcoholism can be devastating. But with effective care and a concerted effort on your part, you can regain control of your behaviors and begin to live a much more hopeful life in recovery.