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Updated on August 10, 2023
7 min read

How to Spot an Alcoholic Face

Kelly Brown
Dr P. E. Pancoast, MD
Written by 
6 Sources Cited
Kelly Brown
Written by 
6 Sources Cited

Heavily drinking alcohol can cause brain damage and adversely affect the heart and liver. Aside from affecting your internal organs, it can also negatively impact your skin and face.

The effects of alcohol on the skin and face include:

  • Redness
  • Puffiness
  • Premature aging
  • Acne
  • Bloating
  • Dullness

Alcohol causes inflammation, affecting you internally and externally. It’s also filled with empty calories, so it tends to cause weight gain.

Alcohol is also dehydrating. Your body tries to retain as much water as possible to counteract the dehydration, causing puffiness.

5 Ways to Spot an Alcoholic Face

Several facial changes indicate alcoholism. These include:

1. Skin Discoloration

People with AUD tend to have a grayish tint to their skin. This is because chronic heavy alcohol consumption causes a vitamin A deficiency, which makes it difficult for your skin to retain a healthy tone.

2. Yellowing of Eyes and Skin

Jaundice can cause a yellowing of the eyes and skin. This condition is associated with liver disease.

Your liver is responsible for processing and flushing waste from the system. When it can’t do this, toxins build up and affect your health. 

If someone has an existing liver disorder or participates in chronic alcohol abuse enough to cause liver damage, jaundice is likely to develop.

3. Swelling or Bloating

People with AUD often have swollen, bloated faces. This is because the body protects itself by retaining as much water as possible to counteract substance abuse's dehydrating effects.

Additionally, some people experience an inflammatory response to drinking alcohol, which causes bloating.

4. Broken Capillaries

One of the main reasons people with AUD develop a red tint when drinking is because alcohol forces the blood vessels in the face to expand and contract. The blood vessels push closer to the skin’s surface and/or break or collapse.

Spider veins might also develop, especially in the eyes. This is why people’s eyes look bloodshot during and after drinking.

5. Drinker’s Nose

Rhinophyma, or “drinker’s nose,” causes a heavy drinker’s nose skin to look thick and bumpy. This is due to alcohol’s effects on the blood vessels.

When someone drinks, their blood vessels expand and are more visible. They might also burst or collapse. Over time, this causes the skin to thicken and change texture.

Usually, a drinker’s nose is caused by heavy drinking, sun exposure, and genetics. This means that not every alcoholic will develop a drinker’s nose.


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Why Do Alcoholics Have Red Faces?

While it’s not necessarily a medical emergency, a red face while drinking is a sign that your body struggles to eliminate the toxins from alcohol. If you ignore these symptoms and continue drinking, you risk serious health problems.

There’s also evidence that people who experience facial redness and continue to drink have a higher risk for cancer. This includes esophageal and breast cancer. This increased risk is because acetaldehyde is carcinogenic.3,4

Alcohol triggers inflammation and causes blood vessels to dilate and sometimes break. Not only does this affect your organs but also your skin.

Alcohol and Rosacea

Alcohol can also worsen rosacea. According to a study in the Journal of the American Academy of Dermatology, alcohol consumption increases the risk of rosacea in women.

Rosacea is a chronic skin condition that causes redness and/or small, red bumps on the face. For those who already have rosacea, drinking alcohol frequently triggers flare-ups.1

Alcohol Flush Reaction

Some people also experience something known as an alcohol flush reaction. This reaction is an indication you have alcohol intolerance.

It occurs in people with a genetic deficiency in the aldehyde dehydrogenase 2 (ALDH2) enzyme. This enzyme is responsible for breaking down acetaldehyde.

Acetaldehyde is a toxic substance produced by the body as it metabolizes alcohol. If your body lacks enough ALDH2, the toxin builds up in your body and causes flushing.

People with this deficiency also experience:2

  • Headaches
  • Nausea
  • Vomiting
  • A rapid heartbeat when drinking

Certain medications can also cause alcohol flush. These include medicines that alter your body’s ability to metabolize alcohol, including:

  • Disulfiram
  • Diabetes medication
  • Medicines for infection
  • Medication for high cholesterol

Can You Test for Alcohol Flush?

Yes. If you experience a reaction after drinking alcohol, you can ask your healthcare provider for an ethanol patch test.

The test is simple and takes only a few minutes. A drop of ethanol is placed on your arm and covered with gauze. You probably have an intolerance if there are signs of redness, swelling, or itching within a few minutes.5

Can You Suddenly Become Allergic to Alcohol?

Some people have no problem drinking and suddenly become intolerant as they age. This is because their body changes later in life. Therefore, the way they respond to alcohol can also change.

Older adults also tend to get drunk faster than they did when they were younger. This is due to two factors:

  • Higher body fat percentage: The older you are, the more muscle you lose.
  • Changes in liver health: Liver functionality can decline with age, so it’s unable to break down alcohol as fast as it could when you were younger.

Reducing Redness When Drinking

You can do a few things to reduce redness when drinking alcohol. These include:

  • Limit how much you consume in one sitting
  • Avoid alcohol entirely
  • Take medications such as Zantac, Pepcid, or Tagamet when drinking
  • Apply topical rosacea creams such as brimonidine or oxymetazoline when drinking
  • Apply makeup to cover the flush when drinking
  • Alternate glasses of water with alcoholic beverages to stay hydrated and reduce your overall alcohol intake

How Long Does Red Face from Alcohol Last?

Everyone is different, but most people only have a red face for a few hours after drinking. The redness fades as the body metabolizes the toxins in alcohol. If chronic heavy drinking has damaged your skin, it could take longer to fade. 


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Other Physical Signs of Alcoholism

There are other physical signs of heavy drinking. For example:

Skin Changes

People with alcohol addiction, also known as alcohol use disorder (AUD), tend to have dry skin. They might develop skin sores, puffiness in the skin, and acne.

Alcohol is dehydrating, which negatively impacts skin health. Other skin signs of alcoholism include:

  • Sunken eyes
  • Decreased elasticity
  • Dry lips
  • Flushing

Alcoholism also affects sleep habits. With little sleep, you may experience:

  • Dark circles under the eyes
  • Pale skin
  • Dull complexion
  • Increased wrinkles or fine lines

Weight Fluctuations

Alcohol is high in “empty calories.” This means you get little to no nutrition for the calories you consume. The more someone drinks, the likelier they are to gain weight.

Additionally, alcohol is dehydrating. It causes the body to retain water, resulting in bloating.

Unsteady Movement and Coordination

Frequent heavy drinking can damage the cerebellum. This area of the brain located near the top of the brainstem regulates balance, fine motor movement, and coordination.

Liver Damage

The liver removes toxins from the blood. Over time, heavy drinking taxes the liver and can lead to cirrhosis. This is a condition in which healthy tissue is replaced with scar tissue.

Liver damage is a progressive problem. It usually begins with fatty liver disease. Alcohol-related hepatitis might develop, which leads to alcohol-related cirrhosis. However, even without fatty liver disease or hepatitis, you can experience liver damage from heavy drinking.

Chronic heavy drinking causes liver tissue to be replaced with scar tissue. Eventually, the liver stops functioning properly.


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How Do You Treat Red Face Naturally?

The best way to treat red face caused by drinking is to avoid alcohol. If redness is caused by a gene deficiency, there isn’t much you can do about it other than not drinking.

Some people use antihistamines to reduce or prevent redness. However, this isn’t advisable. 

Using medication interferes with your body’s signal that you’re accumulating toxic levels of acetaldehyde. You’re interfering with your natural immune system. If you use medication and continue to drink, you’re at risk of overdoing it and causing damage to the body. Medication doesn’t “cure” you; it just masks your symptoms.

If you choose to drink and want to mask redness, consider using makeup to cover the flush. You’ll still feel the effects, but your skin won’t look as rosy.

Updated on August 10, 2023
6 sources cited
Updated on August 10, 2023
All Alcoholrehabhelp content is medically reviewed or fact checked to ensure as much factual accuracy as possible.

We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies.
  1. National Rosacea Society. “New Study Finds Alcohol Raises Risk of Rosacea in Women.”, 2017.

  2. Duke University. “How Is Alcohol Eliminated from the Body? – the Alcohol Pharmacology Education Partnership.”, 2019.

  3. National Institute on Alcohol Abuse and Alcoholism. “Alcohol Flush Reaction | National Institute on Alcohol Abuse and Alcoholism (NIAAA).”, 2022. 

  4. Centers for Disease Control. “3 Weird Things about Acetaldehyde.”, 2018. 

  5.   Cleveland Clinic. “Alcohol Intolerance.”, 2020.

  6. Alcohol Metabolism.” National Institute on Alcohol Abuse and Alcoholism, 2022.

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All content created by Alcohol Rehab Help is sourced from current scientific research and fact-checked by an addiction counseling expert. However, the information provided by Alcohol Rehab Help is not a substitute for professional treatment advice.
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