Many people develop rosy cheeks when they drink a couple of glasses of wine or cocktails; this is a skin response typically caused by a buildup of acetaldehyde in the body when the liver processes alcohol. However, many people are not familiar with the long-term consequences to the skin and overall appearance from drinking too much. In fact, few people understand exactly how much alcohol is too much.

In general, a serving of alcohol is 
  • 12 ounces of beer, about one bottle 
  • 5 ounces of wine, about one glass 
  • 1.5 ounces of liquor, about one shot 
  • The liver can process one serving of alcohol per hour, and when a person drinks more than that, they will begin to feel intoxicated. Drinking two drinks in one hour is not extremely risky, although it can cause changes to cognition and reaction time that make driving dangerous. Problem drinking, however, can be very dangerous, leading to damage to internal organs, risk of serious injury, and potential alcohol poisoning, Binge drinking, heavy drinking, and alcohol use disorder are all forms of problem drinking

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  • For women, heavy alcohol use involves consuming more than seven drinks per week, or about one per day, while binge drinking is four or more alcoholic beverages in one two-hour period; for men, heavy alcohol consumption is 14 or more drinks per week, on average two per day, while binge drinking is five or more servings of alcohol in one two-hour period. Alcohol use disorder, colloquially called alcoholism, is physical dependence on alcohol, compulsive consumption of the beverage, and intense cravings for alcohol when not drinking.
All of these forms of problem drinking damage the liver, kidneys, stomach, brain, heart, and other organ systems. They can also lead to skin damage and premature aging.

  • Accelerated aging: Alcohol dehydrates the body, and the presence of congeners, which are involved in the fermentation and flavoring of most alcohol, increases the risk of hangovers and skin changes. Most often, the puffy eyes, flushed skin, and sagging face related to a hangover will go away; however, drinking a lot of alcohol on a regular basis increases the risk that these changes to appearance will become permanent. Because alcohol is also a liver toxin, changing how the liver metabolizes toxins out of the body increases the presence of toxic substances affecting the skin for longer, leading to a sallow, pale, or even sickly appearance.
  • Vitamins A, B3, and C: These vitamins are involved in healthy skin, and consuming too much alcohol on a regular basis reduces the amount of them available to the body. Over time, this can cause the skin to look tired or dull and lose elasticity, so the skin sags and produces more wrinkles.
  • Spider veins: The dilation of blood vessels, especially in the cheeks, is a side effect of alcohol consumption. If this continues over time, these tiny vessels may permanently widen, leading to ectasia, or spider veins, across the body but especially on the face.
  • Immune system suppression: Many drugs, including alcohol, change how the immune system functions. Chronic heavy or binge drinkers may find that they suffer more illnesses because they drink too much. Similarly, infections from cuts or damage to the skin may not clear up quickly, leading to scarring.
  • Psoriasis: Alcohol consumption is known to exacerbate psoriasis, or red patches of scaly skin that may crack, itch, or swell around the joints. Additionally, people who drink a lot are at greater risk for developing this condition. While the exact mechanism of this is not well understood, it is likely linked to changes in the immune system and blood flow, which can cause psoriasis symptoms to recur more often or worsen.
  • Jaundice: Damage to the liver with consistent, high-volume consumption of alcohol will lead to death of liver cells and less ability for the organ to process toxins out of the body. This will lead to a buildup of some toxins, which can change the appearance of the skin, damaging the elasticity and speeding up the appearance of aging. Additionally, the skin may develop a yellow tint as the liver fails, which is a sign of jaundice.

Premature aging and damage to the skin are just two reasons to end dependence on or addiction to alcohol. Although alcohol is legal for people ages 21 and older in the United States, it is also one of the most widely abused intoxicating substances, leading to numerous deaths every year.