9 Physical Signs of Alcoholism: How Drinking Affects Your Face

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Plus, expert-based tips on recovery for you or a loved one
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Over time, regular alcohol use can cause changes in the face, like dull, red, or dry skin, the appearance of tiny spider veins around the nose, and puffiness around the eyes. On their own, these aren’t enough to determine whether a person suffers from alcohol use disorder, but they may hint at dependency. We have everything you need to know about spotting an alcoholic face, plus recovery tips from psychologists and treatment specialists.

How do you spot an alcoholic face?

  1. Red or flushed face
  2. Bloodshot eyes
  3. Dark circles under the eyes
  4. Swelling and puffiness of the face, especially around the eyes
  5. Dry skin or sores
  6. Spider veins around the nose and face
  7. Yellowing of the skin or eyes
  8. Dull or thinning hair
  9. Premature aging
Section 1 of 7:

Common Features of an Alcoholic Face

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  1. Alcohol makes cells dilate, which can cause a person’s face to look red when they’re drinking. [1] For people who only drink occasionally, this redness usually goes away when they stop drinking. But people who drink excessively may experience permanent redness (called rosacea) even when they’re not drinking. [2]
    • It’s important to note that not everyone with facial redness is a heavy alcohol user.
  2. 2
    Spider veins around nose and cheeks Someone who drinks frequently may have burst blood vessels around the nose. This might cause their nose to look red, or it may lead to visible, spider-like thread veins. This condition, called rhinophyma, may also cause the nose to look swollen and bumpy, and the skin may thicken over time. [3]
    • Rhinophyma is also called “drinker’s nose” or “alcoholic’s nose,” although it can also occur in people who do not drink.
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  3. 3
    Puffiness and swelling in the face and extremities People who drink heavily may experience swelling in their face, hands, and feet. This swelling, called edema, is caused by the body retaining too much fluid and may be a sign that regular alcohol use is affecting their organs. For instance, facial swelling can be a symptom of cirrhosis of the liver. [4]
    • Swelling around the eyes (periorbital edema) is especially common with alcohol use. [5]
  4. 4
    Dry or red eyes When a person drinks alcohol, the blood vessels in their eyes dilate. Additionally, about 30% of people who drink experience dry, itchy eyes as a result of dehydration. These can cause a person’s eyes to look red or bloodshot when they drink. [6]
    • Serious alcoholism can lead to a vitamin A deficiency or liver disease—both of which can lead to chronically red eyes, even if the person isn’t drinking.
  5. 5
    Dark circles under eyes Drinking alcohol to excess can lead to dark circles under the eyes. [7] Alcohol use can also lead to insomnia—so someone who’s struggling with alcohol use disorder may not sleep well, which also contributes to dark circles. [8]
    • Dark circles due to drinking may be a result of dehydration.
  6. 6
    Drooping or crossed eyes Severe alcoholism can lead to a condition called Wernicke-Korsakoff syndrome. Along with cognitive changes, WK syndrome can cause the affected person to have droopy eyelids, crossed eyes, or abnormal eye movements (called nystagmus). [9]
    • Wernicke-Korsakoff syndrome is a sign of advanced alcohol use disorder. At this stage, a person likely needs medical intervention to safely quit drinking.
  7. 7
    Dry, flaky skin Alcohol use causes the body to lose fluids more quickly, quickly leading to dehydration. [10] This can result in dry, peeling, or flaky skin, especially with prolonged use.
    • Chronic dehydration and dry skin can also increase the risk of developing skin infections and sores. [11] Psoriasis and eczema may be more common as well. [12]
    • Over time, drinking may also lead to premature signs of aging, including fine lines and wrinkles.
  8. 8
    Dull or thinning hair Over time, alcohol use can lead to nutritional deficiencies—sometimes because they don’t eat enough while they’re drinking, but also because the alcohol may prevent the body from effectively absorbing those nutrients. [13] Those nutrient deficiencies can lead to dull, brittle, or thinning hair.
    • Niacin deficiency, known as pellagra, is often caused by alcoholism. Pellagra can lead to hair loss, as can deficiencies in iron and zinc. Additionally, zinc deficiency can cause hair to become brittle. [14]
  9. 9
    Pale skin or yellowing skin and eyes Over time, dehydration from drinking can cause a person’s skin to look dull and pale. [15] Severe alcoholism can lead to jaundice, or yellowing of the skin and eyes as a result of reduced liver function. [16]
    • Jaundice is usually a sign of advanced alcohol use disorder. Medical supervision is recommended when a person quits drinking at this stage.
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Section 2 of 7:

Other Physical Signs of Alcohol Abuse

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  1. Someone with alcoholism might also have symptoms that don’t show on the face. While changes to a person’s skin and face are usually evident to the people around them, some physical effects of long-term alcohol use may be more subtle. These can include:
    • Stomach problems: Someone who’s abusing alcohol may experience a loss of appetite, stomach cramps, or an upset stomach, even when they’re not drinking. [17]
    • Numbness in hands and feet: Heavy alcohol use can cause a person to experience tingling or numbness in their extremities. The palms of their hands may also redden or swell. [18]
    • Unexplained bruises or injuries: Alcohol can cause a loss of coordination and may make a person more susceptible to bruises, so a person who’s regularly abusing alcohol may have bruises, cuts, or scrapes that they can’t explain—often in different stages of healing. [19]
    • Weight changes: Alcohol is high in calories, so some people who abuse alcohol may gain weight. Others may have a decreased appetite and experience weight loss. [20]
    • Neglected grooming: A person struggling with alcohol use may have a disheveled appearance, including wrinkled or dirty clothing and unwashed or uncombed hair.
    • Withdrawal symptoms: A person who is dependent on alcohol may experience shaking, nausea, vomiting, or insomnia when they stop drinking. [21]
Section 3 of 7:

Do these signs always mean someone is an alcoholic?

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  1. No, none of these are definitive signs of alcoholism. If someone shows several of these signs, it could indicate that they are a habitual drinker. However, it’s important not to assume that someone struggles with alcohol abuse just because they exhibit one or more of these symptoms. [22]
    • Also, someone may struggle with alcohol use disorder without having any of these visible symptoms.
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Section 4 of 7:

Can you reverse the signs of alcohol face?

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  1. If someone quits drinking, physical signs like redness of the face and eyes, swelling and puffiness, dry skin, and dark circles may resolve fairly quickly. Other changes, like premature aging, may improve, but they may not be fully reversible. [23]
    • Other symptoms of alcohol use disorder, like moderate heart and liver damage, can be reversed over a longer period of abstinence.
    • Some advanced symptoms of alcohol use disorder, like cirrhosis of the liver , memory loss, and vision loss, may be permanent.
Section 5 of 7:

Why does alcohol cause changes in someone’s face?

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  1. Alcohol affects hydration, circulation, and organ function. Drinking alcohol causes your body to become dehydrated—and dehydration can affect every part of your body, including your skin and organs. Alcohol use may also cause: [24]
    • Reduced blood circulation
    • Inflammation
    • Reduced liver and kidney function
    • Vitamin deficiency
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Section 6 of 7:

How to Help a Loved One Who’s Struggling with Alcoholism

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  1. 1
    Share how their alcohol use affects you. Alcohol treatment Specialist Tiffany Douglass, MA, says, “It’s never a good idea to confront a person head-on and tell them they need to stop drinking—that will just make them defensive. Instead, come from a place of vulnerability and where your intention is really coming from.”
    • Douglass recommends saying something like, “When I see you drinking, it makes me really afraid that I’m going to lose you.”
    • Being supportive may increase your loved one’s chances of success. Douglass says, “Having social support is crucial to the long-term success of those who want to stop drinking.”
  2. 2
    Encourage them to seek treatment. Overcoming alcohol use disorder can be difficult, but a person may be more likely to quit if they seek professional guidance early in their recovery. For some people, that might mean talking to their doctor or a therapist; for others, it may mean outpatient or inpatient addiction treatment. [25]
  3. 3
    Be an active part of their recovery. Douglass says, “Usually when one person in a family is an alcoholic or addicted person, there’s also someone codependent who’s enabling that addiction. The reality is that everyone needs to be involved in the recovery process, regardless of if you’re the one drinking or not.”
    • That might look like going to therapy to help you identify and stop codependent behaviors, helping the person in recovery avoid the temptation to drink, or just being a good listener when they need someone to talk to.
  4. 4
    Be firm with your boundaries. “You can only do so much to help another person,” advises licensed psychotherapist Lauren Urban, LCSW. “Learn to recognize your own cues to understand when they’re asking too much of you, like asking you to cover for them or help them manage their addiction. Even if you’re helping someone recover, you can still maintain your separateness from them and live your life outside of that person without feeling guilt.”
    • “If you don’t hold your boundaries,” Urban adds, “it starts to build up as resentment, and it eventually comes out as anger.”
  5. 5
    Find your own support network. Urban says if you’re trying to help someone recover from alcohol abuse, “Seek support from outside sources that might be available to you, whether that be other family members or a therapist, teacher, or minister. You are deserving of support and care too, so find places where you can feel that it’s not all on you.”
    • If you need someone to talk to, try calling SAMHSA’s Helpline at 1-800-662-HELP.
    • Consider joining a group like Al-Anon for support from others who are in recovery or who have loved ones with alcoholism.
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Section 7 of 7:

How to Get Help if You’re Struggling with Alcoholism

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  1. “Initially, I recommend seeking out a local therapist,” says Douglass. “They can help you gauge the level of care you need. You might only need to meet once a week in therapy, or you might need to be treated in an outpatient or inpatient setting.”
    • Talk to your doctor before quitting if you’re a heavy drinker. Douglass says, “If you’re a daily drinker, withdrawal can lead to serious complications like seizures. If you’re trying to quit drinking, seek the advice of your general practitioner, at a minimum.”
    • Reach out if you need someone to talk to. Try calling a helpline like:
      • SAMHSA: 1-800-662-HELP
      • Boys Town: 1-800-448-3000
      • Al-Anon and Ala-teen : 1-800-356-9996
      • National Suicide Prevention: 988
  2. 2
    Ask for support from your family. Douglass says that you’ll have better long-term success if “the people in your life are engaged and in your life on a day-to-day basis.” Reach out to the people who matter to you and let them know that you’re struggling with alcohol use. Ask for their support as you navigate recovery.
    • Urban says that it can help to be specific about the help you need. “It’s okay to set a boundary and tell the other person that you don’t need or want them to police your behavior. Instead, ask them to support you in engaging in healthier activities and avoid the temptation to drink.”
  3. 3
    Get involved with a recovery program for additional support. According to Douglass, “If you’re trying to quit drinking, it can be very helpful to get connected with a social support group. Not only are you connecting with a community that’s engaging in sobriety, making friends, and finding a sponsor, but you’re making a commitment to them, as well.”
    • When it comes to finding a group, Douglass says, “Alcoholics Anonymous is the obvious one, but there are also other groups like Refuge Recovery, which is a Buddhism-based support group for substance abuse and abstinence. There’s also Smart Recover and Rational Recovery.”
  4. 4
    Avoid situations that normally lead you to drink. When you’re trying to stop drinking, Urban recommends that you “Pay attention to the rituals around your addiction. Then, use that information to build new habits and different rituals. A lot of people find things like yoga, exercise, or other physical activities to be a great way to get rid of the stressors that can potentially cause you to relapse.”
    • Clinical psychologist Natalie Feinblatt, PsyD, agrees that it’s important to create new habits: “Having fun without alcohol can look like playing sports with friends, making friends with other people who are sober, or joining a local meetup group or a club. Instead of drinking, spend time doing things like hiking, painting, singing, acting, or photography.”
  5. Urban says, “Don’t run towards relapse, but if it does happen, it’s not the end of your recovery. Accept that it happened, and that it’s part of the process of addiction recovery. Use it to learn more about your triggers, and get back up and keep trying.”
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      References

      1. ↑ https://www.niaaa.nih.gov/publications/alcohol-flush-reaction-does-drinking-alcohol-make-your-face-red
      2. ↑ https://www.aad.org/public/diseases/rosacea/insider/drinking
      3. ↑ https://www.rosacea.org/blog/2019/september/severity-rosacea-rhinophyma-linked-alcohol-intake-291846
      4. ↑ https://my.clevelandclinic.org/health/diseases/15572-cirrhosis-of-the-liver
      5. ↑ https://alcoholtreatmentguidelines.com.au/chapter-4-screening-and-assessment/how-to-screen/physical-examination-for-intoxication-or-signs-of-harmful-use-of-alcohol
      6. ↑ https://alcoholawareness.org/alcoholism/signs/red-eyes/
      7. ↑ https://www.mayoclinic.org/symptoms/dark-circles-under-eyes/basics/causes/sym-20050624?p=1
      8. ↑ https://www.geisinger.org/health-and-wellness/wellness-articles/2025/03/21/16/52/whats-causing-your-undereye-circles
      9. ↑ https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/wernicke-korsakoff-syndrome
      1. ↑ https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/hangovers
      2. ↑ https://www.healthlinkbc.ca/healthwise/physical-signs-alcohol-use-disorder
      3. ↑ https://www.drinkaware.co.uk/facts/health-effects-of-alcohol/general-health-effects/how-alcohol-affects-your-appearance
      4. ↑ https://www.psychiatryinvestigation.org/m/journal/view.php?number=744
      5. ↑ https://pmc.ncbi.nlm.nih.gov/articles/PMC5315033/
      6. ↑ https://www.drinkaware.co.uk/facts/health-effects-of-alcohol/general-health-effects/how-alcohol-affects-your-appearance
      7. ↑ https://americanaddictioncenters.org/alcohol/signs-symptoms
      8. ↑ https://www.healthlinkbc.ca/healthwise/physical-signs-alcohol-use-disorder
      9. ↑ https://www.healthlinkbc.ca/healthwise/physical-signs-alcohol-use-disorder
      10. ↑ http://alcoholtreatmentguidelines.com.au/chapter-4-screening-and-assessment/how-to-screen/physical-examination-for-intoxication-or-signs-of-harmful-use-of-alcohol
      11. ↑ https://americanaddictioncenters.org/adult-addiction-treatment-programs/know-is-someone-on-drugs
      12. ↑ https://americanaddictioncenters.org/alcohol/signs-symptoms
      13. ↑ https://alcoholtreatmentguidelines.com.au/chapter-4-screening-and-assessment/how-to-screen/physical-examination-for-intoxication-or-signs-of-harmful-use-of-alcohol
      14. ↑ https://americanaddictioncenters.org/alcohol/reverse-alcohol-damage
      15. ↑ https://americanaddictioncenters.org/alcohol/signs-symptoms
      16. ↑ https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder

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