Effects of Substance Use on Your Skin

Do Drugs and Alcohol Cause Skin Problems?

Depending on the substance, the route of administration, and even the duration of use, some drug use disorders, the clinical term for addiction, can result in a range of health effects and physical manifestations that adversely affect the nose, teeth, eyes, and skin.²

Research indicates that some signs of prolonged substance use might surface on the face and skin. Again, depending on the substance, skin effects may include flushed cheeks, redness around the mouth and nose, acne, sudden weight loss—resulting in superficial fat loss on the face, as well as complications such as skin infections, ulcers, rashes, and lesions.^1,2

What Drugs Impact Your Skin?

Skin conditions are associated with a variety of substances, and skin and soft-tissue infections are relatively common among individuals who inject substances.³

Injection Drug Use Effects on Your Skin

Injection drug use with stimulants such as cocaine and meth and opioids like heroin can cause various skin issues.⁴

Injection drug use can result in injection marks—colloquially referred to as “track marks”—caused by post-inflammatory hyperpigmentation that can occur from repeated use. Repeated injection drug use can also lead to scarring, which develops when the skin cannot regenerate tissue properly. The scarring can spread beyond the injection site.⁴

Other complications associated with the injection use of cocaine, methamphetamine, or heroin include skin and soft-tissue infections, such as abscesses and cellulitis, a deep bacterial infection of the skin. Additionally, individuals who “skin pop”—injecting the substance under the skin as opposed to into a vein—are 5 times more likely to develop an abscess or cellulitis since skin popping can cause trauma and introduce bacteria into the skin.⁴

Individuals who inject cocaine, meth, or other illicit substances—especially black tar heroin—under the skin or into a muscle (known as muscle popping) are also at an increased risk of developing wound botulism, a rare but serious and potentially life-threatening illness. It occurs when a specific germ called Clostridium botulinum enters a wound and makes a toxin that attacks the body’s nerves, which can make it difficult to breathe, weaken muscles, even cause death.⁵

Research indicates that injection meth use can precipitate slowed wound healing and suppressed immune function, which can exacerbate the susceptibility to Staphylococcus aureus, a bacterial infection.⁶

Methamphetamine Effects on Your Skin

Injection drug use of methamphetamine isn’t the only method of administration that adversely impacts the skin. Meth use administered via any route can cause formication, a neurological symptom where tactile hallucinations produce a sensation that something is crawling on the body or underneath the skin. This can lead to constant and repetitive skin picking behavior or intense itching— combined with neglect of hygiene often seen with chronic meth use, increases the risk for developing skin infections—including abscesses and cellulitis from MRSA.^6,7

Cocaine and Crack Effects on Your Skin

Smoking crack cocaine is associated with burns and eyebrow thinning.⁸

In addition to the potential effects of injecting cocaine, general use (i.e., via any route) of cocaine or crack cocaine can result in a tender, purpuric rash (i.e., vasculitis) with hemorrhagic blisters and necrosis (i.e., tissue death). The cause of this skin complication is not solely due to cocaine, but rather to levamisole, a common contaminant found in powder cocaine and also crack cocaine.⁹

Alcohol Effects on Your Skin

The liver plays a key function in the metabolism of alcohol. Thus, chronic or heavy episodic drinking can cause devastating tissue damage and lead to several alcohol-induced liver diseases. Symptoms associated with alcohol-related liver diseases may involve skin changes including:^5,10

• Spider angiomas, which are caused by dilated blood vessels under the surface of the skin and resemble a red to purplish spider. These often appear on the hands, upper chest, neck, and face.
• Jaundice, which can make the whites of the eyes yellow or give the skin a yellowish tint.
• Bruising easily.

However, alcohol use doesn’t have to be excessive to cause skin problems. Some research indicates that alcohol misuse can lead to a worsening of pre-existing psoriasis and may also contribute to the development of rosacea, nummular eczema (characterized by coin-shaped spots on the skin that can be painful), and seborrheic dermatitis (which is a skin condition that causes scaly patches, inflamed skin, and dandruff on the scalp).⁵

Additionally, there are some indications (mostly anecdotal evidence) that suggest alcohol may contribute to visible signs of aging. For example, the American Academy of Dermatology Association points to lifestyle choices—such as the consumption of alcohol—among other contributing factors to causes of wrinkles and inflammation.¹¹ Furthermore, a sub analysis of a global, cross-sectional, Internet-based survey of self-reported facial aging in women found that heavy alcohol use, meaning 8 or more drinks per week, was associated with increased upper facial lines, under-eye puffiness, midface volume loss, and visible blood vessels.¹²

Can You Reverse the Impacts of Substance Use on Your Skin?

Skin does have the ability to regenerate so it may be possible for your skin to heal and for some of the substance-related effects to reverse, though many of these skin issues can lead to further complications if left untreated. However, this is still an area that lacks substantial research. Improvement may also be dependent on the substance, the duration of use, and the method of administration.^4,9

The important thing to note is that substance use isn’t just damaging your skin. It can cause a range of harmful mental and physical health effects and can impact your entire life.¹⁰ When a person cannot control their substance use and is experiencing significant negative effects on their life, they may be diagnosed with a substance use disorder, commonly known as addiction. Addiction is not a life sentence, and the disease can be managed. There’s plenty of research showing that evidence-based treatment interventions can help you stop substance use, address the addiction, and thus, improve your overall well-being and health, including skin and soft-tissue issues.¹²

Getting Help for Drug and Alcohol Addiction

No matter how things might seem right now, it’s never too late to get help for substance misuse or addiction. American Addiction Centers (AAC) is a leading provider of evidence-based addiction treatment, with rehabs located across the nation. If you or a loved one struggle with addiction, please call to speak to one of our knowledgeable and caring admissions navigators to learn more about treatment and your rehab options.