How to Spot an Alcoholic Face: Common Signs To Look For


Most diseases have signs and symptoms that can help you or your doctor notice and identify the problem.

The same applies to alcohol use disorder, as there are multiple facial signs that may indicate someone could be struggling with controlling their alcohol intake.

This guide explores these symptoms, along with other signs to look for before you can reach a conclusion about whether someone has a drinking problem.

What Does an Alcoholic Face Look Like?

The alcoholic face is a collection of physical signs that can sometimes be associated with chronic heavy drinking or alcohol addiction. It’s not a medical term, but is used as shorthand for the distinct facial features of someone with alcohol use disorder.

Excessive alcohol consumption can cause facial redness, swelling, clammy skin due to excess sweat, and blood-shot eyes. If the liver is compromised by alcohol abuse, the person may present with yellowing skin and whites of the eyes.

How Can You Spot an Alcoholic Face?

Here are the seven common features of an alcoholic face:

1. A Red Face

Chronic alcohol abuse can lead to an alcohol flush reaction. This condition occurs when blood vessels close to the facial skin’s surface are dilated because of alcohol, causing more blood to go through them and resulting in facial redness.

2. Spider Veins

Excessive vasodilation caused by alcohol can lead to the appearance of spider veins, a web-like or branching pattern of blood vessels that resembles a spider web.

This can also happen due to the presence of malfunctioning valves in the facial veins, leading to backflow and blood vessel damage from constant contraction and expansion.

3. Bloodshot Eyes

Bloodshot eyes (conjunctival hyperemia) occur when the tiny blood vessels on the whites of the eyes become dilated and inflamed.

This dilation is facilitated by two factors: the alcohol widening the blood vessels in the eyes and its diuretic effect, which can also increase the frequency of urination. This causes dehydration, affecting tear production and leaving the eyes dry and irritated.

4. Yellowing Skin

Drinking alcohol can damage the liver over the years, leading to a condition known as alcoholic jaundice. Alcohol interferes with the liver’s ability to process bilirubin, a yellowish pigment that’s produced when red blood cells are broken down at the end of their life spans.

Bilirubin can cause a yellowish skin tone on the face, whites of the eyes, and the tissue lining the mouth.

5. Dark Circles Under the Lower eyelid

People who drink alcohol before going to sleep may suffer from insomnia. They wake up a few hours after falling asleep and hardly manage to get back to sleep.

The lack of proper rest, combined with the dilated blood vessels and dehydration due to excessive alcohol consumption, can lead to permanent dark circles that don’t vastly improve even when the person gets enough sleep.

6. Puffy Face

Alcohol can cause fluid retention in the body, leading to a puffy, swollen appearance.

This process is easier to do in areas with loose connective tissue, like the face. Additionally, the inflammation associated with alcohol can make blood vessel walls more permeable.

This allows fluids to leak into the surrounding tissues, contributing further to the puffiness.

7. Excessive Sweating

A clammy, “glossy” face can also be a sign of alcoholism. Since alcohol causes widened blood vessels, the rate of perspiration increases.

Some people also have an intolerance to alcohol, so they might excessively sweat after one or two drinks.

Can You Diagnose an Alcoholic From Their Face?

No, you can’t. While the previously mentioned markers are common and can help identify a person struggling with AUD, they aren’t tools for a definitive diagnosis. That’s because not everyone with alcohol abuse will exhibit these signs, and many of them overlap with symptoms of other conditions.

For instance, many sober people who struggle to sleep will also have dark circles under their eyes, jaundice is the result of some liver diseases that can be caused by a viral infection, and facial redness and puffiness could be the result of a low-grade allergic reaction.

Further, many pathological (and physiological) conditions can cause fluid retention and blood vessel widening.

How is Alcohol Use Disorder Diagnosed?

The only person authorized to give out alcohol use disorder diagnoses is a licensed clinician. They should follow the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) diagnostic criteria for alcoholism.

Can You Reverse the Alcoholic Face Symptoms?

Yes, you can. The body undergoes several changes once the individual stops drinking. It begins with unpleasant withdrawal symptoms, most of which go away with the resolution of the addiction.

Here’s how the body repairs itself:

Dehydration-related Issues

Puffiness, skin sores, and dry skin are often the most reversible signs of an alcoholic face. Reducing alcohol intake, paired with proper hydration, will lessen facial puffiness and improve the skin’s texture within a few days.

Blood Vessel Issues

While a bit slower to resolve than dehydration issues, blood vessels will, for the most part, return to normal. The constant dilation will subside, lessening the flushed or reddened appearance.

Spider veins may linger a bit more and may not completely disappear, but they’ll still get remarkably better.

Systemic Issues

Systemic physical signs of alcoholism take the longest to develop and the longest to treat. If the struggling individual develops alcohol-induced jaundice, the yellowish skin and eye hues may take some time to subside, depending on the severity and duration of the alcohol dependence.

In some cases of extreme liver damage (cirrhosis) quitting alcohol alone may not be enough for the jaundice symptoms to go on their own. In these cases, the patient may be eligible for a liver transplant once they’ve quit drinking for a reasonable amount of time.

Your doctor will be the one to assess the severity of such cases and provide suitable treatment options.

How to Spot Alcoholism Beyond Facial Signs

Unless we’re talking about family members whom you can see consuming alcohol at home, relying on the alcoholic face alone to detect someone’s drinking problem isn’t enough.

If you want more telltale signs, look for:

Weight Shifts

People process alcohol differently. Some individuals may lose weight, while others might exhibit rapid weight gain because of the calories in alcoholic beverages.

Behavioral Changes

Odd or negative behavioral changes may indicate that someone is struggling with dependence or addiction.

Alcohol can promote aggressive behavior because it’s considered a depressant of the central nervous system, leading to lowered behavioral control.

Digestive Issues

Alcohol can irritate the digestive system, leading to nausea, vomiting, and diarrhea. It can also cause several nutritional deficiencies.

Unsteady Gait

Because of alcohol’s effect on the cerebellum, people with problematic drinking may have difficulty keeping their balance, even if they aren’t actively drinking.

Alcoholic Breath

Alcohol has a distinctive smell that can be noticed even from a fair distance. That’s because the breakdown of alcohol produces acetaldehyde, a chemical with a pungent aroma that’s easily detected when in excess.

Keep in mind that you can hazard a guess that someone is struggling with alcohol abuse based on physical signs. However, clinical diagnosis through patient history, behavior, and other physical signs is the sole determining factor in whether a person is struggling with alcohol use disorder.

Alcohol Abuse Causes Health Issues, But Recovery Is Possible…

If you think that someone you care about may have a drinking problem, encourage them to book an appointment with CuredNation. We are available 24/7, and our completely anonymous process and variety of accessible services will make them feel right at home.


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