Clinical psychologist Geri-Lynn Utter grew up in Kensington, Pennsylvania — one of Philadelphia’s grittiest corners — where her family ran a bar that opened at 7am and closed at 2am every day.
As a girl there, Utter would watch big-bellied factory workers show up to steady their hand tremors before their shifts, return at 3pm, and leave at closing. They’d come back the next day to rinse and repeat.
Now a clinical psychologist who works with people with addictions, Utter knows alcohol use disorder falls on a spectrum. While some people with it do look like those bar patrons, many look perfectly healthy.
Others fall in between, acquiring some undesirable physical traits due to the way alcohol affects all organs of the body. Insider talked to Utter and other specialists about some tell-tale signs of alcohol misuse or abuse — and how to change your patterns for better health and looks.
You can develop wrinkles earlier in life.
Alcohol is a diuretic, meaning it causes your body to lose water, leading to dehydration. And dehydrated skin tends to sag and wrinkle, Dr. Joseph Volpicelli, a psychiatrist and addiction medication researcher in Plymouth Meeting, Pennsylvania, told Insider.
“I have patients who spent all this time getting botox or plastic surgery, and all this money on lotions, but the real problem is in their wine rack,” he said.
Older-looking skin can also be related to how the body detoxifies alcohol: by recruiting certain nutrients and antioxidants to your liver at the expense of your skin, Lorna Driver-Davies, senior nutritional therapist at Wild Nutrition, told Refinery 29.
Alcohol disrupts sleep, too, and poor sleep saps your face of precious time to repair.
You have a reddish face.
Utter recalls the men at her family’s bar — fittingly named Utter Nonsense — sporting rosy faces. “It’s almost like the capillaries around the nose and cheeks would start to burst,” she said.
That’s common among alcohol misusers, Volpicelli said, since alcohol is pro-inflammatory.
“When skin gets inflamed, it produces a condition called rosacea,” he said. Rosacea is characterized by redness on the face, and sometimes ears back and chest. It can also develop into acne-like bumps.
Among people with darker skin tones, it can present as stinging or burning and sensitivity to topical products, as well as “darker or dusky brown patches,” dermatologist Dr Justine Kluk told Refinery29.
While some medications and creams can help treat the condition, in the case of alcohol abuse, they’re a Band-Aid for the underlying trigger.
Your hair and nails may become brittle.
Dehydration also affects your skin and nails, leaving them brittle and cracked, Volpicelli said. Long-term heavy drinking can even lead to hair thinning and loss, especially in people who are malnourished from consuming almost all of their calories from booze.
“The right amount of vitamins, minerals, proteins, fats, and carbohydrates are essential to a healthy scalp and head of hair,” according to The Recovery Village Drug and Alcohol Rehab, a network of substance abuse treatment centers.
You may have stained or yellow teeth.
When Annie Grace was drinking glasses, if not bottles, of wine on a daily basis, she’d wake up with purple stains on her teeth. She’d bleach her teeth, but she couldn’t keep up.
“It was just not pretty,” Grace said in one of her videos for The 30-Day Alcohol Experiment, her program that helps people reevaluate their relationship with alcohol.
Even if you’re not a wine drinker, the acid in alcohol eats away at tooth enamel, allowing any color from beverages to tack on, Dr. Timothy Chase of SmilesNY told Healthline.
Over time, heavy drinking can lead to more serious oral problems like gum disease, tooth decay, mouth sours, and oral cancer.
Your belly is disproportionate to the rest of your body.
Beer drinkers aren’t the only ones prone to beer bellies. Even diet-conscious alcoholic beverages like vodka sodas can lead to disproportionate belly weight, if you drink enough of them.
That’s because alcohol in all its forms increases estrogen production and decreases testosterone production, which is linked to increased breast tissue and “trunkel obesity” — or fat around the middle — particularry in men, Volpicelli said
Compared to the fat just under the skin throughout the body, belly fat surrounds inner organs and is associated with a higher risk of serious conditions like
and liver disease.
You can’t exercise it off, either, Volpicelli said. “The problem isn’t in the gym, it’s in the fridge.”
As alcohol abuse progresses, the belly can become hard and distended, and fluid buildup called ascites can be a sign of liver damage.
Your skin has a yellow tint.
Jaundice, or yellowish skin, is also a sign of liver disease.
It can occur when the can no longer filter out a yellow-orange substance in the blood, causing it to show up in the skin, WebMD reports. In darker-skinned folks, it may be more noticeable in the whites of the eye.
“When you start to see that, that’s a really serious issue,” Volpicelli said.
If caught early enough, quitting drinking and other lifestyle changes can treat liver disease. If not, a liver transplant is the only solution.
Before alcohol misuse gets to that point, seek help — it’s OK if vanity leads you there.
“I could talk about all the terrible physical effects of alcohol in terms of what it does to the liver, brain, and heart,” Volpicelli said, “but the thing that gets people into treatment is it causes you to look older.”
Medications, psychotherapy, inpatient and outpatient treatment, and even online communities geared toward “gray area drinkers” can help.
Nonprofits like SMART Recovery are free and expert-endorsed routes to sobriety, and organizations like Sunnyside and like Alcohol Change UK support people in simply reducing their drinking.
“If you can have programs that get people into treatment at an earlier stage in their addiction, you can prevent a lot of really serious problems later on,” Volpicelli said.