Why do Alcoholics have a Red Face?

Dr. John Elgin Wilkaitis

Dr. John Elgin Wilkaitis completed medical school at The University of Mississippi Medical Center and residency in general psychiatry in 2003. He completed a fellowship in Child and Adolescent Psychiatry at Cincinnati Children’s Hospital in 2005. Following this, he served as Chief Medical Officer for 10 years of Brentwood Behavioral Healthcare a private health system including a 105-bed hospital, residential treatment, and intensive outpatient services.

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Why Do Alcoholics Have a Red Face?

According to a recent study, 70% of people with rosacea claim that consuming alcohol triggers rosacea flare-ups. They claim their symptoms become worse by drinking wine, beer, or spirits. Understanding the link between alcohol, rosacea, and other conditions is key to knowing why alcoholics so frequently develop a red face.

What Does an Alcoholic’s Face Look Like?

When a person starts consuming excessive amounts of alcohol (anything over two drinks per day), it’s normal for facial changes to occur. The most common changes that alcoholics notice in their faces are:

  • Dry, bloodshot eyes
  • Dull, gray skin
  • Rosacea
  • Rhinophyma
  • Puffy face
  • Facial redness
  • Yellowing of the eyes

Why Does an Alcoholic’s Face Appear Red and Bloated?

In addition to facial redness, many alcoholics experience facial puffiness or bloating. There are two main reasons an alcoholic’s face will appear swollen or bloated. The first reason stems from the skin’s dehydration caused by the alcohol.

Once the body becomes dehydrated, it goes into the process of retaining water as a survival mechanism. Not only do vital organs in the body retain water, but the skin does as well. As a result, the face can become puffy. Facial puffiness also occurs as a result of the empty calories that alcohol leaves behind in the body, thus causing weight gain. When left untreated, alcohol use disorders often result in abdominal swelling as well as extreme facial bloating.

The second primary reason an alcoholic’s face will appear swollen or puffy comes from the secondary effect of weight gain that alcoholics often experience. Alcohol causes weight gain by inhibiting fat metabolism. It also increases your appetite, diminishes satiety (the feeling of fullness from food), and gives you a higher preference for salty and fatty meals.


Rosacea is a chronic skin condition that affects over 415 million individuals worldwide. The condition is most popularly known for causing facial redness. The nose and cheeks are the most common areas of the face that develop a deep red coloration.

Alcohol, it turns out, is a major precipitating factor for rosacea. When a person drinks alcohol, it dehydrates the body, which can trigger rosacea symptoms. Even a single alcoholic beverage can result in a rosacea flare-up.


Rosacea enlarges and thickens the skin, which can cause extra tissue to form on the nose. This condition is known as rhinophyma and can make the nose seem disproportionately large and bloated. Although the condition can occur in anyone, alcoholism is strongly linked to the development of rhinophyma, also commonly referred to as drinker’s nose or alcohol nose. 

Acetaldehyde, ALDH2 Deficiency, Facial Flushing, and Transient Flushing

A red face caused by alcohol especially occurs in those with an inefficient alcohol metabolism. As the body struggles to process the alcohol, it leads to excessive levels of acetaldehyde. This, in turn, leads to an ALDH2 deficiency, which is commonly known as alcohol flushing syndrome. Roughly 540 million people around the globe suffer from this condition.

Research suggests that facial flushing occurs due to an intolerance within the body to alcohol. Facial flushing and transient flushing can occur in low, moderate, and heavy drinkers. Additional research says that for those who drink rarely or moderately, alcohol consumption that results in a red face signifies a sensitivity to alcohol. In heavy drinkers, a red face simply indicates high levels of alcohol in the body, which results in a red face caused by alcohol sensitivity, dehydration, and fatigue.

Vasoconstriction, Dilation, and Blood Vessels

No matter how much you drink, alcohol constricts your blood vessels. Some studies claim consuming one to two alcoholic beverages per day can actually reduce your risk of cardiovascular disease. However, those who consume more than two drinks per day have a greater risk of inflammation and red skin as a consequence of vasoconstriction. These people also have an increased risk of experiencing a heart attack or stroke.

Broken Capillaries

Alcohol consumption leads to excessive capillary dilation, causing them to become damaged or broken. Over time, the damaged capillaries rise closer to the surface of the skin, resulting in a red face. Much like raised capillaries, it’s also common for blood vessels to swell when a person excessively consumes alcohol. The alcohol will even break down collagen inside the veins, resulting in spider veins, which tend to be blue, purple, and red in color. Spider veins can appear anywhere on the body, including your face.

Understanding the Link Between Alcohol and Rosacea

A 2017 cohort research study found an association between alcohol use and the onset of rosacea. The study also discovered that women who consume a lot of booze or white wine are at increased risk. Alcohol use strongly correlates with rosacea severity, according to the same research. The more alcohol you consume, the greater your chance of developing this illness.

Alcohol’s ability to relax blood vessel walls and raise core body temperature may be at play here. Catecholamines, a group of hormones that controls the stress response, start releasing at a much higher rate as a result of this process. Alcohol use also triggers inflammatory cytokines, which cause the skin to swell. The combination of these elements can cause a flushed face and other rosacea symptoms.

Even though alcohol may exacerbate facial redness and rosacea, it is not the cause. Still, eliminating alcohol consumption is key to avoiding rosacea flare-ups.

When Does an Alcoholic’s Facial Redness Go Away?

Excessive alcohol consumption can result in long-term consequences, including redness in the face. Some people who experience facial redness notice the redness goes away once they quit drinking alcohol. However, for others, the facial redness can last a lifetime.

When an ALDH2 deficiency leads to facial redness, the redness will likely subside completely if a person stops drinking alcohol. The same holds true for those who experience momentary flushing-related facial redness. However, if a person’s facial redness is due to broken capillaries or swollen blood vessels, it may partially go away when they stop drinking alcohol, but some redness will probably stay there forever unless treated using a medical regimen.

How to Drink Moderately and Avoid Red Face

Moderate alcohol use (two drinks per day) may not cause noticeable physical changes in the face and body, but it can. If you normally have two drinks each day, cutting down to one every three days will give your body more time to digest the alcohol and help alleviate some of the negative effects, such as red, puffy eyes and dry skin. 

Alcoholics who don’t allow their bodies a chance to detox from the booze often develop skin problems from being chronically dehydrated. The same holds true for damage to the skin’s blood vessels, and once it’s too late, there’s typically no reversing the damage.

Telling the Difference Between Alcoholics and Rosacea Sufferers

Not all people with rosacea drink alcohol, and it’s usually fairly easy to tell who does and who doesn’t. People with rosacea who don’t drink alcohol usually have a less prominent nose when compared to those who do. It’s also more common to see jaundice and dark circles around the eyes in rosacea sufferers who drink than in those who don’t.

Facial Redness and Liver Problems

Alcoholics can usually reverse the symptoms of dark circles around the eyes, facial puffiness, and dry skin simply by avoiding alcohol. All of these symptoms will reverse as the person’s liver function starts to improve. However, if liver functionality is permanently damaged by cirrhosis and jaundice sets in, there’s a good chance the facial redness and changes won’t go away.

Can Alcoholics Take Medicine to Reduce Facial Redness?

Alcoholics can speak with a physician about reducing facial redness. Most doctors will recommend ceasing the consumption of alcohol or at least cutting back on it. They may also prescribe medicines like Brimonidine and Oxymetazoline to decrease facial redness.

Doctors also frequently tell alcoholics with rosacea to increase their daily water intake to help with facial redness. The more water you drink, the less likely you are to become dehydrated, which significantly decreases the chances of your face becoming red. Research shows that drinking more water also helps get rid of puffy eyes and dry skin.

Which Alcoholic Beverages Cause Red Face?

Everyone has a different alcohol tolerance. Therefore, your body’s reaction to alcohol will determine whether or not drinking will cause a rosacea flare-up. One thing is certain, however, and that is not all drinks result in the same effects on the skin.

Any drink that is high in sugar and sodium increases the likelihood of inflammation and redness in the face. You should try to avoid these drinks as much as possible.

If alcohol causes you to flush easily, try drinking less of it. Don’t try switching from one type of alcohol to another; any type can trigger a red face or a rosacea flare-up. If possible, you should try giving up booze altogether and replacing it with something healthier.

Treatment Options for Alcoholism

Many alcoholics live under the false presumption that giving up alcohol is impossible. Although alcohol is extremely addictive, it is possible for alcoholics to stop drinking. Successful recovery from alcoholism usually requires extended treatment and strong support from friends, family, and co-workers.

The first step toward alcoholism recovery involves choosing a treatment option, which includes:

  • Dual diagnosis treatment
  • Medical detox
  • Inpatient rehab
  • Partial hospitalization programs
  • Outpatient rehab
  • Aftercare
  • Veterans programs

Inpatient Rehab

Inpatient rehab care for alcoholics requires clients to reside at a treatment facility unless first granted permission from a treatment staff member. This keeps clients in a healthy environment as they go through withdrawals and receive treatment.

Many inpatient rehabs offer medically assisted services, ensuring clients receive the medical care they need to successfully withdraw from alcohol as they transition into a healthier lifestyle. Inpatient rehabs can last anywhere from 10 days to 48 months. Extended programs are often referred to as long-term residential facilities.

Outpatient Rehab

Outpatient rehabs for alcoholics allow you to receive alcohol treatment without having to reside at a facility. Many outpatient programs require clients to attend five or more sessions a week, with sessions lasting up to eight hours a day on a daily basis, Monday through Friday. Other programs require fewer treatment sessions. The number of times you’ll have to attend depends on your treatment progress. Outpatient programs usually last anywhere from 30 days to six months.

Start Alcohol Treatment Today

You can start alcohol treatment today at Defining Wellness Centers. Our facility offers a vast range of treatment options, including inpatient and outpatient programs. If you suffer from a co-occurring condition like anxiety, depression, or bipolar disorder, you’ll want to partake in one of the available dual diagnosis treatments. Roughly half of all alcoholics require dual-diagnosis treatments. 

No matter how long you’ve been drinking, it’s never too late to start the recovery process. The sooner you abstain from alcohol use, the sooner your body can start repairing itself. Contact Defining Wellness Centers today to start alcohol treatment.

Begin your Recovery Today

If you are ready to take the step towards a new life, call Defining Wellness today and learn more about how we can help you.