Skin changes—including itching, rashes, sores, infections, flushing, dryness, bruising, or yellowing—can occur with some forms of substance use and with medical complications such as alcohol-related liver disease. However, these signs are nonspecific and can also result from allergies, eczema, acne, infection, medication effects, stress, nutritional problems, or many other health conditions.
You may notice new sores, repetitive picking or scratching, wounds that heal slowly, increased redness or flushing, dry or flaky skin, unexplained bruising, or yellowing of the skin or eyes. Frequent long sleeves or changes in clothing can have many ordinary explanations and should not be treated as evidence of injection drug use or substance use.pubmed.
Use the Checklist and Rating Scale to document specific, repeated behaviors. Record the location, appearance, timing, duration, and progression of visible skin changes, along with any itching, pain, fever, or changes in daily functioning, without inspecting their body or clothing for proof. Encourage a medical evaluation for persistent, unexplained, painful, spreading, or nonhealing skin changes, and obtain urgent care for rapidly spreading redness, swelling, severe pain, pus, fever, confusion, or yellowing of the skin or eyes.
Our skin acts like a canvas, reflecting what is happening inside our bodies. When someone is struggling with alcohol or drug abuse, their complexion is often the first place the damage shows. The old adage that some people wear their emotions of their sleeves, can be extended to the use of various chemicals that frequently show themselves with skin rashes, pimples, excessive dryness or even lesions.
If you notice a loved one’s skin changing rapidly, it could be an outward sign of an internal struggle.
Stimulants like meth and cocaine restrict blood flow, starving the skin of oxygen and vital nutrients. Over time, this can make their face look grey, dull, and leathery, causing them to age years in a very short time. You might also notice open sores, scabs, or scars on their face and arms from obsessive picking.
Alcohol does the opposite by dilating blood vessels. Heavy drinking can permanently stretch these tiny vessels, leading to broken red capillaries (often called “spider veins”) across the nose and cheeks. Because alcohol is incredibly dehydrating, it can also leave their face looking constantly flushed, puffy, or covered in dry, flaky patches that look like sudden eczema.
Additionally, opioids trigger chemical reactions that cause relentless scratching, leaving raw, red rashes. As addiction takes over, basic self-care and hygiene often slip, making them more prone to skin infections and slow-healing wounds.
When a loved one’s skin suddenly loses its healthy glow, breaks out in unexplained sores, or ages overnight, it is rarely just a cosmetic issue. It is often a physical warning sign of a hidden battle. Monitoring what you see is imporant and pointing out noticable changes or growths is vital. It is also important to notice if long-sleeved or turtleneck shirts or sweaters are being used a lot.
This sign is for awareness and education only. It is useful as a screening tool, not a diagnostic tool. It is not a substitute for professional assessment or treatment. If you are concerned about someone you love, speaking with a qualified addiction counselor or psychologist is always the right next step.
Why should you sign up for this newsletter? Because periodically we send out information that might be helpful to you in the future, that way you won’t miss out on relevant information important to you and you loved one.