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Changes in the structure of the skin are caused by a combination of internal, chronological processes, as well as external factors directly related to a person’s choices. For example, exposure to ultraviolet (UV) light is a major external cause. Another important factor is certainly high alcohol consumption. How does alcohol affect human skin? Does the amount and frequency of alcohol consumption matter?
- Alcohol weakens the skin’s antioxidant defense by reducing the concentration of carotenoids in it
- It also causes peripheral vasodilation which can lead to dilation of the facial capillaries and thus redness
- It contributes to the development of skin diseases such as urticaria, fungal and bacterial infections, and exacerbates the existing psoriasis and rosacea
- More information can be found on the Onet homepage
Cutaneous symptoms of liver cirrhosis associated with alcohol consumption
Vascular
The most common and best recognized features of liver cirrhosis are of vascular origin. Persistent facial erythema, caused by chronic vasodilation, causes typical flushing of the face associated with cirrhosis of the liver. The so-called Spider veins are lesions characterized by visible, small and central arterioles. They can be widespread throughout the body, but are most commonly seen on the face and upper chest.
Spider nevuses occur in up to 10 percent. the rest of the population (especially during pregnancy and childhood), but they are most often associated with diagnosed liver dysfunction. They are also the first symptom of alcoholics before they develop overt liver disease. Moreover, in patients with more than 20 “cobwebs”, the risk of bleeding from esophageal varices (as these are common in people who regularly consume alcohol) is 50 percent.
Palmar erythema is another symptom associated with alcoholic liver failure. It occurs in as many as 38 percent. patients with cirrhosis of the liver. The hands are then extremely warm, and patients may complain of their painful throbbing.
Jaundice
The characteristic yellow shade of the skin during jaundice is a symptom of hyperbilirubinemia and the patient usually feels simultaneously severe itching caused by a build-up of bile salts in the skin. Jaundice can be prehepatic (unconjugated) or conjugated (hepatic or hepatic). Bilirubin accumulates in tissues, especially those with high elastin content (skin, especially sclera), leading to their characteristic color, and in the case of the skin – also to the feeling of itching.
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Discoloration
Skin discoloration occurs in patients with advanced liver cirrhosis. While most prominent in primary biliary cirrhosis, they can also occur in liver disease of any origin, including alcohol-related cirrhosis.
Ultrastructural studies have shown that the melanocyte count is normal in these patients, a excessive pigmentation is caused by the deposition of melanin in huge melanosomes within the epidermis. It is not known how such melanin accumulates, but it may be due to failure of lysosomal degradation.
In patients with alcoholic cirrhosis of the liver and associated hemochromatosis, slate-gray pigmentation appears that is more pronounced on sun-exposed skin due to the combined effect of haemosiderin and melanin deposition.
Itching
Itching is a common symptom of both liver disease and alcohol abuse. In drinkers, itching may precede the development of cirrhosis by several years. As much as 40 percent. patients with alcoholic liver disease complain of severe itching. Treating alcohol-related itch is difficult – emollients, phototherapy, bile acid sequestrants and a diet high in unsaturated fats can help.
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Direct effects of alcohol on the skin
Reddening
High alcohol consumption causes blood vessels to widen and the face to turn red. Redness is one of the most commonly reported alcohol side effects among alcohol abusers.
Hives
You may experience hives after consuming alcohol. The reaction can usually develop within an hour and concomitantly with other systemic symptoms such as respiratory failure, hypotension and even anaphylaxis. Alcohol usually causes hives de novobut is even more likely to provoke a reaction in patients with pre-existing disease.
Skin infections
As already mentioned, alcohol has a profound effect on all aspects of the functioning of the immune system, cellular immunity in particular. No wonder that drinkers are much more prone to all types of infections (e.g. tuberculosis, pneumonia), and skin infections are no exception. Bacterial infections (staphylococci, coryneform bacteria) are more common, and any trauma plays a role in the formation and spread of these infections. However, it is fungal skin infections that, although often minor, appear to be particularly common (about 1/3 of heavy drinkers), presumably due to changes in cellular immunity.
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Nutritional deficiencies
The skin is usually affected and marked by (literally) nutritional deficiencies. Although these deficiencies can occur for a variety of reasons, alcohol is a very common cause for two possible reasons – inadequate food intake or, secondarily, impaired liver function and thus malabsorption. The most common causes of skin symptoms are the following nutrient deficiencies:
- Protein malnutrition results in dry, cracked skin. Hair may show alternating bands of light and dark pigmentation. It is a “flag sign” that signifies alternating periods of malnutrition and adequate nutrition. In addition to protein malnutrition, alcohol abuse is associated with a deficiency of several vitamins and trace elements, in particular zinc.
- Vitamin A deficiency causes altered keratinization, resulting in dry skin with follicular papules, similar to that of a toad.
- Vitamin B2 (riboflavin) deficiency causes inflammation of the lips, tongue, conjunctiva and scrotum or vulva.
- Vitamin C is a cofactor for proline hydroxyl, an enzyme essential for collagen synthesis. Vitamin C deficiency (scurvy) is associated with abnormalities in the structure and amount of collagen found in the dermis, blood vessels and connective tissue. This results in a spectrum of ecchymoses, periventicular hemorrhages, weak gums, and slow wound healing.
Exacerbation of a pre-existing skin disease
Psoriasis
Psoriasis is a chronic inflammation of the skin. Genetic factors are important in determining susceptibility to disease, especially one with an early onset (type I psoriasis). Several factors are known to aggravate or provoke a flare-up of psoriasis, namely drugs (e.g. beta blockers), stress, infections (especially streptococcal ones) and injuries. Over the past decade, there has been a lot of interest in the relationship between alcohol and psoriasis. While there has been much debate as to whether alcohol or smoking is exacerbating psoriasis, research suggests that both factors are important and may have a synergistic effect.
Surveys showed that the incidence of psoriasis in drinkers is twice as high as expected. Although psoriasis is directly related to alcohol abuse, it is also more common in people diagnosed with liver disease. However, it seems that the amount of alcohol consumption is important, not the degree of liver damage, as psoriasis was found in 5,3% of the subjects. people with cirrhosis of the liver who drink> 50 g of alcohol per day. Psoriasis in drinkers can be more widespread, inflamed, prone to secondary infections, and more difficult to treat than in nondrinkers.
Rosacea
Rosacea is a disease characterized by redness, telangiectasia of the face (which also causes redness), and the formation of pustules, especially on the nose. Secondary (and late) changes in lymphedema can occur that distort the architecture of the nose, leading to “rhinophyma” or simply nasal hypertrophy. Alcohol makes rosacea worse and many rosacea patients avoid it especially because of the severe redness reaction.
Discoid eczema
Discoid or nematode eczema is an endogenous dermatitis usually seen on the shins of middle-aged men. Single lesions cause a feeling of intense itching. Unlike standard eczema, thyroid eczema is very strongly related to alcohol abuse.
The spectrum of alcohol-related skin diseases is therefore broad and varied. Chronic alcohol consumption in large amounts adversely affects almost all systems in the human body. No other stimulant deserves as much attention as alcohol in terms of the havoc it causes. It causes disturbances in the regulation of vascular functions in the skin and altered immune function, resulting in increased susceptibility to infections. It is also worth paying attention to the actual etiology of the alcohol-related skin disease in question.