Does Alcohol Cause Acne? (Asking for a Friend)

Dear Universe,

I would say I hope you’re well but this isn’t really about you, is it? No, it’s about me, and the burning question I hope you can help me answer: Does alcohol cause acne???

I’m asking because, after a jolly holiday season of margaritas at the office party, honey-laden hot toddies after cold ski days, and poppin’ bottles on New Years Eve, a vagrant cast of cystic pimples are living rent-free on my forehead and chin. If they could—they’ve only got pus for brains—I’m sure they’d point their greasy little fingers at booze and say, “He dunnit.” I know it, they know it, but can dermatology prove it?

Listen, at this point in my testimony I should probably disclose that I’m not new to this rodeo. I have endometriosis, the inflammatory disease affecting roughly 10 percent of people with periods. And after enjoying clear skin throughout my teen years, bouts of hormonal acne have haunted the majority of my adult life. I’ve worked through (most) of the insecurities our impossible beauty standards inspire (thank you, therapy), but I also know that when my skin is inflamed, it’s usually trying to tell me something. So I have to wonder: Why so mad, face? Sure, I’ve been pounding holiday cookies like the next guy—but I do that regardless of the season. Which brings me back to the main point: Usually a light imbiber, I downed more alcoholic drinks in the past month than I had all year.

Here’s the thing, though: Skin health aside, I don’t want to stop partaking altogether. But nothing else I’ve done—buy fancy cleansers, experiment with elaborate skincare routines, meditate like it’s my job—has helped with the acne. So, Universe, can you step in please? Does alcohol cause acne? How? Are some types of alcohol easier on the face than others? And is there any way I can lap at the odd white wine without Puberty 2.0 rearing its unwanted head(s)?

Grown-Ass Adult Woman

Alcohol can trigger acne, but it’s not the direct cause

As it turns out, bacteria, inflammation, excess oil production, and clogged pores are the true culprits behind all those blemishes. But alcohol can trigger many skin conditions, “including acne, psoriasis, and rosacea,” says Rachel Nazarian, MD, FAAD, a dermatologist practicing in New York City. Which means, essentially, that if you are prone to any of those issues already, slamming a flight of jello shots might likely prompt some side effects.

Booze is also a diuretic, so it causes dehydration, which, board-certified dermatologist Rose Ingleton, MD, says signals to your oil glands to produce more, more, more! Not to mention, “high [alcohol] consumption may also suppress immune [system] responses, which could make you more susceptible to [a build up of] bacteria” in the first place.

Ingleton explains that a big night on the sauce could also disrupt your hormone levels—one study found alcohol can boost estradiol (a form of estrogen) and another found that the same went for testosterone levels in premenopausal women—which leads to inflammation. Bad news for people like me: “In theory, those with already existing hormonal imbalances may be more likely to experience [acne] breakouts triggered by alcohol,” she says.

Mixed drinks tend to be the worst offenders

Ingleton puts it simply: “Sugary alcoholic drinks are going to be worse for your skin.”

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