Historically, many people have believed that rosacea is caused by alcoholism. For example, the physical appearance of W.C. Fields--an alcoholic and a rosacea sufferer--helped to create a popular belief that the two conditions are causally linked, according to the Kansas Department of Health and Environment. However, rosacea is not caused by alcoholism. Although alcoholic drinks can exacerbate an existing rosacea condition, teetotallers can suffer equally severe rosacea as drinkers. According to the American Academy of Dermatology, "Rosacea has been unfairly linked to alcoholism."
Rosacea is a skin disease that typically starts as a tendency to blush or flush. Persistent facial redness and itching may then develop, and rosacea can then spread to the patient's ears, chest and back. The eyes may also be affected, with occular rosacea causing dryness and burning of the eyes. Symptoms of rosacea often look like acne, and in advanced cases a reddening and enlargement of the nose--known as rhinophyma--may develop. Rhinophyma is much more common in men than in women, according to the American Academy of Dermatology. Overall, fair-skinned individuals between the ages of 30 and 50 are most likely to develop rosacea, although it may occur in people of any age or ethnicity.
Alcoholism is an addictive disorder, also known as alcohol dependence. The disorder is characterized by chronic, uncontrolled drinking of alcohol even when this drinking is having serious negative effects on an individual's health, work and relationships. Alcoholism is acknowledged as having both biological and social causes and risk factors, according to the NIH and NIAAA, including stress, mental health, age, gender, social environment and genetic predisposition. Long-term alcoholism affects almost every organ and system in the human body, including the skin.
The Effects of Alcohol on Rosacea
Although alcohol does not directly cause rosacea, a patient with rosacea will usually find that alcohol makes the rosacea symptoms worse. Rosacea occurs in individuals who flush easily, due to having blood vessels relatively close to the surface of the skin. Alcohol also increases flushing of the skin, and therefore increases the redness, burning and itching sensations associated with rosacea. Patients with rosacea are advised to limit alcohol consumption and to consume only cold alcoholic drinks. Red wine should be avoided due to its particularly strong ability to exacerbate rosacea symptoms, according to Pohla Smith, writing in the Pittsburgh Post-Gazette.
Rosacea Treatments and the Liver
There is no single standard treatment for rosacea. In addition to diet and lifestyle modifications, certain prescriptions are used to lessen rosacea's symptoms in different individuals. Oral antibiotics or topical steroid creams are commonly used to treat symptoms of redness and itching, but when rosacea is unresponsive to antibiotics, some patients experience relief with the prescription drug isotretinoin. Also known by its brand name Accutane, isotretinoin is an acne medication. Long-term use of isotretinoin is known to cause liver damage--isotretinoin is therefore not a good choice of rosacea treatment for any patient who also suffers from alcoholism. The liver could be severely damaged by the combination of heavy drinking and an isotretinoin prescription for rosacea, according to Body-Detox-Info.com.
Dermatological Effects of Alcoholism
Alcoholism damages the liver, and when the liver fails there are many dermatological symptoms that may mimic or mask the symptoms of rosacea. Liver failure typically causes hyperbilirubinemia--heightened blood levels of bilirubin--which leads to skin itching and scratching. Another dermatological problem associated with alcoholism and liver cirrhosis is the appearance of spider-shaped red pigmentation, known as "spider naevi," on the face, hands, forearms and trunk. Liver cirrhosis can also cause a reddening of the fingers and palms known as "palmar erythema." All of these dermatological complaints may mask the presence and diagnosis of rosacea in a patient who is also an alcoholic.