The holiday season is upon us, and with it comes more opportunities to celebrate with alcohol, sometimes to excess.  If you are one of the 20% of adults who suffer from acne, you may find that your skin breaks out in a fresh batch of pimples after an evening of drinking with friends.  Is it your imagination?  Nope, and I’ll explain why this sometimes happens.  I’ll also give you some tips for taking care of your skin so you can minimize your chances of breaking out with acne during the holidays.

Among alcohol’s many effects, one of the most unusual is that it is a testosterone stimulant.  You can see this in the behaviors of people who have been drinking.  People get louder when they drink, and become a bit too confident.  They take excessive risks and brag about their behaviors.  They may feel sexy, almost promiscuous. 

These behaviors, which are characteristically masculine, appear in both women and men when alcohol is consumed because alcohol stimulates the production of testosterone.  Unfortunately, testosterone is also one of the primary causes of acne.

Testosterone has a strong influence on the hair follicles that cover our body, including the sebaceous gland that is part of each hair follicle.  It is the stimulation of the sebaceous gland that gives us most of our problems with acne.

The effects of testosterone on the hair follicles are first seen during puberty, when levels in both men and women begin to rise.  At this time, hair starts to grow in new places, such as under our arms and between our legs.  This new, testosterone-induced hair is noticeably darker and coarser than the peach fuzz that covered our bodies as children, and the oil production around the hair is heavier, too.   The action of testosterone literally changes the hair into something new – hair on steroids, because that’s what testosterone is, a steroid.

One of the most immediate changes that testosterone produces in the hair follicle is that it stimulates the sebaceous oil gland that is tucked inside each hair follicle.  Under the influence of testosterone, the size of the oil gland more than doubles. 

As it gets bigger, the oil gland produces more oil, which can then plug up the narrow opening of the follicle and start to back up into the gland.  Bacteria can start multiplying in the blocked oil and cause infection, and the body responds with inflammation.  The rapid swelling of the oil gland also puts pressure on nearby tissue and causes inflammation in response.  All of these changes in the sebaceous gland lead to the inflammation and swelling that we call acne.

The follicles most sensitive to testosterone influences on the sebaceous glands are on the face, the back, and the chest.  This is exactly where acne tends to break out, but acne can occur anywhere that a follicle becomes plugged or infected and any time that the sebaceous glands are over-stimulated.

Women don’t handle fluctuations of testosterone very well because it’s not the dominant hormone of their system.  Women handle estrogen fluctuations better, but every fluctuation of our hormones is felt throughout our system.  In general, women are more sensitive to hormone fluctuations than men and will be more likely to experience acne after drinking alcohol. 

When you drink to the point that your behaviors change into the more aggressive testosterone displays, you are exposing your sebaceous glands to toxic doses of testosterone that can stimulate your sebaceous glands and result in acne. The more you drink, the more you raise your testosterone levels and the greater your risk for acne. 

Alcohol also acts as a vasodilator, which means it makes the blood vessels get larger.  This causes the skin to become red or flushed, and explains why people who are drunk don’t feel cold even when they are freezing.  The increased blood flow in your skin makes you feel warm.  Vasodilation is also what gives you a hangover after drinking.  The pressure of your dilated vessels in the brain hurts and causes a headache. 

This condition of enlarged blood vessels, or vasodilation, is not only the path to a killer headache, it is also the perfect environment for inflammation.  Vasodilation causes tiny gaps to appear between the cells of the vessel lining when the vessel is stretched during dilation.  It is through these gaps that white blood cells and plasma leak out into the surrounding tissue and cause the pustules and swelling associated with inflammation. 

While you are drinking, your blood is flowing too fast to allow this leakage but once you stop the blood slows down while the dilation remains.  In the hours following your drinking, your alcohol-dilated vessels may begin leaking into nearby tissue.  This leakage causes the inflamed skin associated with pimples and the headache that often follows drinking. If you are prone to inflammation anyway, the prolonged vasodilation caused by drinking to excess can push your immune system over the edge and cause inflammation.  Maybe knowing that will help you control your consumption!

Once the drinking is done, however, what can you do?  The first thing you should do if you are prone to acne breakouts is to give your skin a good steam cleaning the next morning. 

Take a washcloth and run it under hot tap water.  Wring it out and apply it to your face, especially in the areas where acne occurs.  Keep it pressed into your skin until the washcloth cools, and then do it again.  The heat and moisture will increase the blood flow through your skin and soften the oils that are beneath the surface. You don’t have to scrub your face; you just need to steam it.  If you repeat this a few times during the morning, you will be helping your skin to reverse the effects of inflammation. 

Another tip is to drink coffee after drinking alcohol.  We’ve known for a long time that the caffeine in coffee counteracts the effects of alcohol, and now we understand how it does it.  Caffeine causes your heart rate to increase and blood vessels to constrict.  This is just the opposite of what alcohol does, which is to dilate blood vessels. 

Drinking something with caffeine, like coffee or green tea, reverses the conditions that can lead to inflammation in your skin, and it may make your head feel better, too!  Your pounding headache the next morning is, after all, caused by the vasodilation of alcohol and caffeine will help reverse it.

Taking caffeine with aspirin is another well-known hangover remedy that may also help prevent acne.  Aspirin has strong anti-inflammatory properties of its own, but when it is paired with caffeine it delivers a double whammy punch.  Excedrin is a combination of aspirin, and taking a couple on the morning after may help prevent pimples from coming out in the first place.

If a pimple does manage to break through, aspirin can still come in handy.  Simply crush an aspirin tablet between two spoons so it is in a powder.  Then add just a couple drops of water or Visine to make a paste of the crushed aspirin.  Use a cotton swab to apply the paste directly on a pimple.  Ideally you would do this at night and let it rest on the affected area for many hours, but you can still get beneficial results if you apply it for an hour or two in the morning before you leave the house.

If you would rather purchase a product to treat your acne, choose one that contains Benzoyl Peroxide, which is still considered to be the most effective way to treat acne without a prescription.  There are several different products to choose from at the drug store, but they all require that you use it daily in order to be effective.  If your skin becomes too dry, which sometimes happens with Benzoyl Peroxide, it is better to use smaller amounts of it every day than to skip a day between doses.

So laugh it up and enjoy the holidays.  Drink with caution, and have a good time.  But if you find yourself getting rowdy or breaking out with pimples, remember the effects of alcohol on testosterone.  With a bit of thought and home treatment, you should be able to enjoy alcohol over the holidays without paying for it with your skin. 

Judy Zifka, Esthetician (Skin Care and Waxing)

November 22, 2011

50th Avenue Salon, Portland OR

503-235-6484

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