We like a good cocktail now and then. But what is alcohol really doing to our skin... and which drinks are inflicting the most damage?
We decided to face our fears and talk to Dr. David Colbert, founder of New York Dermatology Group, Dr. Debra Jaliman, author of "Skin Rules: Trade Secrets From a Top New York Dermatologist" and Dr. Jessica Krant, Assistant Clinical Professor of Dermatology at SUNY Downstate Medical Center.
Right off the bat, Dr. Colbert burst our champagne bubble. "It may make us feel good, but alcohol is a hepatotoxin," meaning it specifically damages the liver, he explained. "It's a toxin to the cells that detoxify your body." How does that affect our skin? "One way to look at it," Dr. Colbert said, "is to ask what does someone look like who is dying of liver failure? They're sallow, they're pasty, they're cold, their pores are huge."
Alcohol also contains congeners, said Dr. Colbert, chemical substances produced during the fermentation process that contribute to liquors' unique tastes and smell. Congeners are the main cause of hangovers, so the more congeners in your liquor, the worse your hangover... and the worse you look the next morning.
On top of that, Dr. Jaliman pointed out, "All alcohol dehydrates the skin." This means your skin will appear less plump and fresh the next morning. Between the congeners, the liver damage and the dehydration, it's clear alcohol does damage to our skin. But if we happen to imbibe anyway... which drinks should we steer clear of and which are the least harmful?
Clear Shots (Vodka, Gin, Tequila)
What makes the skin effects of one alcoholic drink different from the next is what else is in the drink. That makes shots the best option, since there's no extra sugar, salt or other harmful ingredients. "If you just have one shot of vodka or just a shot of tequila that you nurse," Dr. Colbert said, "you'll probably look OK the next day." Dr. Jaliman added, "A shot of gin or rum would probably be the best." However, keep in mind that some people who drink shots end up consuming more alcohol than they intended since it's easy to lose track. And more alcohol is never better for your skin.
Dark Shots (Rum, Whiskey, Tequila)
Like clear liquors, straight rum or whiskey comes with the benefits of no additives. But Dr. Krant points out that one key difference between the two is the amount of congeners. "Dark liquor contains congeners and products of extra fermentation that clear liquor does not," she said. More congeners worsen your hangover, and Dr. Krant suggests that the excess impurities of the congeners may contribute to more skin aging (although the connection hasn't been formally proven).
Mojitos & Other Sweet Mixed Drinks
The danger with drinks like mojitos is the sugar. "Sugar anywhere in the diet, along with other excessive carbs, leads to systemic inflammation, which contributes ultimately to cell damage and increased skin aging," Dr. Krant said, "The less sugar you take in with your alcohol, the better for your long-term wrinkle risk." But mojitos, not to mention drinks mixed with Coke, orange juice, Red Bull and other sweet drinks, are loaded with sugar. Sugar also causes acne by spiking your insulin levels, causing inflammation throughout the body.
Plus, Dr. Colbert said, sugary drinks can give you a "sugar hangover" on top of your regular hangover, resulting in sallow skin and bloodshot eyes.
Margaritas, particularly frozen margaritas made with mixes, also contain sugar. But these tequila-based drinks serve up a double whammy due to the salt. "The intake of any salt, no matter the source, does contribute to bloating," explained Dr. Krant. "This is temporary, but no one likes to feel and look puffy on top of a hangover."
Another drink with salt is beer, although it's not dangerously high in sodium levels. "If you drink a lot of salt," Dr. Colbert told us, "you're going to get symptoms like swollen eyes and thirsty skin, and your body is telling you to drink more water to get rid of the salt." On the other hand, beer has some redeeming qualities. "It does contain antioxidants and other antiaging benefits," Dr. Krant said. Plus, ounce for ounce, Dr. Colbert reminded us, beer just has less alcohol in it than straight liquor.
White wine, like mixed cocktails and beer, contains sugar, in addition to some salt. Wine can lead to swollen skin and bloating, plus it makes you hungry, Dr. Colbert said. And sadly, white wine doesn't contain the health benefits that red wine so famously does...
Red wine, as we've often heard, can actually be good for you. "Red wine contains more antioxidants than white, which may help counteract some aging processes," said Dr. Krant. "I would say the best single drink to have to support skin health and minimize aging risks is a glass of red wine."
But red wine is actually the most harmful drink for those with skin issues like rosacea. Dr. Jaliman told us, "76 percent of people that drink red wine have a flair of their rosacea," versus 56 percent of those drinking white wine, 41 percent of those drinking beer and only 21 percent of scotch drinkers. "Red wine can also cause histamine release in some people, leading to increased flushing and more of a hangover," Dr. Krant added. "Any alcohol in excess contributes more to aging than it protects against."
What else could be harming your skin?
As your vision worsens with age, other muscles around the eye pitch in to help you focus, says Ranella Hirsch, MD, past president of the American Society of Cosmetic Dermatology and Aesthetic Surgery. But as these tiny muscles are increasingly taxed, they can deepen lines around the eyes, and that can make you look world-weary (instead of wise). Your dermatologist can improve the appearance of these wrinkles with botulinum injections, but Hirsch says that it's also helpful to get your eyes checked. "A patient will come in for a consultation, and I'll send them to an optometrist," she says. "Sometimes what they really need is a pair of glasses."
Teeth add structure and vertical height to the face. When they get worn down through grinding, nail biting or aggressive chewing, or worse, when a diseased tooth needs to be pulled, the facial skin can become looser, explains Phil Haeck, MD, a plastic surgeon based in Seattle and the past president of the American Society of Plastic Surgeons. Combined with the skin's natural loss of elasticity over time, this can lead to wrinkles and sagging around the mouth. Dentures help fill in the gaps left by missing teeth, but dental implants do a better job at restoring the height of the jaw, Haeck says. You know what to do: Brush twice a day, have your teeth professionally cleaned at least once a year and remember to floss. If grinding is a problem, talk to your dentist about a bite guard.
The delicate skin around your eyes is extremely thin and requires extra attention. Surprisingly, even people who are careful about sun protection often forget to put sunscreen in that area, says Hirsch, which can worsen wrinkles and discoloration. The right pair of sunglasses can serve as another line of defense, but only if they have UVA/UVB protection, as well as lenses opaque enough that you don't squint in bright light (which can exacerbate frown lines and eye wrinkles, adds Hirsch).
You've probably heard of the "mask of pregnancy," or facial hyperpigmentation caused by hormonal surges during pregnancy. Hormonal birth control (especially pills, shots, the ring) can have the same effect, causing brownish-gray patches to appear like shadows on the upper lip, cheeks, forehead and nose, says Jessica Krant, MD, a board-certified dermatologist and assistant clinical professor at SUNY Downstate Medical Center. This type of discoloration can add years to your face: A Procter and Gamble study found that women were perceived as older simply because of patchy, uneven skin tone. Fortunately, hormone-induced melasma usually fades within a year of giving birth or going off the pill, provided that you're religious about sun protection (see last slide). To treat stubborn spots, Krant suggests talking to your dermatologist about brighteners and antioxidants including tretinoin, niacin, vitamin C, kojic acid or azelaic acid.
As we get older, hormonal changes can lead to decreases in collagen, Hirsch says. And weight loss can make this more noticeable. "Think of the face as a sofa," she says. "In the past, when the sofa started to age and sag, women had work done to pull the slipcover -- or the skin -- tighter. Now we know that one of the most convincing ways to make it look younger is to re-inflate the pillows." The latest technique dermatologists use to restore fullness involves injecting the face with various soft-tissue fillers, says Hirsch, but adds that you can "protect your facial pillows naturally" by maintaining a healthy, not-too-thin weight.
So many of us are paying for early sun exposure -- skin damage like brownish-gray patches (melasma), brown spots that look like flat moles (lentigos), broken blood vessels and freckles. "Patients often say, 'The damage is done, and it's too late to fix it,'" says Krant. But that's not entirely true: You can prevent additional damage and reduce the severity of the problems you already have if you remain vigilant. "Additional sun exposure can make conditions like melasma even more noticeable. Existing spots can get darker and larger while new ones appear," explains Krant. Her advice is to embrace excellent sun hygiene (sunscreen, hats, sunglasses -- the whole nine yards) as a way of life.
If you're the kind of gal whose "me time" includes a glass or two of wine after work, you might want to consider how those drinks could affect your looks. That's part of the message of the Scottish government's Drop a Glass Size Campaign, which specifically "encourages women to think about the health effects of regularly drinking above the recommended alcohol guidelines."