wrinkles and overall premature aging. One sign of alcohol addiction is dermatologic stigmata of liver disease, that is when diseases of the liver (often caused by excessive alcohol intake) are reflected on the skin.

Yellowish or hyperpigmented skin with thinning of body hair and nails are signs of hepatic cirrhosis, a type of acute liver disease that alcohol abusers are at increased risk for. Another indicator of severe liver disease is caput medusa or engorged veins in the abdomen.

Some conditions that are not always linked to alcohol abuse but may indicate mild liver disease caused by alcohol are common rashes, dilated arterioles such as spider veins, and/or angioma. Flatly spread psoriasis, marked by thickness in the skin’s outer layer, has also been reported among people who drink too much alcohol.

Additional dermatologic disorders linked to alcohol abuse include rosacea, nummular eczema, palmar erythema and seborrheic dermatitis.

Dr. Henriques pointed out that while many of those conditions are fairly common, they are often among the countless complications and alterations that can indicate any type of drug use or abuse.

“Dangerous drugs like heroin or methamphetamine will certainly alter the skin,” she said. “But both licit and illicit drugs can induce systemic skin disorders.”

Medical relevance

Substance abuse often goes undetected by physicians because it isn’t always self-reported.

Dr. Ezra’s research aimed to make doctors more aware of the visible signs of drug abuse and consequently give them the ability to recognize substance use disorders and provide patients with the most effective treatment.

“In every specialty of medicine physicians need to be aware of signs and symptoms of drug abuse,” Dr. Ezra said. “Sometimes patients come to physicians for ailments that are related to drug abuse, but they don’t come out and tell their physicians that they’re abusing drugs. It’s the physician’s job to take a holistic approach at treating the patient and not only treating a specific concern but all issues. Drug abuse is a very important issue now.”