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Chris Howe, the director at Lakeside Recovery, an addiction treatment centre in St. Catherines, Ont., remembers what he looked like when he was struggling with an active alcohol addiction.
"I was overweight and I had bad skin. People used to describe my skin as looking grey," he said. "And I had dead eyes."
Howe was dehydrated. He said if he pinched his skin, it would almost "stay the shape that you pinched it in for a moment before flattening out."
I was living in a body that was excruciating to me.Chris Howe
In the long term, excessive alcohol use can have effects on someone's physical appearance, alongside the damaging effects on the body internally. Howe described both weight and skin issues that can be common for those struggling with addiction.
Now sober for over 13 years, he said the physical transformation he has gone through, as well as the emotional and spiritual journey, has been "revitalizing."
Yahoo Canada spoke to experts on the changes someone's body can go through from long-term alcohol use and what happens once someone stops drinking. Here's what you need to know.
Can drinking alcohol change the way you look?
According to Healthline, alcohol can cause an inflammatory response in some people, appearing as facial bloating. When someone is addicted to alcohol, facial swelling and bloating may also be caused because the skin is attempting to retain as much water as possible to offset alcohol dehydration.
In a recent viral Instagram reel, social media user Chanda Lynn shared the impact of alcohol on the shape of her face.
As she progressed in her sobriety, her face got slimmer. She realized alcohol made her face puffier, bigger.
Timothy Naimi, the director of the University of Victoria’s Canadian Institute for Substance Use Research, said though this could potentially happen to some people, it may not reliably be the case for all.
Some skin changes he did point to as a possibility after chronic alcohol use were premature aging, spider veins (or varicose veins), or broken blood vessels around the nose and cheeks.
A condition called rhinophyma, a skin condition that causes swelling and redness of the nose, was previously linked to alcohol use, even referred to sometimes as "alcohol nose," but this has since been debunked.
The effects alcohol has on the skin are typically indirect and result from factors such as dehydration, liver damage and nutritional deficiencies.
Dehydrated skin may appear dull and lacklustre, which can be interpreted as paler or less vibrant in complexion, much like Howe's appearance was described by himself and others.
Prolonged alcohol use can also cause liver damage, leading to conditions like jaundice, which is characterized by a yellowing of the skin and eyes.
Dominique Morisano, a clinical psychologist and adjunct professor at the University of Toronto, said alcohol can also affect the coloration of one's facial appearance, such as redness from alcohol flush reaction.
"We also know that individuals affected by Fetal Alcohol Syndrome can have different facial phenotypes," she said, referring to an example of visible characteristics.
Another thing that might change someone's appearance would be weight gain or weight loss from drinking.
How does alcohol affect someone internally?
Long-term alcohol consumption can have profound effects on various organs and systems within the body. Here are some internal effects associated with chronic alcohol use:
Pancreatic issues like inflammation or abdominal pain
Cardiovascular system issues (high blood pressure, irregular heartbeats, increased heart disease risk)
Immune system suppression
Neurological effects (memory loss or cognitive impairment)
Increased cancer risk
Bone density loss
Mental health issues and depression
"Alcohol, in general, is a neurotoxin," said Naimi.
He added that over time, alcohol can increase the likelihood someone has a seizure or can cause neuropathy (where someone experiences numbness or tingling in their hands or feet), and can cause acute neurological effects.
Are the effects of chronic alcohol consumption reversible?
The long-term effects of alcohol consumption on the body can vary, and some changes may be reversible to an extent, if alcohol use is discontinued and a healthier lifestyle is adopted. However, the extent of reversibility depends on several factors, including the severity and duration of alcohol abuse, individual health and whether any irreversible damage has occurred.
"Once you've developed liver cirrhosis, there are lots of changes with the skin — like colour and the puffiness — that sometimes would not be reversible," Naimi explained.
For Howe, who now helps others at the recovery centre, watching people transform physically and emotionally has been rewarding.
"When someone first comes in, I can remember feeling how they look," Howe said. "And I can really connect with the emotional state that is presenting itself physically."
Physical fitness is a big part of Lakeside Recovery's program. So along with therapy, people can participate in yoga, combat sports, breathwork and more.
Howe said a rewarding part of his work is when he gets to see the "signs of life being breathed back into [people]."