Among the many potential health effects associated with drinking too much, issues such as stomach upset, vomiting, decreased coordination, stumbling, and slurred speech are some of the most well-known consequences. Yet, drinking alcohol can also lead to other acute physiological changes such as raising a person’s body temperature or causing skin flushing.
While some of these effects are generally mild and short-lived, others can point to more chronic, compulsive patterns of drinking. Below are some ways in which these physical effects may occur:
Alcohol-Induced Skin Flushing
For some, even having one glass of wine or pint of beer can cause flushing in the face, and the more the person drinks, the redder their skin becomes. This type of skin flushing, which occurs mostly in East Asian populations, is commonly due to a genetically determined deficiency in the production of a liver enzyme called aldehyde dehydrogenase 2 (ALDH2).1 This enzyme is involved in one of several metabolic steps that help the liver break down alcohol as it is cleared from the body; though the mechanism isn’t fully understood, with diminished levels of this enzyme, it’s thought that certain toxic metabolic by-products build up in the body and can cause flushing in the skin.2
Although a blush or flush in the face from alcohol may not be inherently dangerous, the lack of aldehyde dehydrogenase may be associated with more serious conditions. People with a genetic deficiency of ALDH2 may also be at increased risk of alcohol-related esophageal cancer.1,3 Additionally, there is some evidence that flushers may be more at risk for alcohol-related hypertension (high blood pressure).4
One study found a higher risk of drinking-related hypertension in those who flushed following alcohol consumption than in non-flushers.4 This increased risk was seen in flushers who consumed more than four drinks per week (compared with more than eight per week in non-flushers).4
Changes to Body Temperature
Under regular circumstances, the body sweats to lower its temperature through evaporation.5 Many understand that exercise, warm days, and fevers can all cause a person to sweat, but what may be less known is that consuming alcohol can do so as well.5 The liver can metabolize about one standard serving of alcohol per hour.6 As individuals began to drink more, the longer it will take to fully metabolize all of the alcohol consumed. As blood alcohol levels rise in the interim, several different effects of intoxication will become more evident.
During this period of acute intoxication, alcohol acts as a vasodilator—it causes blood vessels to widen and relax.7 Thermoregulation (body temperature control) is impacted by alcohol’s influence on automatic mechanisms like sweating and vasodilation.9
The body’s core temperature—which refers to the temperatures of the abdominal, thoracic, and cranial cavities—is regulated by the brain.8 The body’s shell temperature—or the skin, subcutaneous tissue, and muscles—is influenced more by environmental conditions and skin blood flow.8 When it comes to alcohol consumption, during the digestion process, the liver gives off heat as it metabolizes the alcohol. Therefore, it can create a feeling of being warm but is in fact lowering a person’s core body temperature.9 Though a person may sweat, their temperature is not actually rising, but lowering.9
The shifts in blood supply throughout the body, seen in flushing and felt in temperature changes, actually causes the body to release more heat.9 However, because the person feels warmer, they do not notice that their core body temperature is going down. On warmer days, this may cause a person to feel nauseated or dizzy, while in cold settings, they may be at risk for issues such as hypothermia.9
Hot Flashes from Drinking Alcohol
Generally, when the effects of excessive drinking wear off, a person may experience hot flashes as symptoms of an alcohol hangover develop.10 This post-intoxication state arises as a person’s blood alcohol concentration (BAC) levels return to zero.10 Under normal circumstances (when not associated with intoxication), hot flashes are the body’s way of telling it to cool down and they can appear suddenly or you may feel them coming.8 In association with alcohol, the hot flashes may be a result of the abnormal changes to our body’s thermoregulatory mechanisms.9
Further, those who struggle with heavy and/or binge drinking, or otherwise have developed significant alcohol dependence may experience hot flashes as a symptom of alcohol withdrawal.11 Depending on the magnitude of physical dependence, symptoms may range from mild to physically dangerous. Symptoms may include irritability, anxiety, agitation, high blood pressure, hot flashes, increased heart rate, seizures and in rarer cases, delirium tremens.11 If you’re experiencing these symptoms along with hot flashes after stopping alcohol use, it may be pointing to a more serious problem such as addiction or an alcohol use disorder (AUD).
Does Physiological Dependence Mean You’re Addicted to Alcohol?
Alcohol dependence in and of itself does not constitute addiction, but dependence is often a sign of addiction. It is the physiological manifestation of regular drinking that occurs as the brain undergoes certain neurochemical adaptations in response to certain levels of alcohol being consistently present.12 As alcohol’s immediate intoxicating effects subside, a person may begin to feel acute withdrawal symptoms as the brain attempts to balance itself chemically (tipping the scales towards more excitatory brain signaling). The onset of withdrawal may, in turn, encourage a person to resume drinking in an attempt to manage the unpleasant symptoms.12 A person battling addiction may not only suffer from significant physical alcohol dependence and repeated bouts of withdrawal, but may also be more likely to struggle with additional social, emotional, and behavioral consequences.
How Do I Know If I have a Drinking Problem?
Alcoholism develops as a person becomes no longer able to stop drinking despite trying to, experiences emotional distress when not drinking, and continues to drink no matter the negative ramifications.13 The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines diagnostic criteria for an alcohol use disorder (AUD), with the diagnosis being made based on individuals meeting two (or more) of the below outlined criteria within the same 12-month period:14
- Cravings for alcohol.
- Multiple attempts to stop drinking without success.
- Withdrawal symptoms when alcohol wears off.
- Drinking more at a time and for longer than intended.
- Spending a lot of time getting alcohol, drinking it, and recovering from its effects.
- Giving up social or recreational activities to drink alcohol instead.
- Drinking interfering with fulfilling school, home, and/or work obligations.
- Continuing to drink despite negative interpersonal and social consequences of doing so.
- Drinking in situations that are potentially dangerous (e.g., driving, using machinery, etc.).
- Developing a tolerance for alcohol that requires more to be consumed in order to feel its effects.
- Knowing that drinking is causing physical and/or psychological issues and drinking anyway.
If you suspect that you or someone you care about has an AUD, it may be time to seek professional help. No matter how serious the problem seems, people can recover from alcoholism. The National Institute of Alcohol Abuse & Alcoholism reports that treatment can be very effective, with research showing that one year after alcohol addiction treatment, about 1/3 of people have no further symptoms of problematic alcohol use while many others are able to substantially reduce their drinking and experience fewer alcohol-related problems.15
Learn More About…
. National Institute on Alcohol Abuse and Alcoholism. (2007). Alcohol Metabolism: An Update.
. Chang, J. S., Hsiao, J. R., & Chen, C. H. (2017). ALDH2 polymorphism and alcohol-related cancers in Asians: a public health perspective. Journal of biomedical science, 24(1), 19.
. Wiley Online Library. (2013). Hypertension Associated with Alcohol Consumption Based on the Facial Flushing Reaction to Drinking.
. MedlinePlus. (2019). Sweating.
. MedlinePlus. (2018). Blood Alcohol Level.
. Kudo R, Yuui K, Kasuda S, Hatake K. (2015). Effect of Alcohol on Vascular Function.
. Lim, Chin & Byrne, Chris & Lee, Jason. (2008). Human Thermoregulation and Measurement of Body Temperature in Exercise and Clinical Settings. Annals of the Academy of Medicine, 37, 347-53.
. U.S. National Library of Medicine. (2005). Effects of alcohol on thermoregulation during mild heat exposure in humans. Alcohol, 36(3), 195-200.
. Renske Penning, Adele McKinney, Joris C. Verster. (2012). Alcohol Hangover Symptoms and Their Contribution to the Overall Hangover Severity. Alcohol and Alcoholism, 47(3), 248–252.
. MedlinePlus. (2019). Alcohol Withdrawal.
. Becker H. C. (2008). Alcohol Dependence, Withdrawal, And Relapse. Alcohol research & health : The Journal of the National Institute on Alcohol Abuse and Alcoholism, 31(4), 348–361.
. National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol Use Disorder.
. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Publishing; 490-491.
. National Institute on Alcohol Abuse and Alcoholism. (2014). Treatment for Alcohol Problems: Finding and Getting Help.