Eczema, or dermatitis, is a skin condition that causes itchy, dry, and cracked skin. Alcohol may worsen eczema by increasing inflammation, altering the immune response, or slowing skin healing.

Evidence indicates that alcohol consumption in pregnancy increases the risk of a baby later developing eczema. However, scientists are still learning about the potential link.

Whether alcohol triggers symptoms may depend on various factors, such as the type of eczema a person has, how much they drink, and whether they have any other health conditions. Applying alcohol to the skin can also cause irritation and dryness.

Read on to learn more about alcohol and eczema.

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Researchers are still learning about the role alcohol may play in the development of eczema. So far, studies have not conclusively shown that alcohol directly causes new cases of eczema.

However, some data do suggest a link. A 2018 systematic review and meta-analysis found a positive association between alcohol use during pregnancy and atopic dermatitis (AD) in children. AD is a type of eczema.

In the review, babies whose birth parents drank alcohol during pregnancy were more likely to develop AD. This suggests, but does not prove, that there may be a causal link between alcohol use in pregnancy and eczema in offspring.

Whether alcohol consumption causes eczema to develop in adolescents and adults is less clear. The same 2018 review found no consistent association between increased alcohol intake and eczema in older age groups.

For people who already have eczema, alcohol consumption may trigger symptoms. People may find that they suddenly develop more itchiness or dry skin after they drink alcohol. Some refer to this as a “flare” or “flare-up”.

Sometimes, a flare-up after drinking alcohol is a coincidence or occurs due to multiple factors. However, a 2017 article says it is reasonable to suppose that drinking alcohol inflames the skin in people with eczema because there is already an established link between alcohol and psoriasis, which is another inflammatory skin condition.

A 2021 review also notes that alcohol increases skin inflammation in all people, making it possible that alcohol would worsen the existing inflammation in skin affected by eczema.

A number of mechanisms may explain alcohol’s potentially harmful effect on eczema.

Inflammation

Inflammation is part of the body’s natural response to injury or infection. It can help with healing. However, in inflammatory diseases such as AD, this process becomes chronic and drives symptoms.

Alcohol also triggers an inflammatory response in the body, which may exacerbate eczema.

Histamine

When the body breaks down alcohol, it converts it into acetaldehyde. This compound enhances the release of histamine in the body. Histamine is a chemical the body releases during allergic reactions. This leads to itching, hives, and skin flushing. It may also worsen eczema.

To metabolize histamine, the body uses a chemical known as DAO. Previous research has shown that many people with AD also have a DAO deficiency. The prevalence of DAO deficiency ranges from 19–57%, depending on the study.

Having less DAO means the body cannot break down histamine as effectively, so when the body releases it, it stays in the blood for longer and causes more symptoms.

Skin healing

An older study in Alcohol Research notes that alcohol weakens the ability of skin cells, known as dermal fibroblasts, to make connective tissue. This can slow the healing of wounds, including cracked skin due to eczema.

Alcohol is an ingredient in some personal care products, such as hand sanitizer. Keeping hands clean is important for disease prevention, but it may cause issues for people with eczema.

Alcohol can dry the skin because it is an astringent, which is a substance that draws moisture out of tissues. As people with eczema already have dry skin, using topical alcohol could make it drier.

A 2021 systematic review explored the use of alcohol-based hand sanitizers on the skin. The results showed that a type of alcohol known as n-propanol had a low potential to cause irritation on its own.

However, repeated exposure to 60% n-propanol in people with and without atopic skin conditions caused significant damage to the skin barrier. The damage was worse when the scientists applied n-propoanol along with other irritants, such as sodium lauryl sulfate, which is a common ingredient in many soaps and shampoos.

To tell if alcohol might be a trigger for eczema symptoms, a person can try avoiding alcohol in food or drink for a sustained period of time and then reintroducing it.

When reintroducing alcohol, a person should choose an average day when they do not plan to try anything new, such as eating new food or visiting a new place. This will help reduce the chance of something else triggering symptoms.

This is not a perfect test to determine if alcohol is an eczema trigger, as there are many other factors that could contribute, but it may help people who have a clear and obvious reaction to it.

Another strategy could be to keep a symptom diary, tracking any potential triggers that may have contributed to a flare-up. Over time, a person may identify patterns.

If topical alcohol or alcoholic drinks are triggering a person’s eczema symptoms, they should take steps to avoid it.

Reducing or stopping alcohol consumption

If a person wishes to stop drinking alcohol or reduce their intake, they may consider the following:

  • removing alcoholic drinks or foods from the home
  • setting a goal with a specific and achievable aim, such as drinking only one alcoholic drink per week
  • keeping track of drinking via an app or journal
  • telling friends, family, and coworkers about the decision and asking for their support
  • setting boundaries, such as politely refusing drinks from others

Avoiding alcohol in skin products

A person should also read ingredient labels on topical products before buying them. Companies may list alcohol under various names, including:

  • ethyl alcohol
  • ethanol
  • isopropyl alcohol

Manufacturers may treat alcohol in personal care products with a denaturant to stop people from drinking it. Types of specially denatured (SD) alcohols that appear on product labels include:

  • SD alcohol 23-A
  • SD alcohol 40
  • SD alcohol 40-B

“Alcohol denat.” also appears on some product labels to indicate that it contains denatured alcohol. If a product contains any of the above, it is best to avoid it.

It is worth noting that not all ingredients containing the word “alcohol” on ingredient labels are astringent or drying. The Food and Drug Administration (FDA) permits “alcohol-free” cosmetic products to contain fatty alcohols, as they have a different effect on the skin than regular alcohol. Some examples of fatty alcohols include:

Unless a person is sensitive to these ingredients, they do not need to avoid them.

Anyone who is having difficulty managing their eczema can get help from a primary care doctor or dermatologist. It is also important to seek medical advice if the skin shows signs of infection or has any unusual symptoms, such as:

  • pus or discharge
  • swelling
  • circular or ring-shaped rashes — this could be ringworm
  • persistent bleeding
  • cracks or lesions that do not heal
  • unusual growths
  • unusual changes in skin color
  • a rash that does not respond to eczema treatments

Eczema and alcohol misuse

Research has found high rates of alcohol misuse among people with eczema. Alcohol misuse is when a person drinks excessively.

A 2021 study found that 23% of people with eczema also have alcohol use disorder. The rates are similar among those with psoriasis, at 28%.

Eczema can affect mental health as well as the skin. Reducing alcohol intake may benefit both. If a person is finding it hard to reduce their drinking, they may need support in quitting. They can speak with a doctor or mental health professional for information on treatment.

Seeking help for addiction may seem daunting or even scary, but several organizations can provide support. If you believe that you or someone close to you is struggling with addiction, you can contact the following organizations for immediate help and advice:

Alcohol may contribute to both new cases of eczema and flare-ups for people who already have the condition. However, research on this is still ongoing.

Alcohol may trigger inflammation, raise histamine levels, or prevent the skin from healing quickly if it cracks. Applying products that contain alcohol to the skin can also cause dryness and irritation.

If a person suspects alcohol may be contributing to their eczema symptoms, they can try reducing their use. If this proves difficult or a person would like professional guidance, they can speak with a doctor.