The American Psychiatric Association defines substance abuse as the excessive use of a substance such as drugs or alcohol, that results in significant clinical impairment as well as the loss of ability to function socially, academically, and professionally.1

For many individuals who were otherwise healthy before the substance abuse started, skin-related changes are among the earliest, and most immediately recognizable indication of the development of a substance abuse disorder.2

As such, dermatologists are often the first to notice the pattern of abuse since the signs are external, as opposed to liver, heart, and blood vessel damage, which progress internally, more insidiously and require more thorough medical evaluation to be detected.

Therefore, a better understanding of how skin problems can be manifestations of substance abuse can offer a means of early intervention. Ideally—to circumvent these, and many other health problems from occurring—it is important to prevent a substance abuse disorder from developing in the first place, or to seek treatment for substance abuse as early as possible.

Treatment for chronic skin conditions can be quite difficult. The treatment for skin disorders becomes even more challenging when it is discovered that these health issues are worsened by, or a direct manifestation of substance abuse.

Detection of substance abuse as a factor in skin disorders should, above all, prompt treatment or referral for treatment for the drug or alcohol problem in question.

In the absence of intervening treatment, substance abuse may lead to complications that can become life threatening, dwarfing the significance of any troublesome skin conditions that a patient may have presented with.

Still, the fact that healthy skin can become seriously damaged due to drug and alcohol use remains a concern. The purpose of this guide is to spotlight the various ways that substance abuse can impact skin health and in some cases, give rise to long-term skin disorders.