I'm a skin expert and I can tell if you drink or smoke just by looking at your face. Here's the good (and bad) news about how you can reverse the damage

By CARINA STATHIS, SENIOR FEATURES WRITER, AUSTRALIA

Updated: 08:14 EDT, 9 December 2025

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We all know the feeling of waking up with a pounding headache and queasy tummy after a big night out.

But most people don't think about the long-term impact alcohol and cigarettes have on your appearance.

If you drink or smoke often, the signs become more obvious. The puffy eyes, the flushed cheeks, and the dullness that no amount of moisturiser can fix leave a trail across your skin that can be hard to hide - especially as you get older.

While one night out can leave you looking a little swollen or sleep-deprived, this fades within a day or so. However, years of regular drinking or smoking can alter the complexion altogether, adding broken capillaries and premature lines to the mix.

And yet, to the untrained eye, the signs of alcohol and nicotine-fuelled wear and tear can easily be mistaken for stress, ageing or dehydration.

Sydney skin expert and nutritionist Fiona Tuck, on the other hand, can tell immediately how much a person drinks and smokes, simply by looking at their face - and she has both good and bad news about how you can reverse the damage.

'Alcohol is a diuretic, meaning it makes the body lose fluids and nutrients. In response, the body can retain water, leading to temporary swelling in the face and other areas,' Fiona told the Daily Mail.

'Smoking, on the other hand, depletes nutrients – particularly vitamin C and antioxidants – which adversely affects collagen and elastin.'

Skin expert and nutritionist Fiona Tuck (pictured) has revealed the direct impacts that smoking and drinking have on your appearance, the red flags to be aware of, and whether the results are reversible

ALCOHOL

Fiona said key indicators of frequent drinking include puffiness, pigmentation or brown spots, dilated capillaries and dullness.

Other tell-tale signs include sallow, dull skin, redness or congestion around the nose and cheeks, and a loss of collagen that results in fine lines and wrinkles.

'Alcohol is also a toxin and is inflammatory to the body. Chronic alcohol consumption can lead to systemic inflammation causing inflammaging (chronic, low-grade, inflammation) or premature ageing,' she said.

'Chronic alcohol abuse can also damage the liver, impairing its ability to filter waste products and toxins from the body. This build-up of toxins can contribute to fluid retention, excess free radical damage, pigmentation and premature ageing,' Fiona added.

'Not only that, but alcohol relaxes and widens blood vessels, which can lead to temporary redness and flushing in the face. Over time, the vessels can weaken and may become more prominent.'

If someone is a heavy drinker - a few drinks a day - or a weekend binge drinker, the most frequently seen side effect is puffiness in the face.

'Weight gain or thickness around the mid-section of the torso can also occur. Long-term redness and pigmentation can occur often due to nutrient and B vitamin depletion,' she added.

SMOKING AND VAPING

Research conducted by the National Library of Medicine shows that consuming one drink per day is the equivalent to smoking 0.4 cigarettes.

'Both smoking and alcohol will deplete the body of important nutrients and increase toxins in the body,' Fiona said.

'Premature ageing due to a loss of collagen and elastin and cell damage, and pigmentation due to increased oxidation and lack of antioxidants, are the more long-term side effects associated with heavy drinking and smoking. The skin takes on a dull, lacklustre appearance.'

In recent years, vaping has skyrocketed in popularity as an alternative to cigarettes.

Fiona warns that vaping has not been around long enough to understand the full potential of its detrimental effects on our health and skin.

'Nicotine and toxic chemicals in the vape will undoubtedly, over time, have a negative impact on our health,' she said.

'Nicotine can constrict blood capillaries, reducing nutrient uptake and impeding skin healing. This leaves the skin looking dull and often congested due to an impaired circulatory and lymphatic system.

'Redness and inflammation and even skin issues such as dermatitis may occur due to the chemicals, such as propylene glycol, found in the vape.'

Case study: A long-term binge drinker and 'casual' smoker

Sarah Rusbatch has been sober since April 2019 after years of binge drinking.

Alcohol was once a fun, social activity for Sarah that transitioned into something she did at home - and with that came an increase in anxiety and mental health issues.

She was a casual smoker too, only smoking cigarettes after a few drinks.

It wasn't until an incident at a party in 2017 that Sarah started questioning her habits.

'I got really drunk at a friend's 40th birthday party, went outside for a cigarette and crouched forward in my heels to stub out the butt,' she previously told Daily Mail.

But she lost her balance tipping forward and landed face-first into the concrete, bruising her face and splitting her lip open.

Sarah Rusbatch, formerly a casual smoker and binge drinker, is pictured above. While drinking and smoking, her skin was dull and puffy, and she had spots along her jaw linked to poor liver function (as seen in the photo on the left; she is pictured more recently on the right)

'I didn't drink to just enjoy one drink. I often drank to get drunk,' says Sarah, who has been sober since April 2019

The truth about alcohol and what just one drink REALLY does to your body: DR BRAD McKAY

'The next day, I looked like someone had beaten me up. I felt so ashamed,' she said, adding she then had to attend her daughter's dance concert with a bruised face.

'I was so embarrassed... that's when I decided I can't do this anymore.'

It was the start of a new chapter for Sarah - and after a few extended stints of not drinking, she decided to quit alcohol for good.

When she did drink after a period of abstinence, she noticed she felt sluggish and that her face looked puffy and dry.

'My skin was dull and I often had spots along the jaw linked to poor liver function. My hair was thinning and my eyes were often dull,' Sarah told Daily Mail.

'I was bloated, especially around the tummy and face. No matter what I did at the gym, or what diet I followed, I struggled to keep weight off.

'Within a couple of weeks of quitting, I noticed my eyes were getting brighter and after a month, my skin started to look healthier and younger. The bloating reduced and people started asking what was different about me.'

She also noticed a change when she stopped smoking: her skin became much brighter and lines around her mouth seemed to reduce.

In Australia, one standard drink contains 10g of pure alcohol and the number of drinks in one serving depends on the volume and type of drink. For example, one glass of wine (150ml) usually contains 1.6 standard drinks

Today, she feels like a completely different person - one who is happy, energised and motivated.

Sarah turns 50 next year and believes that she looks better now than she did at 40.

'I feel like I'm ageing backwards. I've lost 8kg [17.5lbs] and feel strong and fit. I sleep well and find it easier to maintain my weight and eat well,' she said.

'When I stopped smoking, I felt healthier and fitter, had more lung capacity when exercising, and I found new tools to manage stress without reaching for wine and cigarettes.'

Case study: Two bottles of wine a night and chain smoking

Over the years, Heidi Anderson has had a complex relationship with alcohol.

She partied nearly every weekend in her 20s, then later, during her commercial radio career, would drink two bottles of wine a night.

To the outside world, she was a funny, bubbly blonde who radiated confidence - yet she was using alcohol to quiet anxiety and dark thoughts.

Like Sarah, Heidi also smoked when she drank. In addition to the booze weight, her skin also suffered due to the alcohol and nicotine.

'I was always puffy. When my friends and I travelled through Europe, they were losing weight and living their best lives and I just kept getting puffier and puffier,' Heidi, 41, told the Daily Mail.

While living in London in her 20s, Heidi Anderson was a drinker and smoker. She had constant gum infections, swollen and bleeding gums, and her skin looked old beyond her years

'I was always puffy. When my friends and I travelled through Europe, they were losing weight and living their best lives and I just kept getting puffier and puffier,' Heidi, 41, told the Daily Mail. These days, she has a drink on occasion, but not often

'I've always experienced really intense anxiety after drinking. The next day, I'd wake up questioning everything I'd said, feeling full of shame and physically wrecked.

'I had no energy at all while everyone else would be going out for lunch or exploring. I'd be completely wiped out.

'There were many times after big nights where I would literally spend a day or two in bed, locked away in a dark room, unable to function. It wasn't just a hangover - it was like my nervous system shut down.'

Smoking also drastically changed her appearance. Heidi had constant gum infections, swollen and bleeding gums, and her skin always looked older.

'Since I quit, my teeth have never been better - and giving up fluoride toothpaste was a game-changer, too.'

Can you reverse the damage of smoking or drinking?

Research suggests the damage caused by smoking and drinking can be reversed - but only to a certain extent.

'The body is designed for regeneration and repair. Age and genetics can also play a role in how well the repair process occurs,' Fiona said.

'Chronic abuse or overloading the body with more toxins than it can cope with, - especially if it is not supported by a healthy lifestyle, such as rest and good nutrition - can result in long-term damage.'

After your final drop of alcohol or puff of a cigarette, your body will automatically start to repair the damage caused - but this can take time, and there are limits.

'The cilia in your lungs - protective hair-like structures - start to recover and regrow within days of quitting smoking,' Fiona said.

'A cough may occur at first as the lungs begin to clear out built-up mucus – a sign of healing. Significant improvements in lung function and mucus clearance appear within one to three months, though full restoration of their cleaning ability can take up to 12 months.'

As the body recovers from substance use, this is usually reflected in the face, with improvements seen after one to three months. The skin can look clearer, brighter and less sallow.

Research also shows mild to moderate liver damage from drinking can improve if drinking stops, but severe damage - especially cirrhosis and significant scarring - is largely irreversible.

While the liver is quite resilient and can recover to a certain degree, it will never fully return to its previous state if you drink regularly and heavily. Once you go past a certain point, it's hard to go back.

'The liver is designed to detoxify and it is a regenerative organ, so it can cope with a certain amount of toxins. However, chronic, heavy alcohol consumption and/or a poor diet can take its toll,' Fiona said.

'You can support the liver detoxification pathways with a nutrient-rich diet, plenty of leafy greens and cruciferous vegetables, and adequate water intake, while minimising ultra-processed foods, alcohol, and foods high in saturated fat and sugar.'

Beyond quitting smoking or drinking, adopting a targeted skincare routine can help to restore your complexion. Experts recommend using sunscreen daily to protect against further damage, applying moisturisers to support the skin's barrier, and considering products with retinoids or antioxidants to encourage regeneration.

Staying hydrated, eating a nutrient-rich diet focused on leafy greens and healthy fats, and getting adequate sleep are crucial habits that help your skin - and body - repair effectively after years of drinking and smoking.