Alcohol consumption, a risk factor for developing eczema?

Up until now, studies have not definitively shown that alcohol is directly responsible for cases of eczema or contributes to "flare-ups" in individuals who already suffer from it. However, some data suggest the existence of a link.

• Alcohol consumption during pregnancy increases the risk of the future baby developing eczema later on: In 2018, a review established a positive link between alcohol consumption during pregnancy and atopic dermatitis in the child. In the study, babies whose biological parents consumed alcohol during pregnancy were more likely to develop atopic dermatitis. This suggests, but does not prove, that there could be a cause-and-effect relationship between alcohol consumption during pregnancy and eczema in children.

• Alcohol can trigger "flare-ups" of eczema: After consuming alcohol, individuals who already suffer from eczema notice that they suddenly have more itching or drier skin. However, this link is not consistent and this "flare-up" after drinking alcohol could be a coincidence or due to multiple factors. A 2013 study considers excessive alcohol consumption as a possible cause of a flare-up of nummular eczema. A 2017 article suggests it is reasonable to think that alcohol consumption could inflame the skin of people with eczema, as there is already an established link between alcohol and psoriasis. A 2021 review also notes that alcohol increases skin inflammation in all individuals, making it possible that alcohol exacerbates existing inflammation in skin affected by eczema.

However, this potential link between alcohol consumption and eczema prevalence is yet to be fully studied, given the lack of clear scientific evidence. The fact that alcohol triggers symptoms may depend on various factors, such as the type of eczema the patient suffers from, the amount of alcohol consumed, and whether or not they suffer from other health problems.

Several mechanisms can explain the potentially harmful effect of alcohol on eczema.

• Stimulating Inflammation: Whether you suffer from a skin condition or not, alcohol can cause inflammation throughout the body, which can exacerbate eczema.

• Boosting blood flow:

• Inducing temporary skin dryness: Alcohol consumption can also affect the skin barrier, a protective layer that retains water and prevents germs and irritants from penetrating. For people with eczema, the skin barrier is already compromised. According to a 2019 research review, alcohol can alter the composition of the skin barrier, leading to a loss of hydration, which can worsen the skin's condition.

• Releasing more histamine: When the liver breaks down alcohol, it converts it into acetaldehyde. This compound promotes the release of histamine in the body, which induces inflammation and causes an increase in itching and redness on the skin. It can also exacerbate eczema.

• Slowing down the rapid healing of wounds: A study published in Alcohol Research suggests that alcohol weakens the ability of dermal fibroblasts to produce connective tissue. This can then slow down the healing of wounds, including cracks caused by eczema, and increase the risk of infection.

If alcoholic beverages trigger eczema symptoms in an individual, that person must take steps to help prolong periods of calm.

• Reducing alcohol consumption: Increasingly, studies are establishing a link between chronic skin conditions and alcohol abuse. A study conducted in 2021 revealed that 23% of people with eczema also suffer from alcohol-related disorders. The rates are similar among people with psoriasis, at 28%. If you consume alcohol, ensure you do so in moderation. Limit your frequency of consumption and the number of drinks you have. If this proves challenging, do not hesitate to discuss it with your doctor.

• Monitoring your alcohol consumption: If you notice that your eczema symptoms worsen when you drink, you can track the progression of your eczema flare-ups. Observe if certain quantities or types of alcohol alter the intensity of your symptoms.

• Monitoring the composition of your drinks: Pay attention to the other ingredients present in your alcoholic beverages. It could be a food allergy, which can also cause skin reactions.

• Undergoing an allergy test: If you believe you are allergic to alcohol or other ingredients contained in a drink, ask your doctor to conduct an allergy test. They will be able to advise you on what you can safely consume and conversely, the ingredients you should avoid.

• Being vigilant about alcohol - medication interaction: Even if alcohol is not the cause of your eczema problems, it can interact with eczema medications or other drug treatments and limit their effectiveness. Ask your doctor if it is safe to combine your medications with alcohol.

• KULTHANAN K. & al. Clinical features and aggravating factors in nummular eczema in Thais. Asian Pacific Journal of Allergy and Immunology (2013).

• DE WIT M. & al. Alcohol use as a risk factor in infections and healing. Alcohol Research (2015).

• NAGATA C. & al. Alcohol intake during pregnancy and offspring's atopic eczema risk. Alcoholism: Clinical and Experimental Research (2016).

• HAMPTON P.J. & al. High prevalence of alcohol use disorders in patients with inflammatory skin diseases. British Journal of Dermatology (2017).

• LIAO W. & al. Dietary modifications in atopic dermatitis: patient-reported outcomes. Journal of Dermatological Treatment (2017).

• THYSSEN J. P. & al. Atopic dermatitis and alcohol use – a meta-analysis and systematic review. Journal of the European Academy of Dermatology & Venereology (2018).

• NORDLIND K. & al. Psoriasis and alcohol. Psoriasis (Auckl) (2019).

• VERSTER J. C. & al. The inflammatory response to alcohol consumption and its role in the pathology of alcohol hangover. Journal of Clinical Medicine (2020).

• HAZARIKA N. & al. Increased prevalence of alcohol use disorder (AUD) in psoriasis and dermatitis (eczema). Skinmed (2021).

• NAKAMURA M. & al. Daily lifestyle and inflammatory skin diseases. International Journal of Molecular Sciences (2021).

• SCHUTTELAAR M. L. A. & al. Lifestyle factors and hand eczema: A systematic review and meta-analysis of observational studies. Contact Dermatitis (2022).