Addiction and Skin Lesions

Published: February 2026 | Last Updated: February 2026 | Reading Time: 7 min

How Addiction Damages the Skin

The skin is the body's largest organ and one of the most visible indicators of substance abuse. Drug and alcohol addiction damages the skin through multiple pathways: direct chemical toxicity, injection-site trauma, compulsive picking behavior, nutritional deficiency, immune suppression, poor hygiene, and impaired wound healing. Understanding these skin manifestations helps with early recognition of substance abuse and motivates treatment-seeking.

Substance-Specific Skin Effects

Methamphetamine — Meth Sores

Methamphetamine causes some of the most recognizable skin damage. "Meth sores" result from formication (the sensation of insects crawling on or under the skin) leading to compulsive picking and scratching, severe dehydration and dry skin, constricted blood vessels reducing skin healing, immune system suppression, poor nutrition and hygiene during binges, and contaminated drug supply causing chemical burns.

Meth sores typically appear on the face, arms, and chest — areas easily reached during picking episodes. They may range from small, red excoriations to large, open wounds prone to infection.

Injection Drug Use — Track Marks and Abscesses

Intravenous drug use causes distinctive skin damage including track marks (scarred veins), abscesses (localized bacterial infections from non-sterile injection), cellulitis (spreading skin infection), and skin popping scars (from subcutaneous injection). Repeated injection into the same veins causes scarring and vein collapse, leading users to inject in increasingly dangerous locations including the neck, groin, and feet.

Heroin and Opioids

Beyond injection-related damage, opioids cause intense itching (especially histamine-releasing opioids like morphine and heroin), which leads to scratching and skin breakdown. Opioid-related immune suppression slows wound healing and increases infection risk.

Cocaine

Cocaine can cause skin necrosis (tissue death), particularly when cut with levamisole, a veterinary deworming agent found in an estimated 70% of cocaine supply. Levamisole causes vasculitis — inflammation and destruction of blood vessels — leading to painful, purplish skin lesions that can become necrotic. Cocaine also causes vasoconstriction that can damage skin, particularly in the nose with chronic snorting.

Alcohol

Chronic alcohol use manifests through spider angiomas (red, spider-like blood vessels on the face and chest), jaundice (yellowing of skin from liver damage), palmar erythema (reddened palms), rhinophyma (enlarged, reddened nose), and worsening of inflammatory skin conditions like psoriasis, eczema, and rosacea.

Krokodil (Desomorphine)

Krokodil causes the most extreme skin damage of any commonly abused substance. Homemade from codeine using toxic chemicals including gasoline and phosphorus, it causes severe tissue necrosis (death) at injection sites, gangrene requiring amputation, and exposed bone and muscle beneath destroyed skin.

When Skin Problems Indicate Addiction

Patterns to Recognize

• Sores or lesions in typical picking areas (face, arms, chest) with no medical explanation
• Track marks or scarring along veins
• Abscesses or recurring skin infections
• Rapid deterioration in skin quality and overall appearance
• Skin changes accompanied by behavioral signs of substance use

Treatment and Recovery

Skin Healing in Recovery

The good news is that many substance-related skin problems begin improving once sobriety is achieved. Immune function recovers, nutrition improves, hygiene is restored, and the body's healing mechanisms resume normal function. Mild to moderate skin damage often resolves within weeks to months.

Medical Treatment

Active skin infections require medical treatment including antibiotics, wound care, and possibly surgical drainage of abscesses. Dermatological care can address scarring and persistent skin conditions.

Addressing Picking Behavior

For individuals with substance-induced picking (excoriation), behavioral therapy techniques including habit reversal training can help stop the behavior even as chemical triggers subside with sobriety.

FAQ

Will meth sores go away after quitting? Many meth sores heal within weeks to months of achieving sobriety as the body's healing mechanisms normalize. However, deep scarring may be permanent. Dermatological treatment can help minimize scarring.

Can skin damage from drugs be permanent? Mild to moderate damage typically heals. Severe damage — deep scarring, tissue necrosis, or gangrene — may result in permanent changes or require surgical intervention. The earlier substance use stops, the better the outcome.

Do all injection drug users get skin infections? Not all, but the risk is very high. Non-sterile injection technique, contaminated drugs, and immune suppression make skin infections one of the most common medical complications of injection drug use.

References

• Hendrickson, R. G., & McKeown, N. J. (2012). Is maternal opioid use hazardous to breast-fed infants? Clinical Toxicology, 50(1), 1-14.
• Tran, H., et al. (2018). Cutaneous effects of commonly abused drugs. International Journal of Dermatology, 57(10), 1125-1132.
• Smith, M. E., et al. (2015). Skin and soft tissue infections in injection drug users. Current Infectious Disease Reports, 17(12), 47.

Written by the Valley Spring Recovery Center Editorial Team

Ready to take the first step toward recovery? Contact Valley Spring Recovery Center today at (201) 781-8812 or reach out to our admissions team for a confidential consultation.