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Skin Changes Due to Drug Abuse

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Long-term drug abuse is known to cause havoc on many body parts, including the skin. Read this article to learn more about various skin changes due to drug abuse.

Medically reviewed by

Dr. Nidhin Varghese

Published At September 26, 2022
Reviewed AtNovember 24, 2023


Drug abuse is associated with severe health problems in the body's essential organs like the skin, liver, kidneys, bladder, and stomach. Skin changes due to drug abuse may be distinctive and easily recognizable. These changes are often drastic and can happen rather quickly. Long-term drug addiction can leave its mark on a drug addict's skin. Abusing drugs over a long period destroys vital nutrients that can cause numerous infections, sores, or inflammation on the skin. Knowledge of the skin manifestations of drug abuse allows for earlier diagnosis and treatment.

What Can Drug Abuse Do to the Skin?

Many illicit drugs, including heroin, cocaine, morphine, and Amphetamines, are injected intravenously. The most common sites for injecting these drugs are the antecubital fossae, arms, and neck.

Drugs may have the following effects on the skin if misused for a long time:

Skin Ulceration

  • Drug users can develop ulcerations, mainly due to intravenous administration.

  • The drugs may cause an effect on the skin directly through an irritant or due to repeated trauma or injury and skin edema that may impede wound healing, leading to skin ulcers.


  • Pruritus may happen in drug abusers, particularly those with cocaine and methamphetamine use.

  • People with pruritus may have the sensation of arthropods crawling on the skin, prompting them to scratch their skin repeatedly, leaving nodules on their extremities.

  • Pruritus is also mainly seen in opioids. Opioids cause histamine release, inducing pruritus, which starts immediately after opioid use and can last up to 24 hours.

  • Long-term methamphetamine users may appear much older than their actual age, have poor dental health, and have acne-like blemishes due to skin pricking referred to as "meth mites."

Skin Infections

  • Skin infections, such as cellulitis, abscesses, and impetigo, are common among drug abusers.

  • The cause of skin infections is multifactorial. They can occur due to unsterile injection of drugs, contamination of drugs with pathogenic organisms, and poor hygiene.

  • The most common organisms causing skin infections are Staphylococcus aureus, including community-acquired methicillin-resistant S. aureus, group A β-hemolytic streptococcus, and other streptococci.

  • Necrotizing fasciitis, a rare infection of the subcutaneous tissues, may also be seen in intravenous drug users. It occurs after a subcutaneous infection, resulting in skin necrosis. It clinically manifests as blisters, fever, fatigue, and pain.

Hypersensitivity Reactions

  • Leukocytoclastic vasculitis is also associated with injection with opioids.

  • Urticaria has also been reported in some drug addicts.

  • Other rare skin reactions include angioedema, a serum-sickness-like reaction due to amphetamine abuse, and fixed drug eruption with heroin use.

Other Skin Infections

  • Skin infections like septic thrombosis, bacteremia, and endocarditis can also occur in drug abusers.

  • The endocarditis may present with cutaneous lesions, including Janeway lesions (painless, small, hemorrhagic spots on the palms or soles) or Osler nodes (painful, red, raised lesions on hands and feet).

  • Intravenous drug users are also at particular risk of having hepatitis B, C, D, human immunodeficiency virus (HIV) 1 and 2, and other bloodborne pathogens due to sharing needles.

  • Drug addicts are also at greater risk for sexually transmitted diseases because drug substances alter judgment, leading to high-risk sexual behavior.

  • Abuse of other drugs, including marijuana, gamma-hydroxybutyrate, and methylenedioxymethamphetamine, increases the risk of bloodborne infections because of diminished sexual inhibition and high-risk sexual behavior.

Rapid Aging

  • Drugs like methamphetamine can make a drug abuser's face leathery and old.

  • Long-term use of this drug negatively impacts the body's blood flow and damages blood vessels, preventing the skin from getting proper blood circulation to stay youthful and healthy.

  • Without proper circulation, the skin begins to break down at a cellular level and can look yellow, gray, brown, or even black, giving the skin a dull, petrified look.

  • Many people who use methamphetamines for an extended period can look twenty years older than they are. They will have deep wrinkles and lines on their face because the drug does the bodywork over time and breaks down collagen.

Oral Changes

  • Drug abuse may also affect oral health. For example, prolonged abuse of methamphetamine causes severe tooth decay, a condition called "meth mouth."

  • People abusing drugs can also experience xerostomia (dry mouth), bruxism (excessive teeth-grinding), and muscle trismus (reduced opening of the jaws).

  • Dental caries also develop cocaine and narcotic abusers, but the pattern of caries is different from that of methamphetamine.

How to Avoid Skin Problems With Drugs?

Drug abuse inhibits the ability of drug abusers to make good choices. But, it is possible to make an effort.

Certain useful steps may avoid skin problems with drugs: These include:

  • The first step to reverse or lessen the impact of drugs on the skin is to avoid abusing them.

  • Cosmetic support may result in minor changes.

  • Rehabilitation services will help drug abusers quit drugs for good, allowing them to make fundamental changes.

  • Seeking the advice of a dermatologist is beneficial. The dermatologist may prescribe medications to help with rehabilitation.

  • Drugs have various effects on drug abusers' skin, but some of these effects can naturally fade once they become sober.

  • A consistent skincare routine is required to see results but may not reverse the effects in some situations.

  • To help relieve "meth mouth," drinking plenty of water and avoiding caffeine, tobacco, and alcoholic beverages can help as water flushes toxins from the body and reduces the chances of bacterial infections.


Drug abuse is associated with many skin manifestations, such as skin ulcerations, pruritis, infections, and rapid aging. In addition, long-term drug abuse marks the abuser's skin and affects mental and emotional well-being. Thus, it is essential to be aware of skin problems due to drug abuse for earlier intervention and treatment. While it is nearly impossible to reverse these skin changes, there are a few ways to take care of the skin and prevent further damage. A consistent skin routine can show substantial results over time. But, the best way to prevent drug-related skin problems is not to use drugs.

Frequently Asked Questions


What Drugs Are Known to Cause Skin Issues?

Any drug has the potential to cause a rash, but some are known to be more prone to doing so. These include nonsteroidal anti-inflammatory drugs (NSAIDs), anti seizure medications, and antibiotics (particularly penicillins and sulfa drugs). An allergic reaction to the drug brings on most drug rashes, but some are not.


What Are the Effects of Drug Abuse?

People who struggle with addiction frequently experience one or more coexisting medical conditions, such as lung or heart disease, cancer, stroke, or mental health issues. Blood tests, chest X-rays, and imaging scans can all reveal the detrimental effects of chronic drug use throughout the body. Among the behavioral effects of drugs are paranoia, aggression, hallucinations, addiction, impaired judgment, impulsivity, and loss of self-control.


What Drugs Cause Pigmentation on the Skin?

Drug-induced pigmentation is a complex issue for patients who take certain medications. Nonsteroidal anti-inflammatory drugs, Amiodarone, cytotoxic drugs, antimalarials, heavy metals, Tetracyclines, and psychotropic drugs are the main substances linked to the development of skin pigmentation. Once the offending drug has been stopped, the pigmentation usually starts to fade. The pigmentation, however, might persist for a very long time or turn permanent.


Can Drugs Cause Acne?

Corticosteroids, anticonvulsants, barbiturates, lithium, DHEA (dehydroepiandrosterone), androgenic steroids, and drugs containing bromides or iodides are some of the medications that can result in true acne or acne-like eruptions. Acne or acneiform eruptions disappear once the offending drug is discontinued.


How Does a Drug Rash Appear?

The severity of drug rashes ranges from mild redness with small bumps over a small area to complete skin peeling. A drug rash can appear immediately after a new medication or may take hours, days, or even weeks to develop. Discoloration brought on by rashes may be red, purple, blue, or gray.


Can Drugs Cause Ulceration of the Skin?

Abusing a wide variety of drugs over time can result in several infections, inflammation, sores, or even skin rot. Drug users may experience ulcerations, mostly as a result of intravenous administration. In addition, the drugs may directly affect the skin by acting as an irritant or indirectly through repeated trauma or injury, resulting in skin edema, which can impede wound healing and result in skin ulcers.


What Is the Other Name For Skin Ulcers?

Skin ulcers are mainly formed due to stress in the blood circulation and are often known as decubitus ulcers or bedsores. These skin ulcers are usually pus filled due to infection, as they are open sores. Therefore, they require a good flow of blood in the area for proper wound healing.


What Is the Treatment For Ulcerated Skin?

Ulcerated skin can be treated and protected with dressing to keep the wound clean, prevent infection, and promote skin healing at the site. In addition, antibiotics (ointments or oral medicines) can be given to a person with infected ulcers. Also, if the sore develops a larger size, a skin graft is advised by the doctor only in cases of infected ulcers.


What Are the Various Types of Ulcers?

 - Venous Ulcers - They develop due to poor blood flow in the lower limbs and are also called leg ulcers.
 - Arterial Ulcers - These ulcers develop in the affected area where the blood supply is inadequate, and can be acute, chronic, or recurrent.
 - Genital Ulcers - These ulcers usually develop in genital areas or anal regions, and can be painless or painful.
 - Mouth Ulcers - These ulcers develop in the lining of the soft tissues of the mouth, such as the inner cheek, gums, palate, tongue, and lips.
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Dr. Nidhin Varghese
Dr. Nidhin Varghese



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