Skin Changes Due to Drug Abuse

Introduction

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

• 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.

Conclusion

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.