Many people suspect alcohol can accelerate aging, both biologically and physically.

To find out more, Health examined the latest research and spoke to medical experts to find out how alcohol impacts aging—from the health of your skin to cellular health, hormone function, sleep, and chronic disease risk.

Alcohol can lead to dehydration and impaired barrier function. Alcohol is a diuretic, which increases water loss through urine, leaving your skin dehydrated and dull. Chronic dehydration can impair the skin barrier, leading to dryness, flakiness, and increased sensitivity.

“It can also cause people to have a bloated look and retain water, especially in areas like the under eyes,” Anthony M. Rossi, MD, FAAD, FACMS, founder of Dr. Rossi Derm MD Skincare, told Health.

Additionally, alcohol causes skin inflammation, which can lead to inflammatory skin diseases such as psoriasis. Studies have also linked increased alcohol intake to rosacea, a skin condition that causes redness and visible blood vessels on the face.

Alcohol also increases oxidative stress and the production of harmful free radicals, which can break down collagen (the skin’s main structural protein) and lead to loss of elasticity. A breakdown in collagen and elasticity can make the skin saggier over time, and make fine lines and wrinkles more noticeable.

Alcohol may help you fall asleep initially, but it actually disrupts deep and restorative sleep. Not getting enough sleep on a regular basis can lead to accelerated aging, as sleep disturbances have been linked to shortened telomere length. Shortened telomeres are associated with greater cellular aging and a shorter lifespan.

“Alcohol may impair sleep quality, especially rapid eye movement (REM) sleep,” Alison A. Moore, MD, MPH, FACP, AGSF, director at the Sam and Rose Stein Institute for Research on Aging and the Center for Healthy Aging, told Health.

Lack of sleep can also impact your hunger-regulating hormones. Sleep deprivation raises your level of ghrelin (the hormone that makes you feel hungry) and lowers your level of leptin (the hormone that regulates fullness).

Drinking alcohol also increases the production of free radicals and causes chronic inflammation—both are linked to accelerated biological aging and an increased risk of chronic (long-term) diseases over time.

Moore says there is robust data that shows telomeres are shorter among those who drink high amounts of alcohol (more than 17 drinks per week), binge drink (5 or more drinks per occasion), and among those with alcohol use disorder. Telomeres are markers of biological aging, and shorter telomeres are linked to a greater risk of developing chronic diseases such as type 2 diabetes and heart disease.

Heavy drinking can also lead to shifts in hormones such as estrogen, testosterone, and cortisol. Regularly drinking any amount of alcohol will raise levels of estrogen in the body, which increases breast cancer risk. Among men, heavy alcohol intake has been found to reduce testosterone levels. Both heavy drinking and binge drinking can increase levels of cortisol, the body’s main stress hormone.

Over the long term, regularly drinking alcohol (especially in higher amounts) is linked to the earlier onset of age-related cognitive decline, which causes brain functions such as memory and thinking to progressively worsen.

Some studies suggest any amount of alcohol has risks for accelerating aging, while other studies say moderate drinking may have some health benefits–but these findings need further study.

“There is clear scientific consensus that heavy alcohol consumption is harmful,” Tianyuan Lu, PhD, an assistant professor at the Department of Population Health Sciences and Department of Biostatistics and Medical Informatics at the University of Wisconsin-Madison, told Health. “The debate lies in whether any amount of alcohol is truly safe. Some observational studies have linked moderate intake to better health outcomes compared to non-drinkers, but these findings may be influenced by other factors, such as socioeconomic status, access to healthcare, diet, or pre-existing health conditions.”

Alcohol can increase your risk of aging faster, but its overall impact on your health depends on how much and how often you choose to drink.

Heavy alcohol use can disrupt sleep, hormones, and increase your risk of developing chronic diseases. Heavy amounts of alcohol can also affect the appearance of your skin, leading to redness, dryness, and moisture loss.

While any amount of alcohol has been found to be harmful for certain markers of aging, long-term, heavy alcohol use and binge drinking are more likely to age you faster than low-to-moderate doses. Further research is needed to investigate alcohol’s exact effects on aging.