What Does Smoking Do to Your Skin?

Smoking: What’s bad for our insides is also bad for our outsides. New studies have linked smoking to a variety of skin problems and ailments, including premature aging. It’s ironic that many people begin smoking to fit in or look cool; years later, they may look older and decidedly uncool as smoking takes a toll on their looks.


In 1964, the U.S. Surgeon General issued a report warning Americans that cigarette smoking increased the risk of lung cancer, emphysema, chronic bronchitis and heart disease. In the years since then, we’ve gained a fuller understanding of the many negative health effects of smoking. In addition, it has become clear that smoking has bad cosmetic effects. People who smoke tend to have more wrinkles and other signs of aging skin than nonsmokers. They may also be more susceptible than nonsmokers to certain skin diseases.


Back in the mid-1980s, a British doctor who said he could tell which patients smoked just by looking at them used the term “smoker’s face” to describe the changes he saw in people with a long history of cigarette use. He noted that many smokers have wrinkles shooting out at a 90-degree angle from their upper and lower lips and/or the outside corner of each eye. In many smokers, the bones of the face appear to be more prominent than in other people, giving their faces a too-skinny, sickly kind of look. Sometimes the skin has a gray cast to it. Other colors not typically seen on the faces of nonsmokers may be noticeable, like orange and reddish-purple. Even swelling around the pigmented portion of the eye has been attributed to smoking. People who smoke a lot may get yellow stains on their fingers that are caused by the burning components of cigarettes. Certain kinds of psoriasis have also been tied to smoking, and even second-hand (passive) smoking has been associated with psoriasis.


The ultimate negative effect of smoking on skin is the development of certain kinds of cancer. For example, all cancers that are related to smoking, including lung cancer, can spread to the skin. People who smoke cigarettes and pipes are more susceptible to cancer of the lip than nonsmokers. In this situation, the cancer itself is disfiguring, as is the surgery.


How could smoking directly affect the skin? It’s possible that some of the wrinkles are caused by the way smokers purse their lips when they inhale. But people who smoke are susceptible to vascular (blood-vessel) problems, and scientists say that a more important cause of facial wrinkles is probably diminished blood flow and oxygen delivery to the skin. Smoking also dries the skin. Dry skin always looks worse than well-hydrated, properly moisturized skin. Smoking may also accelerate the normal loss of bone that occurs with aging. If bone loss occurs in the face, it could account for that bony look smokers often develop in their faces.


Could the wrinkles attributed to smoking actually be caused by genetics instead of smoking? After all, wrinkled skin can run in families. A study of twins published in 2007 suggests that smoking, not genetics, accounts for facial wrinkles. These investigators studied sets of identical twins in which one twin had a history of smoking about a pack a week. The other twin did not smoke. Both twins had about equal sun exposure. The twin who smoked had older-looking skin, with more wrinkles, loose skin and unusual coloring. The American Academy of Dermatology says that people who smoke 10 or more cigarettes a day for 10 or more years are more likely than nonsmokers to get “smoker’s face."

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