itchy skin
Skin Disorders

Smoking Is Harmful to Your Skin

Smoking affects nearly every organ in the body and puts your overall health at risk. It damages your heart, your lungs, your bones, even your fertility. What does it do to the largest organ in the body – your skin? Smoking is related to the development of several skin disorders and if you already have a skin condition, smoking will make it worse. And while it is true that everyone’s skin eventually shows the effects of age, smoking accelerates the development of wrinkles, sagging skin, puffiness under the eyes, uneven complexion, and thinning lips. Along with sun exposure, smoking is a primary culprit in premature aging of the skin.

Smoking causes premature aging in two key ways. First, the toxins in cigarette smoke destroy collagen and elastin, the fibrous components of skin that give it strength and elasticity. As these building blocks of the skin become progressively damaged, the skin sags and develops deep wrinkles. The more you smoke, the sooner you’ll see these effects and the longer you smoke, the more pronounced they’ll be. Even exposure to secondhand smoke will cause this damage.

The second essential effect of smoking on the skin is to deprive it of oxygen and nutrients. Smoking causes narrowing of the blood vessels that deliver these elements that are essential to healthy skin. Their lack contributes to uneven complexion, poor skin tone and the development of a wide array of skin conditions. 

Skin cancer: Smokers are at greater risk of developing squamous cell carcinoma, the second most common form of skin cancer. It is thought that tobacco suppresses the immune response that would prevent squamous cells from proliferating on the outermost layer of skin. Squamous cell carcinoma is easily treated when caught early but can metastasize if undetected and can potentially be life-threatening. Smoking is also the primary cause of several types of oral cancer.

 Pigmentation: Smoking increases melanin in the skin leading to dark spots particularly on the face and hands. These spots can be caused by sun exposure but research suggests that smokers are more susceptible to them. Stained fingers and nails are also common in smokers.

Psoriasis: Smoking is a risk factor for this chronic inflammatory condition characterized by itchy, scaly patches, usually on the elbows, knees, scalp, hands, and feet. The culprit may be the nicotine in cigarettes which affects the immune system, inflammation, and skin cell growth, all of which contribute to the development of psoriasis. 

Wound healing: Narrowing of the blood vessels caused by smoking constricts circulation making it harder for even minor cuts and scrapes to heal and contributing to scarring. Patients are advised to stop smoking before a surgical procedure to reduce the risk of impaired healing of an incision in the skin.  

According to the Centers for Disease Control and Prevention, more than 30 million American adults smoke. But more than 50 million Americans have quit smoking. There are many reasons to quit smoking. Any skin condition you have that is related to smoking will be more manageable when you quit and further damage will be avoided. While not all the damage to your skin will be reversible, there are topical retinoids and vitamin C and E creams that can help and cosmetic procedures like laser skin resurfacing and chemical peels can improve the appearance of the outer layers of skin where damage is most visible. You can quit smoking. Ask your doctor which cessation strategy would be best for you.

Suzanne J. Friedler, M.D., F.A.A.D., is a board-certified fellow of the American Academy of Dermatology with expertise in many areas of medical and cosmetic dermatology.

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation with 15 locations in New York and New Jersey, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies.

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