How Smoking Affects Your Face and Skin

Early Aging and Premature Wrinkles

The toxins in cigarette smoke damage collagen and elastin, the fibrous components of your skin that keep it firm and supple. Without them, your skin can become hardened and less elastic, leading to deeper wrinkles and premature aging.

Smoking contributes to the production of metalloproteinase (MMPs), an enzyme that breaks down collagen. Collagen is a protein that is vital to skin elasticity and smoothness. When collagen is impaired, skin tends to sag.

These wrinkles are usually the most noticeable on your face—between the eyebrows, around the eyes, and around the mouth and lips. Smoking can also cause sagging skin, particularly under the eyes and around the jawline.

Smoking also causes premature aging because it narrows the blood vessels (limiting the amount of oxygen your skin gets), increases the production of free radicals, and lowers levels of vitamin A in the skin.

You may also develop vertical wrinkles around the mouth that come from pursing your lips around a cigarette.

Skin Pigmentation

Smoking increases melanin in the skin, which could lead to dark spots, especially on the face. Repeatedly holding cigarettes between the same fingers can lead to a yellowing of some skin tones from nicotine and other toxins in cigarettes (commonly referred to as tar).

Research shows that people with tar-stained fingers from smoking are more likely to have smoking-related illnesses.

Wound Healing

Smoking causes vascular constriction, which impairs the body's ability to circulate blood and makes it harder for you to heal from wounds.

Even minor cuts and scrapes might take longer to heal properly when you smoke cigarettes. If you smoke, you might be more likely to develop scarring from these minor injuries as well.

The World Health Organization (WHO) states that smoking greatly increases the risk of complications following surgery. In a joint study with the World Federation of Societies of Anaesthesiologists (WFSA), they found that every tobacco-free week after four weeks of smoking abstinence improved health incomes by nearly 20%. They attribute such improvements to improvements in blood flow to essential organs throughout the body.

Psoriasis

Psoriasis is a chronic inflammatory skin condition that produces itchy and scaly patches. It can appear on places throughout the body, including the ears, scalp, hands, nails, and feet.

In dark skin tones, psoriasis may appear violet or dark brown with gray scales. In light skin tones, it may appear red or pink with silvery scales.

Smoking is a risk factor for developing psoriasis. One study found that the more often people smoked, the higher their risk was for developing psoriasis.

People who smoke are also more prone to developing palmoplantar pustulosis, a condition in which painful blisters form on the hands and feet. Like psoriasis, it is a recurrent inflammatory disorder.

Acne Inversa

Hidradenitis suppurativa (HS), more commonly known as acne inversa, is a relatively common inflammatory skin disease where lesions develop in areas of the body where skin rubs against skin, like the armpits, groin, and under the breasts.

Current smokers are also more likely to have more areas of the body affected by HS than people who have never smoked or who have stopped smoking. Quitting smoking may help reduce the severity of the condition and make treatments more effective.

Vasculitis

Vasculitis is a group of autoimmune diseases where blood vessels become narrowed and inflamed, making it harder for the body to deliver blood to the heart and other organs.

Researchers find that smoking puts you at a much higher risk for a type of vasculitis called Buerger's disease.

Buerger's disease symptoms may include:

• Pale, red, or bluish fingers or toes
• Painful sores on the fingers or toes
• Tissue damage or gangrene (tissue decay)

You may also experience cold hands or feet and/or pain in the hands, feet, ankles, or legs.

Unfortunately, there is no cure for Buerger's disease, but it may be managed with medication or surgery.

Palmar Telangiectasia

Telangiectasia (also called "spider veins") is a condition in which small blood vessels in the body widen or dilate, causing damage to capillary walls. It's most noticeable when close to the surface of the skin, where you might see permanent purple blotches or traces of veins.

Palmar telangiectasia specifically occurs on the palms of the hand, and it has been associated with smoking. Since the nicotine in tobacco constricts blood vessels, smoking can lead to this condition.

Eczema

Smoking is also a risk factor for atopic dermatitis (the most common form of eczema) as well as hand eczema. Eczema forms as dry, itchy patches of skin. It appears red in light skin tones and brown in dark skin tones.

People exposed to secondhand smoke also face a greater risk of developing hand eczema. One study found that children exposed to secondhand smoke had a greater risk of developing atopic skin conditions like eczema as adolescents.

Research has also found that smoking is associated with an increased risk for contact dermatitis, a common inflammatory skin condition.

Skin Cancer

Cigarette smoke contains carcinogens, which are cancer-causing substances. If you smoke, you are at a greater risk of developing squamous cell carcinoma, a type of skin cancer.

Tobacco use is the most common risk factor for oral squamous cell carcinoma, a type of oral cancer.

Be sure to reach out to your doctor if you notice any of the following symptoms, which could indicate oral cancer:

• A sore or lump on the lip or mouth
• Pain in the mouth
• White or red patch on the gums, tongue, tonsil, or lining of the mouth
• Sore throat
• Trouble swallowing
• Trouble chewing
• Difficulty moving the jaw or tongue
• Numbness of the mouth
• Loose teeth or pain around the teeth
• Voice changes
• A lump or mass in the neck or throat
• Weight loss
• Ear pain

Worsening Existing Skin Conditions

If you have any of these skin conditions, smoking can make the symptoms worse:

• Systemic lupus erythematosus (autoimmune disease)
• Vascular skin conditions (such as rosacea)
• Oral conditions (such as cold sores)