Smoking effects on skin: from ageing to illness

Dr Anjali Mahto, consultant dermatologist and British Skin Foundation member, explains that smoking damages nearly every organ in your body

"Unlike damage to your heart or lungs, the effects on skin are often outwardly visible," she says. "Not only is smoking related to the development of certain skin disorders, it is a major culprit in premature ageing of the skin."

Premature ageing

Smoking deprives your skin of oxygen and nutrients. While some smokers appear pale, others develop an uneven colour. The habit also stains the smoker's fingers and teeth, and makes them more susceptible to age spots or patches of darker skin, especially if they spend a lot of time in the sun.

There are more than 4,000 chemicals in tobacco smoke, several of which can trigger the destruction of collagen and elastin, which gives your skin its strength and elasticity. Smoking damages the building blocks of skin causing it to sag, not only on your face but also your arms and breasts.

Smokers also develop earlier and deeper wrinkles in addition to a smoker's pucker, caused by using certain muscles around their mouth that non-smokers do not.

Mahto says that the link between smoking and wrinkles has been known for many years. Smoking is an independent risk factor for developing wrinkles. Women seem to be more susceptible to this than their male counterparts.

This commonly shows itself as fine lines around the eyes - sometimes called crow's feet - and mouth at an earlier age than non-smokers.

Spending too much time in the sun increases your odds of getting skin cancer, but smoking also increases this chance. Smokers are much more likely to develop squamous cell carcinoma (SSC) - the second most common type of skin cancer - caused by the uncontrolled growth of abnormal squamous cells in the outermost layer of the skin.

Our expert warns that smokers have a higher chance of developing wart-related cancers - including cancer of the vulva, anus, and penis, as well as genital warts caused by the human papillomavirus (HPV). This could be related to the immunosuppressive effects of nicotine.

Many studies have shown that smoking can interrupt the wound healing process, causing higher rates of wound infection, decreased wound strength, skin graft failure, tissue death, and blood clot formation.

Nicotine is thought to cause blood vessels to narrow and decrease blood flow, reducing the amount of oxygen and other nutrients reaching wound tissues. It can also cause tiny blood clots to form, which can block small blood vessels.

Tobacco also prevents the formation of collagen. Reduced collagen production causes changes in the normal inflammatory processes that occur during wound healing. Furthermore, smoking delays the formation of new blood vessels within a wound.

Psoriasis

Smoking can aggravate other skin conditions such as psoriasis, a relatively common disorder of the skin that causes red, scaly patches of skin.

Mahto explains that smokers have a higher chance of developing this condition compared to non-smokers. They are also more likely to have severe and more extensive disease that is less likely to respond successfully to treatment.

Discoid lupus erythematosus

Smoking can also aggravate discoid lupus erythematosus. This is an autoimmune skin condition where scaly, red patches often appear in sun-exposed sites.

Hidradenitis suppurativa

Also common among smokers is hidradenitis suppurativa, a long-term condition that results in painful boil-like swellings and abscesses under the skin - particularly in the groin and armpits - that can often discharge and leave scarring.

Smoking is bad for your skin, but quitting can cause its appearance to improve. Blood flow recovers, meaning your skin receives the oxygen and nutrients it requires, leading to a healthier looking complexion. The stains found on fingers and nails may also disappear and teeth may look whiter.

Of course, quitting smoking also improves your general health. Within a year, the likelihood of developing heart disease is half that of a smoker. And within ten years, an ex-smoker is no more likely to die of lung cancer than someone who has never smoked.