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Smoking and Its Effects on Skin
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Tobacco smoke contains thousands of harmful substances, many of which are known mutagens and carcinogens. Smoking has been associated with heart disease, lung disease, and cancer. It is also linked to premature aging of the skin, increased amount of infections, and delayed wound healing. In addition, the majority of inflammatory skin diseases tend to more severely affect smokers than non-smokers, and smokers typically respond more poorly to therapy than non-smokers.

Short-term effects of smoking on the skin and mucous membranes include yellowing of the fingers and nails, discoloration of the teeth, and even a black hairy tongue. Long-term effects include dry skin, uneven skin pigmentation, baggy eyes, a saggy jawline, and deeper facial wrinkles and furrows. It is common for the skin of a 40-year-old heavy smoker to resemble that of a 70-year-old nonsmoker. The exact connection between smoking and these effects are unknown, but current theories include the breakdown of elastic fibers in the skin, narrowing of blood vessels, production of free radicals, and reduced levels of vitamin A in the skin.

Smoking slows the body’s ability to heal itself by decreasing blood flow and inhibiting inflammation. This can cause persistent wounds, increased risk of infection and illness, and increased risk of graft rejection in the skin. Smoking has been linked to increased severity in several dermatologic diseases including palmoplantar pustulosis, psoriasis, hidradenitis suppurativa, systemic lupus erythematosus, and various vascular and oral diseases.

The carcinogens in cigarette smoke greatly increase the user’s risk of developing a variety of cancers. Smoking doubles the risk of developing squamous cell carcinoma, a type of skin cancer. The majority of oral and lip cancer cases occur in smokers.

It is important to note that while nicotine replacement is safer than smoking, nicotine itself is toxic and causes narrowing of blood vessels, inhibits inflammation, delays wound healing, and quickens skin aging.

Smoking has significant short- and long-term effects on the skin and mucous membranes, some of which can be life threatening. Consult with your doctor if you need assistance in stopping smoking.


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The medical information provided in this site is for educational purposes only and is the property of the American Osteopathic College of Dermatology. It is not intended nor implied to be a substitute for professional medical advice and shall not create a physician - patient relationship. If you have a specific question or concern about a skin lesion or disease, please consult a dermatologist. Any use, re-creation, dissemination, forwarding or copying of this information is strictly prohibited unless expressed written permission is given by the American Osteopathic College of Dermatology.

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