Research continues to show a direct correlation between smoking and skin damage, according to Dr. Romeo Morales, who recently reviewed the literature relating to the skin-related risks associated with smoking that can be shared with your patients.
“We know that smokers’ faces exhibit a telltale pattern of wrinkling, coarseness and discolouration. But we are also finding these changes in the skin all over the body, not just in areas that are exposed to sunlight and other environmental stresses,” said Dr. Morales, a medical and surgical dermatologist at Advanced Dermatology in New York, N.Y., in a press release.
In one study, for example, researchers who examined non-facial, photo-protected skin such as that of the upper inner arm, found that the number of cigarettes smoked per day and the total years that a person smoked were directly related to the degree of wrinkling and sagging in those areas (Arch Dermatol 2007; 143:397–402).
Increased risk of non-melanoma skin cancer
Smoking-related skin damage is not restricted to wrinkles, said Dr. Morales. Research shows that people who smoke are more susceptible to non-melanoma skin cancers, including basal cell and squamous cell carcinomas. Again, risk increases along with the number of cigarettes smoked daily and the number of years as a smoker, he said.
Smoking, poor wound healing
Other research points to links between smoking and poor wound healing, sagging breasts, psoriasis, dental problems and hair loss. One study found that smoking could add the equivalent of 14 years of
aging to the skin—not to mention taking about 10 years off the smoker’s lifespan, stressed Dr. Morales.
“We know that tobacco smoke has over 400 chemicals, many of which hinder circulation and produce free radicals, which contribute to aging and disease,” Dr. Morales said. Cigarette smoke also impairs the production of collagen and degrades it, along with elastin and other connective tissues in the skin, he added.
Cosmetic Tx options
Smokers are more susceptible to sagging of the upper eyelids and chin, under-eye bags, lines between the nose and mouth and around the lip (the so-called “smoker’s mouth”), he said.
In smokers, signs of aging are generally most pronounced on the lower face. All of these can be treated with non-invasive, in-office procedures, said Dr. Morales, who recommends injectable fillers to aid in reducing wrinkles and restoring volume to sagging skin.
He also indicated that lasers are beneficial and can tighten skin and boost collagen production below the surface.
Dr. Morales advises his patients who smoke to do whatever they can to kick the habit. While the natural process of aging is uncontrollable, the skin effects of smoking are avoidable, he said.