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The Effect of Smoking on The Skin

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In 1985, a Dr. Douglas Model added the term "smoker’s face" to the medical dictionary after conducting a study (published in the British Medical Journal) where he found he was able to identify smokers (who had smoked for ten years or more) by their facial features alone. The distinctive characteristics of a smoker’s face which tend to make people look older than they are were called "smoker’s face" and were present in roughly half of the smokers he surveyed, irrespective of the patient’s age, social class, exposure to sunlight, recent change in weight and estimated lifetime consumption of cigarettes.

"Smoker’s Face" was defined as one or more of the following:

  1. lines or wrinkles on the face, typically radiating at right angles from the upper and lower lips or corners of the eyes, deep lines on the cheeks, or numerous shallow lines on the cheeks and lower jaw.
  2. A subtle gauntness of the facial features with prominence of the underlying bony contours. Fully developed this change gives the face and ‘atherosclerotic’ (sic. A bit like choked up blood vessels) look; lesser changes show as slight sinking of the cheeks. In some cases these changes are associated with a leathery, worn, or rugged appearance.
  3. An atrophic, slightly pigmented grey appearance of the skin
  4. A plethoric, slightly orange, purple and red complexion different from the purple blue colour of cyanosis or the bloated appearance associated with the pseudo-Cushing’s changes of alcoholism"

"The fact that so many of the people with smoker’s face were fairly young indicate that smoker’s face is not simply a symptom of age. The changes in the colour and quality of the skin suggest a toxic process… In my experience, many people notice the ravages of smoking for the first time when it is pointed out to them that they can be identified as smokers by their faces alone."   Dr Douglas Model, British Medical Journal (1985)

What the toxins in cigarette smoke are doing to your skin now!

Cigarette smoke contains more than 4000 toxins many of which are absorbed directly into the bloodstream and are taken by the blood right into the structure of your skin.

Smoking cigarettes reduces the efficiency with which the skin can regenerate itself – smoking causes the constriction (narrowing) of the blood vessels at the top layers of the skin which in turn reduces blood supply (to the skin). It is the reduced blood supply which causes a reduction in the availability of oxygen (which is necessary for all living cells) and the removal of waste products, dead cell fragments etc… which provide the necessary environment for regeneration.

Cigarette smoking causes the blood vessels at the top layers of the skin to constrict and so reducing the oxygen level in the blood there. This thickens the blood and reduces the levels of collagen in the skin (it is actually because of this that smoking is also associated with slow or incomplete healing of wounds).

In fact, smoking a single cigarette can produce cutaneous (pertaining to the skin) vasoconstriction (decrease in the calibre of blood vessels) for up to 90 minutes. One study suggests that blood flow in the thumb decreases about 24% after smoking one cigarette and by 29% after two cigarettes. Another study suggested that digital (finger) blood flow fell by an average of 42% after smoking one cigarette. A further study found that smoking for 10 minutes decreases tissue oxygen tension for almost an hour and concluded that the typical pack-a-day smoker would remain hypoxic* for most of each day. (Smith and Fenske, Journal of the American Academy of Dermatol)

*hypoxic – a reduction of oxygen supply to a tissue below physiological levels despite adequate perfusion of the tissue by blood.

Smoking makes your skin thinner

A recent British study took 25 pairs of identical twins where one twin was a lifelong smoker and the other had never smoked. The doctors used an ultrasound technique to gauge inner arm skin thickness. The smoker’s skin was a quarter thinner than that of the non-smokers and in a few cases there were differences of up to 40 per cent.  (Twins study, St Thomas's Hospital)


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Updated February 2019