How Smoking Affects Your Face and Skin

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As of Dec. 20, 2019, the new legal age limit is 21 years old for purchasing cigarettes, cigars, or any other tobacco products in the U.S.

By now, we all know that smoking has serious health risks. Lung disease, cancer, and heart problems are all tied to smoking. But did you know that smoking can also take a serious toll on your face and skin? It can lead to premature wrinkles and aging, which can affect your appearance and self-esteem.

There are other more serious risks to your skin as well. Cigarettes contain toxins that can cause premature aging and other skin conditions, including skin cancer. If you already have a skin condition, smoking can worsen its symptoms.

If you currently smoke and notice that your skin is suffering, talk to your doctor about ways you can manage your symptoms and resources to quit smoking. In many cases, your skin may begin to heal itself once you quit.

At a Glance

Cigarette smoking doesn't just risk your internal physical health—its health effects can also appear on your face and skin. Premature aging is common, but you are also more likely to experience slower wound healing, pigmentation, eczema, skin cancer, and other skin conditions if you are a smoker. If you smoke or have smoked in the past, keep up with regular skin checks and talk to your doctor if you notice any areas of concern.

1

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.

For those who smoke, wrinkling usually starts much earlier than it does for people who don't smoke.

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.

2

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.

3

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.

Most doctors advise their patients to quit smoking before a surgical procedure because smoking impedes the healing process of an incision in the skin.

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.

4

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.

The link between psoriasis and smoking may be the nicotine in cigarettes. Nicotine affects the immune system, skin inflammation, and skin cell growth, all of which can contribute to the development of 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.

5

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.

One study found that cigarette smoking is the biggest environmental risk factor for developing acne inversa.

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.

6

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.

According to the Centers for Disease Control and Prevention (CDC), nearly every case of Buerger’s disease is associated with smoking cigarettes or using other forms of tobacco, such as cigars and chewing tobacco.

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

7

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.

One study found that out of 30 people who currently smoked, half of them had palmar telangiectasia; out of 16 people who used to smoke, 31.2% had the condition.

8

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.

9

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.

Symptoms to Watch For

Squamous cell carcinoma might look like rough or scaly patches, raised lumps, open sores, or wart-like growths on your skin. The growths may be brown in dark skin tones or red in light skin tones. Let your doctor know if you notice these or any other irregular textures on your skin.

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
10

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)

How Quitting Tobacco Improves Your Skin

If you're coping with a skin condition related to smoking, you are much more likely to better manage your symptoms or even start recovering when you quit smoking.

By quitting, you'll reduce the inflammation of blood vessels that leads to many smoking-related skin conditions. Your circulation and heart rate will improve, as will the functioning of your heart and lungs. The return of normal blood flow will bring oxygen and nutrients to skin cells and your skin can begin to look healthier.

Overall, your body will start to heal itself. Your ability to heal from wounds will improve, too.

One study found that dark spots and discoloration of the skin had subsided in participants several weeks after they quit smoking.

People with acne inversa who smoke generally have more affected areas of the body than people with the condition who don't smoke. Similar findings have been reported for people with psoriasis and eczema as well.

Doctors urge people with Buerger's disease to quit smoking to improve symptoms and curb the progression of the condition.

Dermatologists are encouraged to advise their patients to quit smoking, regardless of whether they have a skin condition or not, to avoid any potential damage that smoking can do to the skin.

How Soon Will You See Improvements?

Research suggests that quitting smoking can improve the appearance of the face and skin in as little as four weeks. One study found that redness and age spots decreased a month after a person stopped smoking. Another study found that pigmentation may improve four to 12 weeks after quitting.

Mental Health Considerations

People with skin conditions may experience low self-esteem, self-consciousness, anxiety, and/or depression, especially when the symptoms of their condition increase.

If you're experiencing any mental health symptoms as a result of your skin condition, be sure to reach out to your doctor for help.

Your doctor can refer you to a mental health professional who can help you cope.

Cognitive behavioral therapy (CBT) has been shown to have a positive effect on people with skin conditions like psoriasis. You may be able to improve your quality of life with this emotion-based therapy, addressing the underlying feelings you have about your condition to develop a more positive outlook.

It may take some time, but the benefits to your health and well-being are worth the effort it takes to quit smoking. If you're having trouble, remember there are many resources that can help.

Try reaching out to a support group near you or download a quit smoking app on your phone. Every day that you go without smoking is another day your skin has a chance to repair itself.

27 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Yazdanparast T, Hassanzadeh H, Nasrollahi SA, et al. Cigarettes smoking and skin: A comparison study of the biophysical properties of skin in smokers and non-smokersTanaffos. 2019;18(2):163-168.

  2. Nath D, Shivasekar M, Vinodhini VM. Smoking induces the circulating levels of matrix metalloproteinase-9 and its association with cardiovascular risk in young smokersMedeni Med J. 2022;37(4):306-312. doi:10.4274/MMJ.galenos.2022.45057

  3. Kathuria S, Puri P, Nandar S, Ramesh V. Effects of air pollution on the skin: A review. Indian Journal of Dermatology, Venereology, and Leprology. 2017;83(4). doi:10.4103/0378-6323.199579

  4. Kasprzak D, Wnorowski A. A variety of processes that affect the perception of skin aging. Current Issues in Pharmacy and Medical Sciences. 2019;32(3). doi:10.2478/cipms-2019-0027

  5. John G, Louis C, Berner A, Genné D. Tobacco stained fingers and its association with death and hospital admission: A retrospective cohort studyPLoS One. 2015;10(9). doi:10.1371/journal.pone.0138211

  6. McDaniel JC, Browning KK. Smoking, chronic wound healing, and implications for evidence-based practiceJ Wound Ostomy Continence Nurs. 2014;41(5):415-E2. doi:10.1097/WON.0000000000000057

  7. Almadani YH, Vorstenbosch J, Davison P, Murphy A. Wound healing: A comprehensive review. Seminars in Plastic Surgery. doi:10.1055/s-0041-1731791

  8. World Health Organization. Tobacco & Postsurgical Outcomes.

  9. Richer V, Roubille C, Fleming P, et al. Psoriasis and smoking. Journal of Cutaneous Medicine and Surgery. 2015;20(3). doi:10.1177/1203475415616073

  10. Naldi L. Psoriasis and smoking: Links and risksPsoriasis (Auckl). 2016;6:65-71. doi:10.2147/PTT.S85189

  11. Putra-Szczepaniak M, Reich A, Jankowska-Konsur A, Czarnecka A, Bagłaj-Oleszczuk M, Anita H-G. Pack-year cigarette smoking affects the course of palmoplantar pustulosis. Advances in Clinical and Experimental Medicine. 2021;30(2). doi:10.17219/acem/131750

  12. Bukvić Mokos Z, Miše J, Balić A, Marinović B. Understanding the relationship between smoking and hidradenitis suppurativa. Acta Dermatovenerol Croat. 2020;28(1):9-13. PMID: 32650845.

  13. McDermott G, Fu X, Stone JH, et al. Association of cigarette smoking With antineutrophil cytoplasmic antibody–associated vasculitis. JAMA Internal Medicine. 2020;180(6). doi:10.1001/jamainternmed.2020.0675

  14. Liew NC, Lee L, Nor Hanipah Z, Gee T, Jabar MF. Pathogenesis and management of Buerger’s disease. The International Journal of Lower Extremity Wounds. 2015;14(3). doi:10.1177/1534734615599654

  15. Centers for Disease Control and Prevention. Smoking and Buerger's Disease.

  16. Pesut DP, Samardzic AM, Bulajic MV, Cvok-Debeljak TT. Palmar telangiectasia is associated with the intensity of smoking. Jornal Brasileiro de Pneumologia. 2019;45(2). doi:10.1590/1806-3713/e20180273

  17. Levi A, Shechter R, Lapidoth M, Enk CD. Palmar telangiectasias: A cutaneous sign for smoking. Dermatology. 2017;233(5):390-395. doi:10.1159/000481855

  18. Jing D, Li J, Tao J, et al. Associations of second-hand smoke exposure with hand eczema and atopic dermatitis among college students in China. Sci Rep. 2020;10(1). doi:10.1038/s41598-020-74501-2

  19. Alotaibi GF, Alsalman HH, Alhallaf RA, et al. The association of smoking with contact dermatitis: A cross-sectional studyHealthcare (Basel). 2023;11(3):427. doi:10.3390/healthcare11030427

  20. Jiang X, Wu J, Wang J, Huang R. Tobacco and oral squamous cell carcinoma: A review of carcinogenic pathwaysTob Induc Dis. 2019;17:29. doi:10.18332/tid/105844

  21. Panta P, ed. Oral Cancer Detection: Novel Strategies and Clinical Impact. Springer; 2019. doi:10.1007/978-3-319-61255-3

  22. Gometz E. Health effects of smoking and the benefits of quitting. AMA Journal of Ethics. 2011;13(1). doi:10.1001/virtualmentor.2011.13.1.cprl1-1101

  23. Ishiwata T, Seyama K, Hirao T, et al. Improvement in skin color achieved by smoking cessationInt J Cosmet Sci. 2013;35(2):191-195. doi:10.1111/ics.12025

  24. Yazdanparast T, Hassanzadeh H, Nasrollahi SA, et al. Cigarettes smoking and skin: A comparison study of the biophysical properties of skin in smokers and non-smokersTanaffos. 2019;18(2):163-168.

  25. Ishiwata T, Seyama K, Hirao T, et al. Improvement in skin color achieved by smoking cessationInt J Cosmet Sci. 2013;35(2):191-195. doi:10.1111/ics.12025

  26. Tuckman A. The potential psychological impact of skin conditions. Dermatol Ther (Heidelb). 2017;7(S1):53-57. doi:10.1007/s13555-016-0169-7

  27. Schwartz J, Evers AW, Bundy C, Kimball AB. Getting under the skin: Report from the international psoriasis council workshop on the role of stress in psoriasisFront Psychol. 2016;7:87. Published 2016 Feb 2. doi:10.3389/fpsyg.2016.00087

By Terry Martin
Terry Martin quit smoking after 26 years and is now an advocate for those seeking freedom from nicotine addiction.