Many people are aware of the dangers to the lungs and the heart that result from smoking. However, not as many may be aware of how smoking affects the largest organ of the body: the skin.
Perhaps, smokers don’t respond to warnings about heart disease, emphysema, and several types of cancer because they cannot see it in the mirror. If smokers continue to smoke, however, not only will they have problems internally, but also externally for the whole world to see.
What is “smoker’s face”?
“Smoker’s face” is a term coined in 1985 by Dr. Douglas Model. During his long-term study on the effects of smoking on the skin, he observed physical changes that occurred on the skin of smokers which were not observed on the skin of non-smokers. Dr. Model noted that “these characteristics were typical of long-term smokers and could be observed regardless of the age of the smoker, their weight, or the degree of their exposure to the sun.”
The physical characteristics of smoker’s face are:
• Dry and dehydrated skin
• Dull, lifeless color
• Prominent lines and wrinkles that occur in places that they do not occur on the face of a non-smoker. These lines and wrinkles often appear on a smoker’s face years before they would on a non-smoker’s face.
• Loss of elasticity
• Thinning of the skin
• Areas of mottled discoloration
The combination of these characteristics not only make a person look much older than they actually are, but also very unhealthy. The dull and dehydrated complexion combined with the thinning skin and lost elasticity causes the skin to appear drawn and sunken in, resulting in the facial bone structure to be visible. Add in the lines, wrinkles, and discoloration and the skin gets a very tough, leathery look and feel. All of this is due to the physiological changes that happen to the skin from smoking.
How smoking affects the functions of the skin
So how and why does smoking cause these physical characteristics of the skin? There are a few reasons. First and foremost, smoking asphyxiates the skin; meaning that it depletes the skin of oxygen and nutrients. This happens because the toxins, chemicals, and carbon monoxide inhaled in cigarette smoke cause the blood vessels to constrict, which slows the circulation of blood and nutrients to the skin. The tiny capillaries located near the skin’s surface are not receiving any nutrients, so they respond by dilating (permanently) to allow for more circulation of blood, nutrients, and oxygen. This causes them to be visible, which is known as “broken capillaries”.
Smoking also interferes with the body’s production of collagen and elastin, the two protein fibers that keep the skin soft, supple, and firm. The production of these proteins naturally slows with age, but smoking speeds up the process. When the skin is depleted of nutrients and oxygen, it affects the skin’s ability to produce new collagen and elastin, as well as “tear down” old and damaged proteins and tissues. If old and damaged tissue is present, new collagen will not form.
Smoking and skin cancer
It is common knowledge that smoking causes cancers of the lungs and other internal organs of the body. However, it can also cause squamous cell carcinoma (SCC), a type of skin cancer. In terms of severity, SCC is in the middle of the skin cancer spectrum. It is more serious than basal cell carcinoma (BCC), and not as deadly as malignant melanoma; but that is not to say that it cannot cause death.
Although SCC is very treatable if it is detected early, it does have the ability to metastasize to distant tissues and organs, which can become fatal. According to the Skin Cancer Foundation, SCC is the second most common form of skin cancer in the United States (after BCC).
Although SCC is typically caused by overexposure to UV rays from the sun or tanning beds, a 2001 Dutch study revealed that smoking is also an independent risk factor for SCC. Although why or how smoking causes this type of skin cancer was not determined, the researchers observed that “in current smokers, the risk of developing squamous cell carcinoma is 3.3 times higher than in non-smokers.*” Quitting smoking reduces this risk by approximately half.
The army of free radicals unleashed into the body by cigarette smoke causes unfavorable changes to the skin as well as the entire body. Free radicals damage healthy cells and healthy DNA, which can cause them to mutate, or grow abnormally. This causes many problems with the functions of the body, which can lead to premature aging and can potentially cause serious diseases like cancer.
Smoking compromises the body’s ability to heal
Many smokers who hear or read about how smoking ages the skin may think “That’s OK, I’ll just get a facelift or a chemical peel”. Unfortunately, it’s not that simple. In order to be a candidate for a surgery, or an aggressive skin care treatment like chemical peels or laser resurfacing, the patient must have an immune system that is intact, and a body that can effectively perform the process of wound healing. Due to the reduced amount of nutrients a smoker’s skin (and body) receives, as well as decreased blood flow, the skin’s ability to heal and regenerate itself is compromised. Nutrients that are necessary for healing, like Vitamin A, are no longer available. This drastically increases a person’s risk for complications during and after a surgical procedure, as well as for scarring. The aesthetic end results of the procedure may also be compromised.
Most doctors require that surgery candidates do not smoke or consume nicotine within a certain time period before having a procedure done, or during recovery, and will order lab tests to ensure compliance. Skin care professionals also are supposed to require this waiting period.
In the end, who really wants to go under the knife? The amount of pain and downtime associated with a cosmetic surgery is much longer and more unpleasant than quitting smoking. It’s common to see the nice before and after pictures, but the pictures of the recovery are not often shown, because they are not easy on the eyes. It is much easier to just quit smoking, get your body healthy again, and maintain an effective anti-aging skin care regimen/diet to help minimize and correct the damage that has already been done.
*De Hertog SA, Wensveen CA, Bastiaens MT, et al. Leiden Skin Cancer Study. “Relation between smoking and skin cancer.” J Clin Oncol 2001 19(1):231-8. 3 September 2008.