Tobacco and the Skin: Adverse Effects and Complex Relationships

June 2010 in “ Clinics in Dermatology ”

Andrei I. Metelitsa, Gilles J. Lauzon

androgenetic alopecia psoriasis palmoplantar pustulosis hidradenitis suppurativa systemic lupus erythematosus polymorphous light eruption oral lesions oral cancers aphthous ulcers Behçet disease ulcers pemphigus vulgaris pyoderma gangrenosum nicotine creams male pattern baldness lupus canker sores Behçet's disease nicotine cream

TLDR Smoking harms skin health, causing slower wound healing, more wrinkles, and worsening some skin conditions, but may protect against certain others.

The 2010 document reviews the adverse effects of smoking on skin health, indicating that smoking delays wound healing, accelerates skin aging and wrinkling, and has a complex relationship with skin cancer, including some evidence of a protective effect against melanoma. It is strongly associated with psoriasis, particularly palmoplantar pustulosis, and exacerbates the severity and lowers remission rates of the condition. Smoking also has a strong link to hidradenitis suppurativa, is a risk factor for androgenetic alopecia in men, and is associated with systemic lupus erythematosus, affecting the efficacy of antimalarial therapy. Additionally, it is connected to polymorphous light eruption and various oral lesions, with an increased risk of oral cancers. However, some reports suggest smoking may decrease the incidence of certain skin conditions, such as aphthous ulcers and Behçet disease ulcers, and may reduce the risk of pemphigus vulgaris. Nicotine creams and smoking have shown positive responses in treating pyoderma gangrenosum. Despite these potential protective effects, the document emphasizes the importance of dermatologists in advising patients to quit smoking due to its overall negative impact on skin health.

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Research cited in this study

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research Hidradenitis Suppurativa and Associated Factors: Still Unsolved Problems

53 citations, July 2009 in “Journal of the American Academy of Dermatology”

The study suggests smoking is common in HS patients but its role is unclear, and more research is needed to understand HS causes.

research Association of Androgenetic Alopecia With Smoking and Its Prevalence Among Asian Men

91 citations, November 2007 in “Archives of Dermatology”

Smoking linked to hair loss in Asian men.

research Molecular Mechanisms of Androgenetic Alopecia

229 citations, August 2002 in “Experimental Gerontology”

AGA causes hair loss by shrinking hair follicles due to DHT binding, and can be treated with finasteride and minoxidil.

research Androgen Metabolism as It Affects Hair Growth in Androgenetic Alopecia

143 citations, October 1996 in “Dermatologic Clinics”

Too much androgen can cause hair loss; finasteride may help.

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