Psoriasis is a skin disease that involves inflammation triggered by the immune system. Research shows that smoking increases the risk of developing psoriasis and affects the severity of the condition for those who already have it.

Smoking can also affect how those with psoriasis respond to treatment.

This article will explore the link between smoking and psoriasis, what the research says, and how quitting smoking can help.

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More than 7.5 million adults in the United States have psoriasis, an immune-related condition that can cause inflammatory skin disease. This can take the form of scales, or plaques, on the skin.

Some people who have psoriasis also develop psoriatic psoriasis, which causes issues with their joints.

The exact reason behind the immune response that causes psoriasis is unknown. However, several factors can cause psoriasis to develop.

Experts think that the interaction of certain genes is a factor, and researchers have uncovered more than 80 genes that they believe play a role in the condition. They also think that the immune system and environmental factors are involved.

Risk factors for developing psoriasis include lifestyle habits, such as:

  • smoking
  • drinking alcohol
  • being sedentary
  • not sleeping enough
  • having obesity

People with psoriasis already have an increased risk of developing cardiovascular disease and metabolic syndrome. Experts know that smoking is a risk factor for both of these conditions.

Palmoplantar pustulosis is a rare condition related to psoriasis in which fluid-filled pustules develop on the palms and the soles of the feet. It has associations with smoking, and according to an older report, 95% of people with this condition are smokers at the onset of this disease.

Researchers believe that psoriasis may develop when the immune system changes due to a triggering event. Smoking could play a role in this.

A cigarette contains roughly 600 ingredients, and when burned, it can create more than 7,000 chemicals. At least 69 of these chemicals cause cancer.

Tobacco products, such as cigarettes, cigars, and e-cigarettes, contain nicotine. Some reports indicate that nicotine is as addictive as heroin, cocaine, or alcohol.

Other studies have shown that nicotine has a significant impact on the immune system and can alter immune responses in the body.

Numerous studies have found that smoking not only increases a person’s risk of developing psoriasis but also worsens symptoms.

In an older 2012 study, researchers evaluated the association between smoking and psoriasis among 185,836 people as part of the Nurses’ Health Study (which ran from 1996–2008), the Nurses’ Health Study II (1991–2005), and the Health Professionals’ Follow-up Study (1986–2006). The participants were older women, younger women, and men, respectively.

The researchers found that smoking was an independent risk factor for psoriasis in both men and women. Those who were heavy smokers and those who had smoked for longer had an elevated risk of developing psoriasis. The risk of developing psoriasis was highest among those who had smoked for 30 or more years.

A 2020 meta-analysis found that people who have ever smoked (“ever smokers”), currently smoke, or smoked in the past had a higher risk of developing psoriasis than their peers who had never smoked.

The same study also found that ever smokers with psoriasis were less likely to show improvement in their disease 6 months after starting treatment with biologic agents than nonsmokers.

This suggests that smoking affects the efficacy of biologic agent treatments among ever smokers with psoriasis.

A Danish study found that people with psoriatic arthritis who currently smoked or used to smoke had worse baseline outcomes. Those who were current smokers also experienced a poorer response to tumor necrosis factor alpha inhibitor (TNFi) therapy and adhered to treatment for less time than their nonsmoking peers.

Smoking can lead to serious health problems. Although smoking is addictive, it is possible to cease smoking for good. The Centers for Disease Control and Prevention (CDC) states that since 2002, there have been more former smokers than current smokers.

Smoking harms nearly all organs in the body and can lead to serious diseases and complications. Studies have shown that smoking can cause psoriasis and worsen psoriasis symptoms.

Quitting smoking can decrease the risk of developing psoriasis. One older study found that people who once smoked, but had not smoked for 20 years, had a decreased risk of developing psoriasis. This is similar to the risk level of those who had never smoked.

Scientists do not yet know if quitting smoking will improve symptoms of psoriasis. A study at King’s College London in the United Kingdom is currently underway to examine the impact that quitting smoking can have on psoriasis symptoms.

The researchers expect that their experiments will demonstrate that chromosome changes seen in the skin of those with psoriasis have links to smoking. They also hypothesize that ceasing smoking can reverse the chromosomal changes triggered by tobacco.

They are hopeful their findings will provide scientific reasoning for introducing stop-smoking programs among those with psoriasis.

Anyone who wishes to stop smoking or is concerned about their health should speak with their doctor.

Below are some commonly asked questions about smoking and psoriasis.

Will quitting smoking help psoriasis?

Research suggests that quitting smoking decreases the risk of developing psoriasis. However, scientists do not yet know if quitting smoking helps improve symptoms of psoriasis.

What triggers psoriasis to get worse?

Common triggers for psoriasis include stress, smoking, alcohol, illness (particularly strep infections), injury to the skin, and certain medications.

Do smoking and alcohol affect psoriasis?

Yes, smoking and alcohol are considered common triggers for psoriasis.

What illness is connected to psoriasis?

Research shows an association between psoriasis and arthritis, depression, inflammatory bowel disease, and cardiovascular diseases.

Smoking increases the risk of developing psoriasis. It also worsens symptoms of psoriasis and can adversely affect how those with psoriasis respond to treatment.

Psoriasis has associations with an increased risk of metabolic syndrome and cardiovascular disease, and smoking is a known risk factor for both of these conditions.

Studies have demonstrated that stopping smoking lessens the chance of developing psoriasis. As a result, psoriasis experts advise people to stop smoking.

Studies are underway to determine whether stopping smoking can improve psoriasis symptoms.