The skin can absorb nicotine from cigarettes. This may cause adverse effects such as premature skin aging, delayed wound healing, and increased infections. It may also lead to skin diseases like psoriasis, acne, eczema, and skin cancer.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

Tobacco contains nicotine, a highly addictive chemical. Tobacco smoke also contains thousands of harmful substances that are toxic to cells, including skin cells.

In the United States, nearly 13 in 100 people aged 18 and older currently smoke cigarettes.

Most adults who smoke want to quit. According to the Centers for Disease Control and Prevention (CDC), more than half of adults who smoke say they have tried to quit smoking within the last year. However, fewer than 1 in 10 succeed in quitting every year.

This article explores the harmful effects smoking can have on the skin and the rest of the body. It also considers the benefits of quitting smoking for the skin and overall health.

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The body absorbs nicotine into the intestinal mucosa, skin, and respiratory tract.

Keratinocytes are specialized cells that form the skin barrier and contribute to crucial immune functions, such as attacking pathogens.

Nicotine promotes apoptosis — cell death — in these cells, damages blood vessels in the skin, and reduces blood flow.

Additionally, nicotine changes the structure and function of skin fibroblasts. A fibroblast is a type of skin cell that contains collagen proteins. These cells are important for:

Finally, nicotine alters the body’s adaptive and innate immune responses.

Learn more about the immune system here.

Below we will look at the 16 effects smoking has on the skin.

1. Skin aging

Smoking affects collagen and elastin, which are elastic fibers that keep the skin plump and firm.

Tobacco smoke extracts cause oxidative stress in skin fibroblasts, impair collagen formation, and increase the expression of an enzyme that degrades collagen.

Plus, a 2021 review found that smokers had less circulating vitamin D. Vitamin D plays a role in maintaining the skin barrier and helps with tissue repair.

Smoking also narrows blood vessels to the skin, reducing the amounts of blood and nutrients that reach the skin.

Collagen supplementation can help restore skin hydration, elasticity, and collagen density. Research suggests it may have promising results for short- and long-term wound healing and skin aging.

Read more about the general effects of skin aging.

2. Wrinkles

Smoking is an independent risk factor for the formation of wrinkles, especially in the middle to lower third of the face. This leads to more defined wrinkles and other facial features, including:

  • eyelid skin redundancy
  • forehead wrinkles
  • nasolabial folds
  • upper lip wrinkles

In a 2017 study focusing on pairs of twins in which one twin smoked and one did not, researchers noted that people find nonsmokers more attractive based on appearance.

Additionally, a 2019 study found that the skin in the nasolabial folds was denser and thicker in smokers than in nonsmokers.

Pursing the lips and squinting as the smoke irritates the eyes when inhaling also likely enhances wrinkle formation in the eye and mouth area.

Learn more about treating wrinkles.

3. Skin tone and pigmentation

Smoking promotes melanocyte formation in the skin, which can lead to age spots and dark spots.

People who smoke also tend to have dull, pale skin that may appear bluish or gray. This can be due to restricted blood flow to the skin, which can deprive it of oxygen and other nutrients. This may cause uneven skin pigmentation in some people.

Chronic exposure to environmental factors such as tobacco smoke, heat, and ultraviolet (UV) radiation can cause an accumulation of oxidative stress, which contributes to aging-related skin pigmentation.

Find out more about ways to even a skin tone.

4. Sagging skin

Chemicals in cigarette smoke increase transepidermal water loss and degeneration of collagen and elastic fibers. The loss of these building blocks, which give the skin its strength and elasticity, causes the skin to droop and sag.

Research published in 2020 also found that the skin of people who smoke is stiffer than the skin of those who do not.

Find out how to firm up sagging skin.

5. Delayed wound healing

According to the World Health Organization, smoking promotes wound opening and slows down healing by decreasing the body’s inflammatory process and immune function.

A 2012 review of 140 cohort studies found that smokers had a higher likelihood of:

  • delayed healing
  • dehiscence, which is partial or total separation of previously closed wound edges
  • postsurgical site infection
  • wound complications
  • lack of bone healing

Stopping smoking at least 4 weeks before surgery can reduce postsurgical complications.

Learn more about open wound care.

6. Infections

Immune cells in the skin help prevent infection and promote the rebuilding of tissue.

Smoking inhibits the body’s adaptive and innate immunity. It may also suppress the activity of macrophages — an essential component of the immune system — and contribute to dysregulation, leading to tissue damage and excessive inflammation.

Smoking increases a person’s risk of infections and tends to worsen the progression and outlook of infectious diseases.

Adults who smoke also have a higher risk of pneumococcal disease.

Current and former smokers have higher human papillomavirus viral load. They are also at an increased risk of trichomoniasis and genital chlamydia.

Keep reading to learn more about general infections.

7. Skin cancer

Current and heavy smokers have a higher risk of developing squamous cell carcinoma. Moreover, smokers with melanoma are 40% less likely to survive than nonsmokers.

Read more about skin cancer.

8. Psoriasis

Smoking increases a person’s risk of psoriasis and may affect the condition’s severity and response to treatment.

Current and past smokers are less likely than nonsmokers to experience symptom improvement with biologic medications.

Learn more about the possible links between smoking and psoriasis.

9. Eczema

Experts link active and passive smoke exposure to an increased risk of atopic dermatitis.

Additionally, a 2020 study found that exposure to secondhand smoke is an independent but modifiable risk factor for atopic eczema and hand eczema in adolescents.

Read more about eczema from our dedicated hub.

10. Acne

Smoking may have an association with acne. A 2017 study suggests that higher nicotine dependence may worsen acne pimples.

Find out more about acne here.

11. Vasculitis

Buerger’s disease is a type of vasculitis. Experts believe that chemicals in tobacco may irritate the blood vessel lining, causing it to swell and leading to vasculitis.

Symptoms of Buerger’s disease include the presence of the following in the upper or lower extremities:

There is a strong association between Buerger’s disease and heavy smoking, and tobacco use can cause the disease.

Smoking also has an association with an autoimmune type of vasculitis called antineutrophil cytoplasmic antibody-associated vasculitis (AAV).

A 2020 study found a dose-response relationship between AAV and smoking, meaning that people who smoked longer had an increased risk of the condition. People with AAV are more likely to be current or former smokers.

12. Palmar telangiectasia

Telangiectasia, or spider veins, are dilated blood vessels near the skin surface or mucosal surface. Telangiectasia on the palms is a symptom of prolonged smoking.

13. Lupus

Smoking is a risk factor for developing systemic lupus erythematosus (SLE). There may also be a dose relationship between cutaneous SLE and smoking.

Experts suggest that smoking may induce keratinocyte activity such as apoptosis and pro-inflammatory cytokine production.

According to a 2021 study, stopping smoking has the following benefits:

  • improved host defense
  • reduced disease activity
  • lower systemic inflammation

Nicotine can decrease the effectiveness of antimalarial therapy, a treatment method for lupus.

Learn more about lupus prevention and treatment.

14. Alopecia

Males who smoke 10 or more cigarettes per day have a 3 times greater risk of developing moderate to severe androgenic alopecia. Smoking can cause hair loss as a result of several factors, including:

  • DNA damage
  • blood vessel constriction
  • free radical damage to hair follicles
  • enhanced effects of hormones and aging

15. Polymorphic light eruption

Polymorphic light eruption is a type of itchy rash that results from exposure to the sun or artificial UV light. People who smoke more than 15 cigarettes per day have a greater risk of developing this condition.

16. Palmoplantar pustulosis

Palmoplantar pustulosis is a rare, chronic inflammatory disorder characterized by pustules on the palms and toes. It has a strong association with tobacco smoking and tends to occur in current and past smokers.

In a 2015 case study, researchers found that stopping smoking and applying an emollient cream led to the cessation of the skin condition within 3 months.

Smoking remains the primary cause of preventable disease, disability, and death in the United States.

It is toxic and harms nearly every organ in the body.

Smoking and secondhand smoke exposure can cause:

Read more about health conditions smoking can cause.

Age spots and redness may decrease as early as 1 month after a person stops smoking. Similarly, a small 2013 study found that changes in skin color that resulted from smoking began to reverse within 4–12 weeks of smoking cessation.

Quitting smoking can also help reduce signs of skin aging. A 2010 study found that quitting led to an average reduction of 13 years in participants’ biological age.

After a person quits smoking, the body will restore its collagen production. This can lead to visible changes, including brighter and smoother skin, as a result of improved circulation and a reduced carbon monoxide level in the blood.

Learn more about other ways to stimulate collagen production.

Stopping smoking can also help prevent a person from developing skin conditions associated with smoking.

Quitting smoking can improve a person’s general health in the following ways:

  • enhance the quality of life
  • add as much as 10 years to a person’s life expectancy
  • reduce health risks, including cancer, respiratory diseases, and heart disease
  • reduce the financial burden on families and society
  • benefit the health of pregnant people, fetuses, and babies

Stopping smoking can reduce stress, anxiety, and depression. The effect of quitting may be comparable to the effect of antidepressants.

Read more about what happens after a person quits smoking.

The American Cancer Society outlines three steps to quit smoking:

  1. Decide to quit.
  2. Plan and manage each day without smoking.
  3. Talk with a doctor or pharmacist.

Approaches that can help with quitting smoking include:

  • reading self-help information
  • attending individual or group counseling
  • setting up a reward system
  • asking a friend for help
  • doing a physical activity such as walking
  • downloading apps or signing up for services that provide support in quitting
  • taking medications to help with nicotine withdrawal

Aside from prescription medications, a person can talk with their doctor about nicotine replacement products such as over-the-counter lozenges, patches, and gums.

Read more tips on how to give up smoking.

Each year, 50% of people who smoke try to quit, and 3 in 5 who ever smoked have quit.

The overall benefits of quitting smoking start to occur in as little as a few minutes and continue for years after a person stops smoking.

Smoking can adversely affect the skin, leading to premature skin aging, skin cancer, and other conditions. Quitting smoking can help improve skin health and overall appearance by promoting better blood circulation and collagen production.

Quitting smoking also has overall health benefits, such as reducing the risk of other physical and mental health conditions.

A person who wishes to quit may benefit from a variety of approaches. It is best to seek the advice of a doctor or pharmacist to learn about the options available for quitting smoking.