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How Smoking Affects Skin Health

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Introduction to smoking and skin health

Smoking is associated with a range of detrimental health effects, the most well known of which are lung cancer and cardiovascular disease. There are many lesser known health effects as well, including effects on the skin.

In many cases, these changes to skin are not life threatening, though they can change the physical appearance of the smoker. For example, smoking is associated with premature ageing and wrinkles. Smoking is also associated with very serious skin conditions, including squamous cell carcinoma of the skin (a type of skin cancer) and psoriasis. Awareness of the changes to physical appearance and the serious skin conditions associated with smoking may help motivate individuals to quit smoking.

How smoking affects the skin

The precise ways in which tobacco smoke damages or changes skin are not fully understood, though scientific studies have produced evidence about a number of possible ways. Studies suggest that tobacco smoke exposure decreases capillary and arteriolar blood flow, possibly damaging connective tissues that help maintain healthy skin. Skin fibroblasts (the cells in connective tissue that form collagen and elastin) are damaged by tobacco smoke.

There is also evidence that tobacco smoke is phototoxic. Smoke becomes more toxic in the presence of ultraviolet light (UV), such as is found in sunlight, and causes more damage to skin cells than either smoke or UV would cause on their own.

Changes to physical appearance


As people age, their skin also ages. The ageing process is influenced by a number of environmental factors. Sun exposure is the most prominent risk factor for premature ageing. Although it is much less well known, cigarette smoking is also a risk factor for premature skin ageing.

Several studies have reported that cigarette smoking causes an individual’s skin to age even more than exposure to sunlight does. Studies have also reported that the effect of exposure to tobacco smoke and sunlight at the same time is more dangerous than the combined effect of either exposure alone, and that women are at greater risk than men.

The ageing of skin can be measured by a number of features. Most obviously, skin becomes wrinkled. Wrinkling is caused by changes to skin elasticity and concentrations of skin components such as collagen and elastin. Differences in skin features between individuals who do and do not smoke can therefore be measured by physical appearance, or by analysing skin tissues for concentrations of components.


Numerous studies have found that premature wrinkling is associated with smoking. There is evidence that the more an individual smokes, the more the premature ageing effect occurs, so heavy smokers will experience more premature wrinkles than those who only smoke occasionally. One study, in which eight judges individually rated the age of smokers and non-smokers from their photographs, reported that smokers were, on average, rated as being 2.7 years older than their actual age, while non-smokers were rated at 0.7 years younger than their actual age.

Another study reported that moderate smokers were almost twice as likely to wrinkle prematurely than non-smokers, and heavy smokers were almost three times more likely to wrinkle prematurely.

Other studies have examined exposure to both cigarettes and sunlight, to assess the relative importance of each of these exposures in the development of wrinkles. Evidence from these studies suggests that smoking may be a more important factor in the development of wrinkles than sun exposure.

There is evidence that individuals exposed to both tobacco smoke and sunlight prematurely winkle more than individulas exposed to tobacco smoke or sunlight alone. One study found that smokers were 5.8 times more likely to develop wrinkles than non-smokers, while those with excessive sun exposure (i.e. more than two hours per day) were only 2.65 times more likely to wrinkle than those who were not excessively exposed to sunlight. Individuals who smoked heavily (35 pack years or more) and had excessive sun exposure were 11.4 times more likely than non-smokers with less than two hours per day of sun exposure to develop wrinkles. This is a considerably greater risk than the combined individual risks of exposure (i.e. 5.8 for tobacco + 2.65 for sunlight = 8.45 times more likely). As tobacco smoke is phototoxic, this synergistic effect of combined tobacco smoke and sun exposure is unsurprising.

Another study reported that smoking more than 20 cigarettes per day was associated with an almost 10-year increase in skin ageing. The study found no significant association between sun exposure and wrinkles.

Smoking Cost Calculator


Learn more about the dangers of cigarette smoking

This information will be collected for educational purposes, however it will remain anonymous.

The Cost of Smoking tool works out the financial cost that smoking is having for you.

To work this out you first need to find out how much you spend per day.
Cost Per Day (CPD) = (number you smoke per day/number per pack) * cost per pack
CPD = (40 per day/20 per pack) * $10
CPD = 2 * $10
CPD = $20
So the amount spent each day is $20.00.

You can work out how much you spend over time using the formulas below.

  • $ spent per month = CPD * 30.5
  • $ spent per year (CPY) = CPD * 365
  • $ spent so far = number of years spent smoking (YSS) * CPY
  • Total you will have spent in 5 years = (5 + YSS) * CPY
  • in 10 years = (10 + YSS) * CPY
  • in 20 years = (20 + YSS) * CPY
  • in 30 years = (30 + YSS) * CPY
  • in 50 years = (50 + YSS) * CPY

There is some evidence that women’s skin is more affected by tobacco smoke exposure than men’s skin. One study reporting a premature ageing effect in both sexes found that smoking men were 2.3 times more likely than non-smoking men, and smoking women more than 3 times as likely as non-smoking women, to age prematurely. The study did not explore the possible reasons why women’s skin was more sensitive to the detrimental effects of tobacco smoke than men’s skin.

Skin tissue composition

As skin ages, the composition of skin tissues changes. A number of studies have examined the skin tissues of smokers and non-smokers as a measure of premature ageing. A Dutch case control study measuring the extent of elastosis (a condition in which skin loses elasticity as a result of connective tissue degeneration) and telangiectasia (a condition characterised by fine red lines in the skin caused by the dilation of small blood vessels) in smokers and non-smokers reported that the likelihood of developing either condition increased with the number of cigarettes smoked. This was true for both men and women, although the effect was most apparent in men. Another study, which used computer assisted analysis to assess elastosis in four layers of facial skin, reported significantly greater elastosis in smokers compared to non-smokers.

Skin tone and colour

In addition to wrinkles, smoking increases an individual’s risk of gauntness and facial discolouration.

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calendar icon Created: 22/5/2009 calendar icon Modified: 10/6/2009