When you smoke a cigarette, 5,000 harmful chemicals are released into your body. The innocuous-looking shisha or hookah also contains high levels of arsenic, lead, and nickel, if it isn’t tobacco-based. Compared to a single cigarette, hookah smoke is known to contain 36 times more tar and 15 times more carbon monoxide. The compositions in vape smoke and electronic cigarette aerosol vary across brands, but the formaldehyde content in them is always more than a regular cigarette. As per researchers at the United States’ Johns Hopkins University, vape aerosols contain “nearly 2,000 chemicals, the vast majority of which are unidentified”.
Therefore, these options aren’t ‘safe’. And it’s not just your lungs or throat or other ‘vital’ organs that get affected — your skin takes the beating too. So, besides several cancers, heart diseases, lung damage, and dental disease, you see adverse effects on your skin such as dullnesses, premature ageing, pigmentation, and more.
Nicotine, carbon monoxide, free radicals may be a part of popular parlance, but we know very little about how they affect us.
The deadly combination
Nicotine, an addictive stimulant in tobacco leaves, can narrow our smaller blood capillaries, leading to reduced blood flow to the skin, leaving it pale and dry.
Carbon monoxide combines with haemoglobin in red blood cells (RBCs) and blocks the path for oxygen to reach body parts. It attaches faster than oxygen, resulting in less oxygen being available for the body’s tissues, including the skin. All of it results in dull, patchy skin.
Free radicals are unstable molecules present in cigarette smoke that attack healthy body tissues, including collagen fiber, which is responsible for providing skin with its natural elasticity. Free radicals can damage your skin cells and cause sagging. Some of the most common side effects are given below.
Skin ageing and smoking wrinkles
The most common effect of smoking is premature ageing. Research shows that the skin health of a 40-year-old heavy smoker is similar to that of a 70-year-old non-smoker. The harmful chemicals in cigarettes can cause vertical creases on the ear, highlight furrows, deep lines around lips, puffed eyelids, slacking jawline, uneven skin tone, and dry, coarse skin.
Moreover, smoking can speed up ageing. Pouting to inhale the smoke can deepen lines around the lips, which is a common long-term impact seen in smokers.
Skin dullness and pigmentation
A 2004 study in Nutrition Journal suggests that smokers have comparatively lower amounts of antioxidants in their bodies than non-smokers — due to nutrient depletion. This causes the skin to develop a pallid, dull, grey complexion. Smoking also results in the depletion of vitamin A, a vital nutrient in the growth of new skin cells, which helps in enhancing the skin’s glow.
Further, smoking also increases the formation of melanocytes in the skin, which, in turn, triggers the production of melanin, the skin colouring pigment. Over time, increased melanin gets accumulated leading to the development of age spots and dark spots in smokers.
Delay in wound healing
Smoking also hinders the process of wound healing. This increases the probability of infections, blood clotting, surgical graft failure, and even tissue death. It can be linked to insufficient oxygen supply to skin cells, reduced collagen production, and delay in the growth of new blood vessels inside the wound. Additionally, smoking contributes to the development of arterial ulcers, leg ulcers, diabetic foot ulcers, and calciphylaxis.
Psoriasis
Psoriasis is an autoimmune disease that causes scale-like itchy, red, dry patches of inflammation on the skin. Research has found that smoking increases the risk of developing this condition manifold times. A study conducted by the Harvard Medical School on 78,500 women stated that the risk of psoriasis increases by 20 per cent after 10 years of smoking. This is because cigarette smoke contains toxic chemicals that can potentially confuse the immune system. This can result in the overproduction of white blood cells and cause unwanted inflammation.
Palmoplantar Pustulosis
PPP is a chronic, treatment-resistant skin disorder characterised by the formation of small, pus-filled blisters (pustules) on palms and soles, surrounded by red, inflamed skin. The condition can be painful and disabling, and it may also cause cracking and scaling of the skin besides itching and burning sensations. PPP occurs when nicotine binds with acetylcholine receptors in sweat glands and ducts, leading to changes in their structure. This is why over 90 per cent of the affected population are found to be smokers.
Buerger’s disease
The chemicals in tobacco can lead to the formation of blood clots, obstructing blood flow, and causing blood vessels to swell. This can result in Buerger’s disease, a form of vasculitis that can cause tissue damage, pain, and, in severe cases, gangrene or tissue death, which can ultimately lead to amputation. While the precise causes behind Buerger’s disease are unknown, heavy tobacco consumption through smoking is considered to be the most significant one.
Skin cancer
Compared to non-smokers, individuals who smoke are at twice the risk of developing a particular type of skin cancer — squamous cell carcinoma. Additionally, smoking also increases the chances of developing precancerous oral leukoplakia, and even oral cancer by 75 per cent.
What’s more, passive smoking is even more hazardous since the components of the smoke are more concentrated — cigarettes have a filter at the end. You can develop the aforementioned skin issues as easily as smokers. According to a 2020 study, passive smoking has been linked to a higher possibility of developing atopic eczema, atopic dermatitis, and hand eczema.
Furthermore, a 2023 report by Swiss firm IQAir says that India is the eighth-most polluted country in the world. The constantly increasing levels of pollution, combined with passive smoking, can severely damage your skin.
How can you prevent this?
The most effective way to save your skin from further damage is to quit smoking as soon as possible and lead a healthy lifestyle.
Smoking leaves your cells dehydrated. To minimise the damage already done, increase your water intake. For external hydration, you can use moisturisers containing glycerin, niacinamide, and peptides. These ingredients can accelerate the production of new skin cells and help in repairing your damaged skin while restoring lost moisture. You can also use antioxidants to protect your skin from the damage caused by free radicals.
Reversal of skin damage from smoking is possible. Within 4-12 weeks of quitting smoking, you will notice a decrease in age spots and redness. Your complexion will start to reverse, followed by restored collagen production, resulting in brighter and smoother skin. Moreover, quitting smoking can help slow down skin ageing by almost 13 years.
Don’t spend your money on smoking. Instead, invest in a healthy lifestyle.
Dr Deepali Bhardwaj is a dermatologist, anti-allergy specialist, laser surgeon and internationally trained aesthetician. She tweets @dermatdoc. Views are personal.
(Edited by Humra Laeeq)