How smoking affects the skin: 16 side effects and risks you should know

Smoking is one of the most damaging habits for overall health, and your skin is no exception. The World Health Organisation (WHO) reports that smoking kills over 8 million people each year, with nicotine being one of the most addictive chemicals.

Beyond lung disease and cancer, smoking directly affects the skin’s appearance, healing ability, and long-term health.Cigarette smoke contains thousands of harmful chemicals. These toxins damage skin cells, reduce blood flow, and trigger premature ageing. Over time, smokers may notice wrinkles, dullness, sagging, slow wound healing, and an increased risk of skin diseases such as psoriasis, eczema, lupus, and even skin cancer.

16 side effects of smoking on skin: Skin cancer, psoriasis, wrinkles, and more

Smoking doesn’t just harm your lungs, it strikes at your skin, too. According to a study published in Advances in Dermatology and Allergology, the chemicals in tobacco smoke, including nicotine and various carcinogens, are directly linked with many skin conditions and visible damage such as premature ageing. Smokers are more likely to suffer from psoriasis, acne, eczema, alopecia (hair loss), lupus erythematosus, skin cancer, and other chronic dermatoses.

1. Premature ageingSmoking speeds up the natural ageing process by destroying collagen and elastin fibres – two key proteins that keep your skin plump, firm, and youthful. When these fibres break down, the skin loses its strength and flexibility, leading to fine lines, sagging, and dryness. Research shows that smokers often look 10 years older than non-smokers of the same age. The more cigarettes smoked daily, the faster the ageing process.2. WrinklesOne of the most visible skin effects of smoking is deep wrinkles, particularly around the eyes, lips, and forehead. This happens because reduced blood flow deprives the skin of oxygen and nutrients, while facial movements like squinting and lip-pursing reinforce wrinkle lines. A famous twin study revealed that the smoking twin had significantly more facial wrinkles than their non-smoking sibling, proving the clear connection between smoking and premature wrinkling.3. Uneven skin toneNicotine and carbon monoxide in cigarette smoke restrict blood vessels, which lowers oxygen supply and leads to a pale, dull, or greyish complexion. Smokers often develop age spots and dark patches, caused by melanin overproduction triggered by oxidative stress. In addition, toxins in smoke damage the skin barrier, making the complexion appear blotchy and uneven.4. Sagging skinLoss of collagen and elastin doesn’t only cause wrinkles – it also leads to sagging and drooping skin.

Smokers often notice loose skin under the eyes, cheeks, and jawline. Even areas not usually linked to ageing, such as the upper arms and breasts, can sag more quickly in smokers. This effect is sometimes referred to as "smoker’s face", a recognised clinical condition.5. Delayed wound healingSmoking reduces blood circulation and damages fibroblasts , the skin cells responsible for repairing tissue. This slows down the healing of cuts, burns, acne scars, and surgical wounds.

Smokers are at a higher risk of wound infections, scarring, and complications after medical procedures. Many surgeons even require patients to quit smoking at least four weeks before surgery to improve healing outcomes.6. Higher risk of infectionsA healthy skin barrier and immune system protect against infections. Smoking weakens both. It impairs the activity of white blood cells (macrophages and neutrophils), making it harder for the body to fight bacterial, viral, and fungal infections.

As a result, smokers are more prone to skin infections, slower recovery from warts, cold sores, and fungal rashes, and a higher risk of more serious systemic infections.7. Skin cancerCigarette smoke contains more than 70 known carcinogens, which increase the risk of skin cancers such as squamous cell carcinoma (SCC). Studies show that smokers with melanoma have a 40% lower survival rate than non-smokers, suggesting smoking worsens prognosis.

Additionally, oral cancers in the lips, tongue, and throat are strongly linked to tobacco use.8. PsoriasisPsoriasis is a chronic autoimmune skin condition that causes red, scaly patches. Smoking is a well-documented trigger, with nicotine increasing inflammation and oxidative stress in the skin. It not only raises the risk of developing psoriasis but also makes flare-ups more severe and reduces the effectiveness of treatments such as biologics and light therapy.9. EczemaBoth active smoking and second-hand smoke exposure increase the risk of atopic dermatitis (eczema), particularly in children and teenagers. Cigarette smoke disrupts the skin barrier, allowing allergens and irritants to trigger itching, redness, and flare-ups. In households where parents smoke indoors, children face a significantly higher risk of hand eczema and chronic atopic dermatitis.10. AcneSmoking may worsen inflammatory acne by increasing oxidative stress and sebum (oil) production.

While the link is debated, several studies suggest that smokers have more frequent acne breakouts, stubborn pimples, and slower healing. Some dermatologists also use the term "smoker’s acne", describing acne that resists standard treatments.11. Vasculitis (Buerger’s Disease)Buerger’s disease is a rare but serious condition caused by inflammation of blood vessels, strongly associated with heavy smoking. It reduces blood flow to the hands and feet, causing skin ulcers, chronic pain, tissue damage, and even gangrene in severe cases.

Smokers with vasculitis may eventually require amputation if they do not quit.12. Spider veins on the palmsKnown medically as palmar telangiectasia, this condition is marked by tiny, visible blood vessels spreading across the palms. Long-term smoking damages small blood vessels, making them dilate and visible under the skin. While not life-threatening, it is an early sign of vascular damage caused by smoking.13. LupusSmoking increases the risk of systemic lupus erythematosus (SLE) and cutaneous lupus, autoimmune conditions that cause inflammation, rashes, and joint pain.

It also reduces the effectiveness of standard lupus treatments, including antimalarial drugs. People with lupus who smoke often have more severe flare-ups and a harder time managing symptoms.14. Hair loss (Alopecia)Smoking affects the hair as much as the skin. Nicotine restricts blood flow to hair follicles, depriving them of oxygen and nutrients. This accelerates male pattern baldness (androgenic alopecia) and increases risk of premature greying.

The DNA damage and free radicals in cigarette smoke also weaken hair roots, causing thinning and breakage.15. Polymorphic light eruptionThis is a sun-induced rash that appears as itchy red spots or blisters. Smokers are more vulnerable to this condition because their immune system is weakened, and their skin barrier is already compromised by toxins. People who smoke more than 15 cigarettes per day have a significantly higher risk of developing this rash during spring or summer.16. Palmoplantar pustulosisA rare but painful skin disorder, palmoplantar pustulosis causes blister-like sores filled with pus on the hands and feet. It is strongly linked to smoking, with most patients being current or former smokers. In many cases, quitting smoking completely clears up symptoms within a few months, showing how directly tobacco affects this disease.Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before making any changes to your health routine or treatment.