Skin looks worse after quitting smoking

We know smoking is bad for our health. Decades of research have proven that smoking is the leading risk factor for disease burden in Australia. It is linked to 39 diseases, including 19 types of cancer, 7 types of cardiovascular disease, and chronic obstructive pulmonary disease. Smoking impacts every organ in the body — including the skin. From speeding up the effects of aging to causing skin cancers, smoking can significantly impact the way our skin looks and functions. Below, we look at the effects of smoking on the skin. We also break down why you might have developed bad skin after quitting smoking and explain what you can do about it.

Effects of Smoking on Skin

When you inhale cigarette smoke, your body is exposed to over 7,000 chemicals and toxic substances, including nicotine and tar. These elements can damage your skin in a number of ways.

Skin Ageing

Smoking speeds up the process of skin ageing.

Many of the chemicals in tobacco damage the collagen and elastin fibres within the skin. These fibres help to keep the skin strong and elastic, giving it that youthful ‘plump’ appearance.

When collagen production decreases and the skin’s elasticity is damaged, the skin begins to sag and wrinkle. This is why smokers often experience wrinkled skin at a younger age than non-smokers.

Smoking also exposes our skin to more free radicals, which are molecules that weaken the skin cells and tissues. This causes skin sagging, wrinkles, and dark spots. Free radicals are produced by our bodies naturally, but are also found in alcohol, pollution, foods, and, you guessed it — tobacco.

Smoking depletes vitamin A levels in our bodies, which are essential for protecting our skin from free radical damage.

It’s also thought that pursing your lips to smoke repeatedly can contribute to the formation of wrinkles around the mouth.

Skin Complexion

When you smoke, your skin complexion changes. This is largely due to the nicotine content in cigarettes.

Nicotine is the addictive chemical found in cigarettes. It causes the blood vessels in the skin to narrow, which limits the amount of oxygen your skin receives. When your skin is starved of oxygen, the colour tends to drain from the face and you are left with an uneven, dull, and grey complexion.

Smoking increases the levels of melanin in the skin, which can lead to dark spots and pigmentation. You may also experience skin yellowing from the nicotine and tar within cigarettes. This typically appears around your fingers where you hold your cigarette.

Skin Healing

Nicotine causes vascular constriction, which impairs the body’s ability to send blood through the body.

This lack of blood flow makes it more difficult for your skin to heal wounds, and your skin is also more likely to scar from injuries.

Skin Cancer

A 2013 study found that smoking doubles the risk of squamous cell carcinoma (SCC), the second most common form of skin cancer.

SCC may appear as rough or scaly patches, open sores, warts, or raised lumps on the skin. They are likely to appear brown on dark skin tones and red on lighter skin tones.

Buerger’s Disease

Vasculitis is a group of autoimmune diseases that occur when the blood vessels become inflamed and narrow. The body struggles to deliver these blood vessels to various organs.

Cigarette smoking puts you at risk of a particular type of vasculitis, known as Buerger’s Disease.

Symptoms of Buerger’s Disease include pale, red or bluish fingers and toes, painful sores on your extremities, gangrene, and pain in the feet, hands, ankles, or legs.

Spider Veins

Spider veins, medically known as telangiectasia, occur when small blood vessels within the body dilate, damaging the capillary walls.

They are most noticeable when this happens close to the skin’s surface. They usually appear as purple blotches or very prominent veins.

Smoking has been closely linked with palmar telangiectasia, which occurs on the palms of the hands.

A study found that out of 30 participants who currently smoked, half had palmar telangiectasia.

Psoriasis and Eczema

Nicotine affects the immune system, skin cell growth, and inflammation in the body, which is why it can cause skin conditions such as psoriasis and eczema.

Psoriasis is a chronic inflammatory skin condition that produces itchy, scaly patches on the skin. Smokers have a higher risk of developing psoriasis. Cases also tend to be more severe in smokers.

Smoking can also cause atopic dermatitis, which is the most common form of eczema. Eczema presents as dry, itchy patches on the skin.

Does Smoking Cause Acne?

Increasingly, research is showing that smoking can cause or worsen acne. It has been heavily linked to the onset of adult acne.

Smoking actually causes a particular type of acne called atypical post-adolescent acne (APAA). This form of acne is non-inflammatory and has a different pathway from inflammatory acne, which is the more common form.

This condition is also known as smoker’s acne.

It should be noted that smoking can also trigger hidradenitis suppurativa (HS) which is known as acne inversa. It is an inflammatory skin disease that causes wounds to develop where skin rubs against skin, such as under the breasts or armpits.

Smoker’s Acne Symptoms

While inflammatory acne presents as inflamed, red pimples, APAA appears as blocked pores, whiteheads, and blackheads.

Whiteheads are small pimples without redness, while blackheads are open spots on the skin that become clogged with oil and dead skin cells.

Smoker’s acne can appear anywhere on the body.

Why Does It Happen?

It’s thought that smoking triggers acne in two different but related ways.

Firstly, smoking increases sebum peroxidation of the skin. Sebum is the oily substance within the pores that causes blackheads. Peroxidation occurs when free radicals attack the fatty acids within the sebum.  When the fatty acids within the sebum break down, bacteria are formed. This creates the ideal environment for acne to develop.

Secondly, smoking decreases vitamin E production by degenerating the fatty acids that transport it through the body. Vitamin E is the antioxidant that prevents free radicals from causing peroxidation. Without enough Vitamin E, free radicals are left to attack the sebum and repeat the peroxidation cycle.

Smokers are four times more likely to have acne than non-smokers.

What Happens to Your Skin When Quitting Smoking?

When you quit smoking, you reduce the inflammation of the blood vessels that is responsible for smoking-related skin concerns. Your circulation and heart rate also improve, as does your heart and lung function.

These changes have flow-on benefits for your skin.

Skin Cell Turnover Increases

We know that nicotine inflames the blood vessels, which restricts blood flow and oxygen to the skin. Our skin cells need oxygen in order to regenerate effectively. When you quit smoking, the inflammation of your blood vessels settles, and the blood supply to the skin cells increases again. This means your cells will receive enough oxygen and antioxidants, which prompts skin cell turnover.

Aging Process Slows

When you stop smoking, the collagen production in your body returns to normal again. This means your dark spots and discolouration will fade, and your skin will have a healthier, bouncier appearance. While the smoking-related wrinkles won’t go away, quitting will slow down the development of more wrinkles.

Complexion Improves

You’ll likely notice improvements to your complexion within the first 24 hours of quitting smoking. The blood vessels are no longer restricted and your circulation improves, meaning oxygen is travelling more freely around the body. This will help to even out your complexion and restore colour to your skin.

Skin Benefits of Quitting Smoking: A Timeline

So, when do the skin-related benefits of quitting smoking appear?

Just 24 hours after quitting, the colour in your skin will begin to return thanks to increased circulation and blood flow.

One week after quitting, the oxygen levels in the skin increase, which creates more vibrancy in the skin.

One month after quitting, circulation in the body is fully restored. This means increased cell turnover, which gives the skin a healthy glow.

Six months after quitting, you will likely see a reduction in fine lines and pigmentation.

One year after quitting, your skin recovery is complete. You will likely find your skin appears brighter, is more resilient, and is less prone to irritation and pigmentation.

When you quit smoking, you are likely to experience a range of unpleasant nicotine withdrawal symptoms. 

Over time, your body has gotten used to receiving a regular dose of nicotine during the day. When you quit, your body will signal to you that it desires another hit of nicotine. You may experience a number of withdrawal symptoms including anxiety, cravings, irritability, headaches, stomach upset, and flu-like symptoms.

While uncommon, acne flare-ups are also a possible side effect of quitting. Essentially, the body goes into stress mode when adjusting to a world without cigarettes. This can trigger inflammation, which can worsen or trigger acne breakouts. Any major change to the body, like quitting smoking, can throw our hormones off balance and cause increased oil production within the skin.

Your diet may also be responsible for your post-quitting breakouts. If you’ve changed your diet during your quitting period, your skin may be reacting to this. Foods high in iodine, such as soy, dairy, and shellfish, are triggers for acne.

The good news is that once the nicotine is cleared from your system, the acne flare-up will settle again. You will likely notice the acne reduces again once the withdrawal period ends. This usually takes about four weeks.

The best thing you can do is stick to your quit plan and prepare to reap the skin-rewarding benefits of smoke-free living.

A Final Word

When you quit smoking, the health of all of your organs improves — that includes the skin. Smoking can cause a range of skin-related issues, including advanced aging, pigmentation, psoriasis, acne, and spider veins.

While you may experience acne flare-ups in the initial phase of quitting, this will soon settle and the health of your skin will be greatly restored. Quitting improves skin by slowing the aging process, promoting skin cell turnover, increasing circulation, and boosting collagen production.

Have a question about quitting? You can book a telehealth appointment with a specialist-trained GP for free to discuss your road to quitting.

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