Why smoking is bad for your skin

Frequent readers will know that I routinely recommend that my patients quit smoking to look and feel their best. All of my handouts about the different surgeries that I do emphasize how important it is to stop smoking. I have refused to do rhinoplasties or face lifts on smokers until they quit (and many actually do!). But why is that important? Why do I care so much?

Jeff the diseased lung thinks you should stop smoking. #JeffWeCan

Everybody knows that smoking increases your chances of getting heart and lung disease and different kinds of cancers. While those things are important, those aren’t the major reasons that I want all of my patients-not just surgical patients, but everybody- to stop smoking. Today we’re going to explore why tobacco is the enemy of good looking skin.

1) Studies have shown that tobacco smoke affects the quality of the collagen in your skin. Collagen is a protein that makes up a lot of the material in your skin. It is constantly being remodeled which is why it’s good to use retinol-based skin care products. For more on retinol, check out this post from my archives. Tobacco smoke causes the break down of healthy collagen and other proteins found in healthy skin.(1)

2) Cigarette smoke is full of free radicals. What’s a free radical? Basically it’s a piece of matter that damages DNA and other big molecules. You’ve heard about how good antioxidants are for you, right? Well one reason why is that antioxidants help scrub out free radicals. Your skin is assaulted by all kinds of other things that cause free radicals to form (UV light for instance). Cigarettes just make that worse!

3) Nicotine is a powerful vasoconstrictor. In other words, it causes the little blood vessels feeding your skin to get squeezed off. Healthy skin has lots of blood and nutrients running to it to look its best. When you deprive it of those things, it’s not going to look as good! This is the main reason why I want my surgical patients to quit. Smokers don’t heal as well and are more prone to post-operative problems.(2)

People also ask me about vaping. For those of you who aren’t sure what that is, it’s an alternative to smoking. People fill vaporizers with various liquids that get heated up and inhaled. Many contain nicotine. While they’re probably safer for you than cigarettes, the ones that contain nicotine won’t be any better for your skin health.

If you’re an active smoker, don’t worry, I’d still love to talk to you. However, I won’t do cosmetic surgical procedures on you until you’ve quit. Many people have successfully used that as a motivator. I tell people that I want them off of cigarettes for six weeks in advance of surgery and for six weeks after. For most people, if they’ve made it that long, then they just don’t pick it back up.


1) Morita, A. Tobacco smoke causes premature skin aging. J Dermatol Sci. 2007 Dec;48(3):169-75. Epub 2007 Oct 24.

2) Pluvy, I et al. Smoking and plastic surgery, part II. Clinical implications: a systematic review with meta-analysis. Ann Chir Plast Esthet. 2015 Feb;60(1):e15-49. doi: 10.1016/j.anplas.2014.09.011. Epub 2014 Oct 25.

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