Today’s question:
Dear Nicki,
I started smoking when I was a teenager, smoked for about ten years. Then I quit fifteen years ago. Sometimes I feel like I have more wrinkling than other women my age. Is this due to the smoking?
-Former smoker
Dear Former Smoker,
Unfortunately, yes. Smoking regularly when you are a teenager is associated with 1.75 times the risk of wrinkles when you are older; however, smoking longer during any stage of your life – specifically longer than 19 years – increases your risk to 2.93 times. This is from a 2002 study in the International Journal of Dermatology, which found that a higher degree of wrinkling was noted in individuals 20-39 who had ever smoked than in non-smokers. Older individuals who smoked between 11 and 19 years were 1.75 times more likely than non-smokers of the same age, sex, and social status to exhibit noticeable skin wrinkling. Those who smoked for a time period longer than 19 years were 2.93 times more likely than non-smokers from the same demographic to exhibit conspicuous skin wrinkling. Therefore, the effects of smoking on the skin only worsen with time.
Smoking-related wrinkles are not only found on the mouth, but all over the body. Although “smoker’s mouth” and facial wrinkles are commonly noted, a 2007 study in theArchives of Dermatology found that smokers were more likely than non-smokers to exhibit deep body wrinkles as well. In the study, two dermatology residents and one medical student examined photographs of 82 people ranging in 22-91 years old (average age: 56), and assigned a wrinkling score (0, none; 8, severe), without knowledge of which individuals smoked and which did not.
There are three acknowledged factors that cause wrinkles in smokers, although there are probably several others at play. One is that cigarette smoking has been found to activate matrix metalloproteinases, enzymes which degrade collagen and elastin fibers (Baumann-cited, Lahmann et. al.). Matrix metalloproteinase activation causes the skin of smokers to prematurely wrinkle, sag, and become more transparent.
A second factor is that smoking has been shown to decreasecapillary and arteriolar blood flow in the skin, which may very well damageconnective tissue components that are important to maintainingthe integrity of the skin (Grady and Ernster, 2002). Dr. Leslie Baumann, M.D. notes in her textbook Cosmetic Dermatology that the lack of blood flow slows the rate of wound healing, and therefore patients should be advised to stop smoking prior to any surgery, including a cosmetic surgery or procedure, for which adequate blood flow is required for proper outcome.
A third factor is that smoking increases oxidation activity and vitamin A levels, which are both antioxidants. Vitamin A has also been found to increase collagen levels. A study in the American Journal of Clinical Nutrition found that supplementation with 1000 mg vitamin E partially ameliorated the higher peroxidase levels, but high levels of vitamin A have been found to be toxic, so additional supplementation is not generally recommended (ask your doctor).
It has also been found that white people are affected more than black people, and women are more affected than men (Baumann-cited, Boyd et. al.). Further, hormone replacement therapy does not reduce the risk of facial wrinkling for women who smoke (Baumann-cited,Castelo-Branco et. al.). Genetics must play a role to some degree, although smokers as a whole, regardless of pack-years or frequency, exhibit greater conspicuous skin wrinkling than non-smokers.
Bottom Line
One cigarette may not make you look older, but the younger you are when you have a cigarette, and the longer you smoke, the more likely you are to experience premature wrinkling.
Hope this helps -
Sincerely,
Nicki