We all know that smoking causes cancer. But does it cause acne?
To be honest, the jury’s still out.
While some studies suggest that smoking makes acne worse, others studies don’t.
In this article, I’ll try to make sense of the research that’s already out there. Keep reading to find out what I learned.
The Correlation Between Smoking and Acne
Truth bomb: The studies that measure the relationship between smoking and acne are all over the place. Sometimes they show a positive correlation, sometimes a negative correlation, and sometimes no correlation.
Either way, here’s a quick recap of the major studies that are out there:
- [Positive correlation] A study conducted in Hamburg, Germany found that acne was more common in active smokers, with 40.8% of smokers exhibiting acne compared to 25.2% of non-smokers. Furthermore, heavier smokers were found to have more severe acne.
- [No correlation] In a questionnaire-based study conducted in Iran, researchers compared smokers with acne and non-smokers with acne, but they didn’t find a significant difference between the two groups.
- [Positive correlation] An Italian study conducted on 1047 women (aged 25-50) found that 41.5% of smokers had post-pubertal acne, compared to 9.7% of the non-smokers. Surprisingly, all patients with severe acne were also heavy smokers—puffing over 15 cigarettes per day.
- [Negative correlation] An Israeli study conducted on 27,083 men discharged from the army found a negative correlation between smoking and acne. In fact, researchers found that active smokers were less likely to have severe acne than non-smokers.
- [No correlation] A Danish study conducted on 186 adolescents (aged 15-22) found no correlation between cigarette smoking and acne. Interestingly however, they found that oral contraceptives (birth control) was associated with lower rates of acne.
- [Positive correlation] Another study reviewed the medical records of patients (from either Hong Kong or India) with acne. In terms of the male patients, researchers again found a positive correlation between smoking and acne.
- [Negative correlation] After administering a questionnaire to 165 patients with acne, Mills et al. found that the percentage of smokers in the group was lower than the national average. From this, they hypothesized that smokers were less likely to develop acne because of nicotine’s anti-inflammatory effects.
After looking at the studies, it looks like younger people (those aged 22 and below) don’t deal with the negative effects of acne, while older people (those aged 25 and above) do. Of course, that’s just my opinion. More research is needed to draw a definite conclusion.
Side note: You’ve probably heard the mantra: “Correlation does not imply causation.” So just because two variables—in this case, smoking and acne—have a statistical relationship with one another, it doesn’t necessarily mean that they’re entwined in a cause-and-effect relationship. These two things could be related. Or acne could be caused by any number of things (i.e. diet, stress, environment, etc.).
How Smoking Can Affect Your Skin (And Maybe Your Acne)
Let’s admit it. The studies surrounding smoking and acne are contradictory at best. But that doesn’t mean that you can get off scot-free. Your skin will undoubtedly suffer if you start/continue to smoke cigarettes.
Here are some of the things you can expect from cigarette smoking.
- Slows down the wound healing process. You might have heard that smoking constricts your blood vessels. Well, when your blood vessels are constricted, oxygen and nutrients have a hard time reaching your wound. That might mean that your acne scars will stick around longer.
- Increases sebum secretion rates. One study found that smokers secreted 3 times more sebum than their non-smoker counterparts.That’s a pretty significant finding, especially since increased sebum production is one of the major factors that leads to acne.
- Makes your sebum comedogenic. The same study (from the previous bullet point) found that smokers’ sebum contained less Vitamin E (an antioxidant) and more peroxidated squalene (a lipid gone bad). Since Vitamin E has protective effects and peroxidated squalene has comedogenic (aka pore-clogging) effects, the authors of this study hypothesized that smoking and acne are indeed related.
- Leads to wrinkles. Cigarette smoke is toxic. And as such, it leads to oxidative stress, or an imbalance of free radicals (the bad guys) and antioxidants (the good guys). This type of “stress” can actually degrade collagen and elastin, ultimately leading wrinkled/saggy skin.
- Puts you at a greater risk for skin cancer. Everyone knows that smoking cigarettes leads to lung cancer. But that’s not where the story ends. One study found that smoking is a significant risk factor in squamous cell skin cancer.
I’ll level with you. According to the studies that are out there, a direct line between smoking and acne doesn’t really exist. Some studies found a relationship between the two, while other studies didn’t. So smoking might make acne worse, it might make acne better (a la Mills’ hypothesis of nicotine’s anti-inflammatory effects), or it might not have any relationship with acne.
But, whatever you do:
Please don’t use the lack of research to continue/start smoking.
Because, at the end of the day, there’s a ton of research that definitively says that smoking is just plain BAD. It can lead to a multitude of health problems. Not to mention, in United States, there are about 480,000 smoking-related deaths per year. Yikes!