Smoking — Acne?

Dear Alice,

Does smoking promote or cause acne or breakouts?

Pimpled Puffer

Dear Pimpled Puffer,

There is a lot of debate about the link between smoking and acne, and the studies that have been done have conflicting results.

A meta-analysis (researchers looking at multiple studies on the same topic) on smoking and acne found that there does not seem to be a definite link between acne and smoking in any direction. In fact, a couple of the studies reviewed found subjects who smoked were less likely to have acne than those who didn't smoke (this was a small number of studies, so it may be difficult to generalize to a larger population that smoking prevents acne). Other studies reviewed also revealed a negative association between smokers and acne. One such study found that women ages 25 to 50 with severe post-adolescent acne were more likely to be smokers. As you can see, research findings have been contradictory and more research needs to be done to establish a more definitive link.

Although the connection between smoking and acne remains unclear, smoking can lead to other health-related issues that adversely affect the skin, such as:

  • Thin, fragile, and sagging skin
  • Grey skin appearance
  • Prominent wrinkles
  • Yellowing/browning of the skin and nails
  • Psoriasis
  • Contact dermatitis
  • Poor wound healing
  • Palmoplantar pustulosis
  • Increased risk of squamous cell carcinoma (a type of skin cancer)

If you're concerned about your skin appearance due to smoking, Pimpled Puffer, you may consider trying to cut back or quit. And guess what? There are many resources available to help you! Check out  the Go Ask Alice! Cigarettes, Chewing Tobacco, & Other Nicotine archives and the recommended resources below. If your acne is bothering you, you may want to see a health care provider or a dermatologist to discuss skin care and acne treatment options. Here’s to clearing both the smoke and your skin!

Last updated Jul 27, 2015
Originally published Nov 01, 1993

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