You've heard the statistics. Smoking causes three million deaths per year worldwide.1-2 It causes many forms of cancer and untold pain and suffering, not to mention billions of dollars in preventable health care costs.3 Common sense would say that smoking negatively effects almost every bodily condition, including acne. But evidence remains unclear whether this is true.1-4 A study published in the Journal of Investigative Dermatology in 2006 in which trained nurses interviewed 27,083 young men over a 20 year period came to a surprising conclusion: "Active smokers showed a significantly lower prevalence of severe acne than nonsmokers."5 In another study, published in 2007 in the Journal of the European Academy of Dermatology and Venereology, researchers reported that of the 594 participants studied, "In girls, smoking was significantly associated with lower prevalence of acne. No significant associations between acne and smoking variables were detected among boys."6 A study published in the British Journal of Dermatology in 2001 seems to refute these findings. 896 people were examined for the study. Smokers tended to have more acne, and the more they smoked, the worse their acne presented itself.7 A more recent study of 1046 adult women, performed in 2009, showed a "strong correlation" between smoking and non-inflammatory acne.8 Other studies have showed no statistical difference between smokers and non-smokers in regards to acne.9-11 In short, evidence is conflicting and the medical research community needs quite a bit more data to come to a consensus.
While smoking may or may not aggravate acne, it nevertheless does harm the skin.12 Smoking constricts blood vessels and damages the surface of many parts of our bodies, from the cells that line our organs to the skin that protects us. It also induces an inflammatory reaction in the body, precipitating a huge list of diseases. Specific to the skin, smoking is linked to poor wound healing and psoriasis.1-2 It may also be related to skin cancers.3
Smoking is also closely associated with wrinkles and premature skin aging.1-2 Smoking creates free radicals, impairs collagen production, and degrades skin proteins, all of which age the skin.2 Quitting smoking, or not taking up smoking in the first place, is one of the best preventative measures against premature aging. Smoking can also stain the teeth and hasten hair loss.1-2 Not surprisingly, in surveys of body esteem, smokers tend to rank lower than non-smokers.4
As with many things in life, there are exceptions to the rule. For instance, evidence is showing that smoking may actually help protect against mouth sores and rosacea. The potential positive effects of smoking are most likely from nicotine, and not from smoking itself. Nicotine by itself is not necessarily harmful. In the case of acne, the constriction of blood vessels that nicotine produces may inhibit the production of more severe forms of acne in a lucky few people. How and if this happens is still up to debate.
Resource to help you quit: smokefree.gov