With all of the discussion about the negative effects of cigarette smoking on health, let’s not lose sight of the fact that there is something else that is of even greater concern for many people – the fact that cigarette smoking makes you look older. This goes for electronic cigarettes as well!

The reason is thought to be that tobacco extract decreases the production of collagen and increases the breakdown of collagen in the skin. This leads to a weakening of skin structures that in turn leads to an increase in wrinkles and a weakening of supporting structures that allows for facial drooping and bulging in areas such as the lower eyelids. Although electronic cigarettes do not contain tobacco, the nicotine they contain is thought to exert similar effects on the skin.

A recent paper in a prestigious plastic surgery journal (Plastic and Reconstructive Surgery 2013; 132: 1085-1092) looked at this in a most visual way. Each year there is an annual gathering of twins and multiples at the Twins Day Festival in Twinsburg, Ohio. Researchers from Case Western Reserve University in Cleveland interviewed a number of these twins and found 79 sets where one of the twins was a smoker and the other a non-smoker, or where one twin had smoked 5 or more years longer than the other twin. Side-by-side photographs of the twins were taken, and these were judged by a panel of plastic surgeons who did not know which twin smoked or smoked more. The results were striking: Aging changes in smokers were more pronounced in the eyelid, jowl, and mouth regions. Overall the panel was able to correctly judge which twin smoked or smoked longer by just looking at the overall photos. Bottom line: Smoking makes you look older! Interestingly the aging changes in the forehead, between brow, and crow’s feet regions were not increased by smoking. The reason may be that these wrinkles are due to contraction of facial muscles in these areas rather than the negative effects of smoking.

Interestingly, although smoking definitely has negative effects on the skin, it may also affect one’s facial appearance by the effect of smoking on how one’s body fat is distributed. In smokers the fat seems to be located more centrally in the trunk as opposed to the face. The decrease of facial fat may increase the tendency toward facial wrinkle formation.

Whatever the reason for the increase in facial aging, however, there is no better time to stop smoking than now. With New Year’s Resolutions just around the corner, let’s make “Stop Smoking” #1!

Please feel free to share any comments or thoughts.

George Sanders, M.D.