Smoking and Aging

In the December 2007 Archives of Dermatology there is an article published about a pair of identical twins. Although you cannot access the article without purchasing the access, photos of the two women are on the cover of the journal, and a clickable box on the link will enlarge the cover and the photos.

Both the twins, age 52, lived remarkably similar lifestyles and had similar jobs, drivers for a delivery service, and similar histories of sun exposure. Neither was a tanner but both reported "somewhat regular" sun exposure during adulthood and "frequent sunburns" during childhood. Neither had used sunscreens or topical anti-aging products. They lived in the same towns until the past year. The major difference in their histories was that one twin had a history of smoking 52.5-pack-years, probably  close to two packs daily while the second, less wrinkled, twin was a nonsmoker. The nonsmoker not only had fewer wrinkles but her skin was also tighter appearing, with shallower creases than the skin of her sister.
There are other studies that confirm the aging effect of cigarette smoking, but the mechanism is unknown. There have been a number of speculations, including the adverse effect of smoking on the microcirculation, and the apparent ability of constituents of cigarette smoke to damage collagen and elastic fibers in the skin.
Those of us who work with the skin know that the skin of smokers frequently looks different, with a somewhat gray cast. Also, it is well recognized that smokers are much more likely to have problems healing from injuries and surgeries.
It has been estimated that more than $160 billion was spent in 2005 on products and procedures to reverse the effects of skin aging. Certainly the avoidance of smoking, and possibly passive cigarette smoke as well, plus the regular use of sunscreens, even when outdoors in the winter, is an inexpensive way to start.

Gerald N. Bock MD
Stockton, CA
California Skin Laser Center