Table of ContentsView AllTable of ContentsSymptomsCausesOther ConditionsVaping and AcneFAQs
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Other Conditions
Vaping and Acne
FAQs
Cigarette smoking can cause certain types of acne. It is associated with a non-inflammatory form of acne called atypical post-adolescent acne (APAA), or simply “smoker’s acne.“It is also linked to an acne-like condition known as acne inversa, which can irreversible damage.
Chemicals in tobacco smoke can damage the skin in the same way they do other organs of the body. They can also change the composition and density of skin oils, known assebum, leading to clogged pores and the outbreak ofblackheads and whiteheads.
This article explains how smoking and acne are linked. It also explores whether e-cigarettes (vaping) can contribute to acne outbreaks.
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Symptoms of Smoker’s Acne
Researchers at the San Gallicano Dermatological Institute in Italy were among the first to suggest that smoking causes a specific type of acne known as atypical post-adolescent acne (APAA). The condition is popularly known as “smoker’s acne” due to its close association with cigarettes.
APAA is a non-inflammatory form of acne that doesn’t cause the redness, warmth, and swelling of inflammatory forms likecystic acne,nodular acne, andacne vulgaris(the most common form of acne).
Rather than producing inflamed pimples, APAA causes small, non-inflamedskin bumpsknown ascomedones. Comedones form when sebum and dead skin cells block oil-producing glands in the skin known assebaceous glands.
There are two types of comedones that can occur with smoker’s acne:
With smoker’s acne, the outbreak of comedones can give the skin a rough, patchy texture.
While APAA can affect the chin, forehead, nose, and even the back, the lips—where comedones commonly occur—are usually not affected.
Causes of Smoker’s Acne
Researchers have found that two interconnected factors contribute to the development of APAA.
The first is something called sebum peroxidation. This is when unstable molecules known asfree radicalsattack fatty acids in sebum, causing the oil to break down and become thicker and stickier. This can lead to blocked pores and comedones.
What Is Smoker’s Flu?
Smoking and Other Forms of Acne
Although APAA is strongly linked to cigarette smoking, it is unclear if smoking is directly linked to acne vulgaris and other more common forms of acne. Claims that it does so remain controversial.
A 2020 review of studies found conflicting evidence as to whether smoking and acne are linked, with some studies reporting a direct correlation and others finding no correlation at all. Further research is needed.
Acne Inversa
Acne inversa, also known ashidradenitis suppurativa, is an inflammatory skin condition that is most definitely linked to smoking. It causes large pus-filled nodules that can burst open and leave visible scars. Middle-aged female smokers are most commonly affected.
Acne inversa is not “acne” in the traditional sense of the word. While it looks similar to acne vulgaris, it affects theapocrine glandsthat secrete sweat rather than the sebaceous glands that secrete sebum. The acne-like bumps are also larger and occur mainly in the armpits, groin, thighs, or buttocks
While the cause of acne inversa is known, smoking appears to be one of the main triggering factors for the disease.
How to Prevent Acne Scars
Does Vaping Cause Acne?
Like smoking,vapingcan causeserious health concerns. But compared to cigarette smoke, vaping produces far fewer hydrocarbons and theoretically poses less of a risk of acne,
This doesn’t mean that vaping poses no risks. E-cigarettes contain a substance called propylene glycol that can severely dehydrate the skin and mouth.Nicotinein e-cigarettes has the same effect.
While there is no clear connection between vaping and acne, skin dehydration will invariably increase sebum production in order to keep the skin well moisturized. With the increased production of sebum comes an increased risk of acne.
There is also evidence that nicotine used in most e-cigarettes can cause premature skin aging.
Is Vaping Better Than Smoking?
Summary
Cigarette smoking can lead to a non-inflammatory form of acne called atypical post-adolescent acne (APAA), or simply “smoker’s acne.” Smoking can also cause an inflammatory skin condition known as acne inversa that can lead to irreversible scarring.
It is unclear if vaping has any direct association with acne. Even so, many e-cigarettes contain nicotine and other chemicals that are known to be damaging to the skin.
What to Know About Nicotine Withdrawal
Frequently Asked QuestionsOver the short term, smoking can cause the yellowing of the finger and nails and the darkening and discoloration of the tongue. Long-term effects include dry skin, deeper facial wrinkles, uneven skin tones, baggy eyes, lip wrinkles, and a saggy jawline.Smoker’s acne is a form of atypical post-adolescent acne (APAA), This is a non-inflammatory acne typically treated with a combination of two or more topical agents includingtopical antibiotics, topical azelaic acid, and topical benzoyl peroxide.Smoking causes blood vessels in the skin to narrow. By quitting, those vessels can widen and provide more oxygen and nutrients to tissues. This, in turn, increasesskin cell turnover, which can improve the quality of the skin as well as its ability to heal wounds like acne.Acne scars can be treated withdermal fillers,collagen injections,steroid injections,laser resurfacing, anddermabrasion(for really deep scars).Vaping is not considered a risk factor for acne scarring, but there is evidence that it can contribute to other adverse skin changes, such as premature skin aging.
Frequently Asked Questions
Over the short term, smoking can cause the yellowing of the finger and nails and the darkening and discoloration of the tongue. Long-term effects include dry skin, deeper facial wrinkles, uneven skin tones, baggy eyes, lip wrinkles, and a saggy jawline.
Smoker’s acne is a form of atypical post-adolescent acne (APAA), This is a non-inflammatory acne typically treated with a combination of two or more topical agents includingtopical antibiotics, topical azelaic acid, and topical benzoyl peroxide.
Smoking causes blood vessels in the skin to narrow. By quitting, those vessels can widen and provide more oxygen and nutrients to tissues. This, in turn, increasesskin cell turnover, which can improve the quality of the skin as well as its ability to heal wounds like acne.
Acne scars can be treated withdermal fillers,collagen injections,steroid injections,laser resurfacing, anddermabrasion(for really deep scars).
Vaping is not considered a risk factor for acne scarring, but there is evidence that it can contribute to other adverse skin changes, such as premature skin aging.
15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mitri A, Lin G, Waldman RA, Grant-Kels JM.Effects of tobacco and vaping on the skin.Clin Dermatol.2021 Sep-Oct;39(5):762-71. doi:10.1016/j.clindermatol.2021.05.004Vinkel C, Thomsen SF.Hidradenitis suppurativa: causes, features, and current treatments.J Clin Aesthet Dermatol.2018 Oct;11(10):17-23.Melibary YT, Alkeraye S, Alnutaifi KA, et al.Occasional acne; an acne variant.Clin Cosmet Investig Dermatol. 2019 Apr 10;12:219-22. doi:10.2147/CCID.S199991Kurokawa I, Nakase K.Recent advances in understanding and managing acne.F1000Res. 2020;9:F1000 Faculty Rev-792. doi:10.12688/f1000research.25588.1Patterson AT, Tian FT, Elston DM, Kaffenberger BH.Occluded cigarette smoke exposure causing localized chloracne-like comedones.Dermatology.2015;231(4):322-5. doi:10.1159/000439046Yang YS, Lim HK, Hong KK. et al.Cigarette smoke-induced interleukin-1 alpha may be involved in the pathogenesis of adult acne.Ann Dermatol.2014 Feb;26(1):11–16. doi:10.5021/ad.2014.26.1.11Zhang JZ, Fang X, Yu SR, Luo D, LI TT, Kang XJ.Association between acne and smoking: systematic review and meta-analysis of observational studies.Chin Med J (Engl).2021 Aug 5;134(15):1887–8. doi:10.1097/CM9.0000000000001286Vossen ARJV, Van der zee HH, Prens EP. Hidradenitis Suppurativa:A systematic review integrating inflammatory pathways into a cohesive pathogenic model.Front Immunol. 2018;9:2965. doi:10.3389/fimmu.2018.02965.Oh AY, Kacker A.Do electronic cigarettes impart a lower potential disease burden than conventional tobacco cigarettes? Review on e-cigarette vapor versus tobacco smoke.Laryngoscope. 2014 Dec;124(12):2702-6. doi:10.1002/lary.24750Ezerskaia A, Pereira SF, Urbach HP, Verhagen R, Varghese B.Quantitative and simultaneous non-invasive measurement of skin hydration and sebum levels.Biomed Opt Express.2016 Jun 1;7(6):2311–20. doi:10.1364/BOE.7.002311Visconti MJ, Ashack KA.Dermatologic manifestations associated with electronic cigarette use.J Am Acad Dermatol. 2019 Oct;81(4):1001-7. doi: 10.1016/j.jaad.2019.03.088American Osteopathic College of Dermatology.Smoking and its effects on the skin.Yazdanparast T, Hassanzadeh H, Nasrollahi SA, et al.Cigarettes smoking and skin: a comparison study of the biophysical properties of skin in smokers and non-smokers.Tanaffos. 2019 Feb; 18(2): 163–8.Gozali MV, Zhou B.Effective treatments of atrophic acne scars.J Clin Aesthet Dermatol.2015 May;8(5):33–40.Eltony SA,, Ali SS.Histological study on the effect of nicotine on adult male guinea pig thin skin,Anat Cell Biol. 2017 Sep;50(3):187–99. doi:10.5115/acb.2017.50.3.187
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mitri A, Lin G, Waldman RA, Grant-Kels JM.Effects of tobacco and vaping on the skin.Clin Dermatol.2021 Sep-Oct;39(5):762-71. doi:10.1016/j.clindermatol.2021.05.004Vinkel C, Thomsen SF.Hidradenitis suppurativa: causes, features, and current treatments.J Clin Aesthet Dermatol.2018 Oct;11(10):17-23.Melibary YT, Alkeraye S, Alnutaifi KA, et al.Occasional acne; an acne variant.Clin Cosmet Investig Dermatol. 2019 Apr 10;12:219-22. doi:10.2147/CCID.S199991Kurokawa I, Nakase K.Recent advances in understanding and managing acne.F1000Res. 2020;9:F1000 Faculty Rev-792. doi:10.12688/f1000research.25588.1Patterson AT, Tian FT, Elston DM, Kaffenberger BH.Occluded cigarette smoke exposure causing localized chloracne-like comedones.Dermatology.2015;231(4):322-5. doi:10.1159/000439046Yang YS, Lim HK, Hong KK. et al.Cigarette smoke-induced interleukin-1 alpha may be involved in the pathogenesis of adult acne.Ann Dermatol.2014 Feb;26(1):11–16. doi:10.5021/ad.2014.26.1.11Zhang JZ, Fang X, Yu SR, Luo D, LI TT, Kang XJ.Association between acne and smoking: systematic review and meta-analysis of observational studies.Chin Med J (Engl).2021 Aug 5;134(15):1887–8. doi:10.1097/CM9.0000000000001286Vossen ARJV, Van der zee HH, Prens EP. Hidradenitis Suppurativa:A systematic review integrating inflammatory pathways into a cohesive pathogenic model.Front Immunol. 2018;9:2965. doi:10.3389/fimmu.2018.02965.Oh AY, Kacker A.Do electronic cigarettes impart a lower potential disease burden than conventional tobacco cigarettes? Review on e-cigarette vapor versus tobacco smoke.Laryngoscope. 2014 Dec;124(12):2702-6. doi:10.1002/lary.24750Ezerskaia A, Pereira SF, Urbach HP, Verhagen R, Varghese B.Quantitative and simultaneous non-invasive measurement of skin hydration and sebum levels.Biomed Opt Express.2016 Jun 1;7(6):2311–20. doi:10.1364/BOE.7.002311Visconti MJ, Ashack KA.Dermatologic manifestations associated with electronic cigarette use.J Am Acad Dermatol. 2019 Oct;81(4):1001-7. doi: 10.1016/j.jaad.2019.03.088American Osteopathic College of Dermatology.Smoking and its effects on the skin.Yazdanparast T, Hassanzadeh H, Nasrollahi SA, et al.Cigarettes smoking and skin: a comparison study of the biophysical properties of skin in smokers and non-smokers.Tanaffos. 2019 Feb; 18(2): 163–8.Gozali MV, Zhou B.Effective treatments of atrophic acne scars.J Clin Aesthet Dermatol.2015 May;8(5):33–40.Eltony SA,, Ali SS.Histological study on the effect of nicotine on adult male guinea pig thin skin,Anat Cell Biol. 2017 Sep;50(3):187–99. doi:10.5115/acb.2017.50.3.187
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Mitri A, Lin G, Waldman RA, Grant-Kels JM.Effects of tobacco and vaping on the skin.Clin Dermatol.2021 Sep-Oct;39(5):762-71. doi:10.1016/j.clindermatol.2021.05.004Vinkel C, Thomsen SF.Hidradenitis suppurativa: causes, features, and current treatments.J Clin Aesthet Dermatol.2018 Oct;11(10):17-23.Melibary YT, Alkeraye S, Alnutaifi KA, et al.Occasional acne; an acne variant.Clin Cosmet Investig Dermatol. 2019 Apr 10;12:219-22. doi:10.2147/CCID.S199991Kurokawa I, Nakase K.Recent advances in understanding and managing acne.F1000Res. 2020;9:F1000 Faculty Rev-792. doi:10.12688/f1000research.25588.1Patterson AT, Tian FT, Elston DM, Kaffenberger BH.Occluded cigarette smoke exposure causing localized chloracne-like comedones.Dermatology.2015;231(4):322-5. doi:10.1159/000439046Yang YS, Lim HK, Hong KK. et al.Cigarette smoke-induced interleukin-1 alpha may be involved in the pathogenesis of adult acne.Ann Dermatol.2014 Feb;26(1):11–16. doi:10.5021/ad.2014.26.1.11Zhang JZ, Fang X, Yu SR, Luo D, LI TT, Kang XJ.Association between acne and smoking: systematic review and meta-analysis of observational studies.Chin Med J (Engl).2021 Aug 5;134(15):1887–8. doi:10.1097/CM9.0000000000001286Vossen ARJV, Van der zee HH, Prens EP. Hidradenitis Suppurativa:A systematic review integrating inflammatory pathways into a cohesive pathogenic model.Front Immunol. 2018;9:2965. doi:10.3389/fimmu.2018.02965.Oh AY, Kacker A.Do electronic cigarettes impart a lower potential disease burden than conventional tobacco cigarettes? Review on e-cigarette vapor versus tobacco smoke.Laryngoscope. 2014 Dec;124(12):2702-6. doi:10.1002/lary.24750Ezerskaia A, Pereira SF, Urbach HP, Verhagen R, Varghese B.Quantitative and simultaneous non-invasive measurement of skin hydration and sebum levels.Biomed Opt Express.2016 Jun 1;7(6):2311–20. doi:10.1364/BOE.7.002311Visconti MJ, Ashack KA.Dermatologic manifestations associated with electronic cigarette use.J Am Acad Dermatol. 2019 Oct;81(4):1001-7. doi: 10.1016/j.jaad.2019.03.088American Osteopathic College of Dermatology.Smoking and its effects on the skin.Yazdanparast T, Hassanzadeh H, Nasrollahi SA, et al.Cigarettes smoking and skin: a comparison study of the biophysical properties of skin in smokers and non-smokers.Tanaffos. 2019 Feb; 18(2): 163–8.Gozali MV, Zhou B.Effective treatments of atrophic acne scars.J Clin Aesthet Dermatol.2015 May;8(5):33–40.Eltony SA,, Ali SS.Histological study on the effect of nicotine on adult male guinea pig thin skin,Anat Cell Biol. 2017 Sep;50(3):187–99. doi:10.5115/acb.2017.50.3.187
Mitri A, Lin G, Waldman RA, Grant-Kels JM.Effects of tobacco and vaping on the skin.Clin Dermatol.2021 Sep-Oct;39(5):762-71. doi:10.1016/j.clindermatol.2021.05.004
Vinkel C, Thomsen SF.Hidradenitis suppurativa: causes, features, and current treatments.J Clin Aesthet Dermatol.2018 Oct;11(10):17-23.
Melibary YT, Alkeraye S, Alnutaifi KA, et al.Occasional acne; an acne variant.Clin Cosmet Investig Dermatol. 2019 Apr 10;12:219-22. doi:10.2147/CCID.S199991
Kurokawa I, Nakase K.Recent advances in understanding and managing acne.F1000Res. 2020;9:F1000 Faculty Rev-792. doi:10.12688/f1000research.25588.1
Patterson AT, Tian FT, Elston DM, Kaffenberger BH.Occluded cigarette smoke exposure causing localized chloracne-like comedones.Dermatology.2015;231(4):322-5. doi:10.1159/000439046
Yang YS, Lim HK, Hong KK. et al.Cigarette smoke-induced interleukin-1 alpha may be involved in the pathogenesis of adult acne.Ann Dermatol.2014 Feb;26(1):11–16. doi:10.5021/ad.2014.26.1.11
Zhang JZ, Fang X, Yu SR, Luo D, LI TT, Kang XJ.Association between acne and smoking: systematic review and meta-analysis of observational studies.Chin Med J (Engl).2021 Aug 5;134(15):1887–8. doi:10.1097/CM9.0000000000001286
Vossen ARJV, Van der zee HH, Prens EP. Hidradenitis Suppurativa:A systematic review integrating inflammatory pathways into a cohesive pathogenic model.Front Immunol. 2018;9:2965. doi:10.3389/fimmu.2018.02965.
Oh AY, Kacker A.Do electronic cigarettes impart a lower potential disease burden than conventional tobacco cigarettes? Review on e-cigarette vapor versus tobacco smoke.Laryngoscope. 2014 Dec;124(12):2702-6. doi:10.1002/lary.24750
Ezerskaia A, Pereira SF, Urbach HP, Verhagen R, Varghese B.Quantitative and simultaneous non-invasive measurement of skin hydration and sebum levels.Biomed Opt Express.2016 Jun 1;7(6):2311–20. doi:10.1364/BOE.7.002311
Visconti MJ, Ashack KA.Dermatologic manifestations associated with electronic cigarette use.J Am Acad Dermatol. 2019 Oct;81(4):1001-7. doi: 10.1016/j.jaad.2019.03.088
American Osteopathic College of Dermatology.Smoking and its effects on the skin.
Yazdanparast T, Hassanzadeh H, Nasrollahi SA, et al.Cigarettes smoking and skin: a comparison study of the biophysical properties of skin in smokers and non-smokers.Tanaffos. 2019 Feb; 18(2): 163–8.
Gozali MV, Zhou B.Effective treatments of atrophic acne scars.J Clin Aesthet Dermatol.2015 May;8(5):33–40.
Eltony SA,, Ali SS.Histological study on the effect of nicotine on adult male guinea pig thin skin,Anat Cell Biol. 2017 Sep;50(3):187–99. doi:10.5115/acb.2017.50.3.187
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