Can Smoking Cigarettes Cause Acne?

It's hard to escape hearing about all the negative effects associated with smoking cigarettes. One of the more surprising consequences is that it can cause or worsen acne, especially in adults.

A person with a cigarette in their hand
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Smoker's Acne

Some researchers believe that smoking may indeed be a cause of acne. Researchers at the San Gallicano Dermatological Institute in Rome, Italy suggest that smoking cigarettes may cause acne breakouts.

The study indicates that among adults with acne, non-smokers were more likely to suffer from inflammatory acne. Smoking, on the other hand, shows a higher relationship to non-inflammatory (atypical) post-adolescent acne (APAA).

These findings point to what could be considered a new entity among smoking-related skin diseases. The researchers have dubbed it "smoker's acne."

Higher Chance of Non-Inflammatory Acne

These non-inflammatory breakouts do not appear as the red (inflamed) pimples we often associate with acne. Rather, non-inflammatory acne blocks pores and often appears as skin-colored bumps (comedones) on the skin and non-inflamed blackheads. It can occur anywhere on the body but is most apparent on the cheeks.

Further, the researchers found that smoking increased sebum peroxidation and reduced vitamin E.

Sebum is the oily substance found in pores and when it's blocked, non-inflamed blackheads and comedones can appear on the skin. Vitamin E is an antioxidant and vital to a healthy immune system. A reduction in this may increase bacterial infections that cause acne.

What Do the Numbers Say?

According to researchers, 42 percent of smokers suffered from acne compared to 10 percent of non-smokers. But cigarette smokers seemed to develop non-inflamed acne at a much higher rate than other adult acne sufferers. Within the 1046 women in the study (ages 25 to 50), three-quarters of those with non-inflamed acne were smokers.

The number of cigarettes smoked didn't seem to have an effect on the severity of acne breakouts. However, women who had experienced acne in their teen years were four times more likely to experience smoker's acne as an adult.

Among non-smokers who suffered from non-inflammatory acne, almost half (48.9 percent) were exposed to environmental factors. These included working in a steam-filled kitchen or being constantly exposed to smoke, which could have contributed to their acne.

Study Findings

The study's findings include:

  • 42 percent of smokers had acne, compared to 10 percent of non-smokers.
  • 76 percent of those with non-inflammatory acne were smokers.
  • 91 percent of smokers who suffered from acne had the non-inflammatory form.
  • Among those with severe non-inflammatory acne, 81 percent were smokers.
  • The number of cigarettes smoked per day made no statistical difference.

It May Not Be Acne

Acne inversa (hidradenitis suppurativa) is another skin condition that has been linked to smoking. It is a chronic disease that can leave scars and is most common in middle-aged women.

The connection here is that it looks very similar to acne, though it occurs on specific parts of the body. While an adult smoker's facial acne may be true non-inflammatory acne, acne inversa appears where you have sweat glands.

If you are concerned about acne-like bumps in your armpit, groin, thighs, and other sweaty areas, it's a good idea to see your doctor. Acne inversa may also look similar to boils, but it's important to get treatment as early as possible to mitigate its effects.

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  2. Capitanio B, Sinagra JL, Ottaviani M, Bordignon V, Amantea A, Picardo M. Acne and smoking. Dermatoendocrinol. 2009;1(3):129-35. doi:10.4161/derm.1.3.9638. 

  3. 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.

Additional Reading
  • Ring HC, Saunte DM, Riis PT, Thorlacius L, Esmann S, Jemec G. Diagnosis and Treament of Hidradenitis Suppurativa. Ugeskriftet. 2017;179(18).