Everyone knows smoking is detrimental to health. Smoking is the leading cause of preventable death in the U.S., causing more than 438,000 deaths per year, according to the American Lung Association. But did you know smoking is bad for your skin and interferes with healing after surgery? Smokers have sallow, dry, rough-looking skin that lacks the vibrant plumpness of the healthy skin of a non-smoker. And despite any healthy habits a smoker develops (such as using sunscreen or exercising), smoking cancels out those efforts. Another little-known fact is that smoking interferes with the healing process following surgery. It doesn’t matter whether you’ve had a facelift or knee replacement‑smoking interferes with healing.
When you light up, smoking shrinks small blood vessels in the body and as a result, the vessels can’t deliver oxygen or nutrients as well, which reduces hydration (or a plumping effect) to skin. Smoking reduces blood supply to your skin the same way a garden hose would only leak out a trickle of water if you stood on it. It stimulates the nicotinic receptors, [located in the central nervous system, which help close?] the tap (or valve) to your blood vessels. Even worse, recent studies show that smoking causes hardening of the arteries (atherosclerosis). When you stop smoking, it improves blood flow in three months. This improved blood flow benefits all tissues, including your skin as well as your heart and lungs. I tell my patients to get off the garden hose and stop smoking for more youthful-looking skin. When long-time smokers see me for a surgical procedure such as a facelift (or mini facelift), I generally recommend they completely stop smoking for up to six months before scheduling surgery. If they return to their smoking routine following surgery, the skin improvements are quickly reversed. My surgical colleagues find similar issues such as slower healing when their patients continue to smoke after surgery. The structural integrity of the tissues is less, meaning the tendons, bones and skin, for example, are not as strong or healthy.
Patients often ask me about electronic cigarettes, or e-cigarettes. These battery-operated devices heat liquids, turning them into an inhalable vapor. Some patients I’ve seen use them to wean off cigarettes. While there’s no scientific evidence that lighting up with e-cigarettes is safe, my advice for healthy skin is to avoid them.
Most e-cigarettes have nicotine, which is the vaso-constrictor that reduces blood flow, just like cigarettes. According to the Mayo Clinic, most experts agree that e-cigs are likely to cause fewer harmful effects than traditional cigarettes. However, researchers have found that some e-cigarettes have nicotine amounts that are different from what’s described on their label, as well as flavoring agents and other additives have shown to be toxic. (For more information, go to www.mayoclinic.org.
Exercising is another simple way to improve the quality of your skin. When I operate on a patient who exercises regularly, I know she’ll heal more quickly than a patient who does not. A 65-year-old woman who exercises regularly, for instance, will heal more quickly than a 50-year-old woman who doesn’t. It’s clear that athletes heal faster. Exercise increases blood flow to all tissues. Surgeons call it “tissue perfusion,” which is when oxygen and other beneficial blood products work their way into the tissues and enrich the cells. All surgeons know that improved blood supply leads to better wound healing and a better chance of surgical success. And that goes for any surgery patient¾whether the procedure is a facelift or a hip replacement. Exercise increases the blood supply to all bodily tissues. There may even be new blood vessel growth with vigorous exercise. In fact, when someone suffers a heart attack, new vessels grow in other parts of the heart to compensate for the reduction in blood flow from the arteries that are plugged. This is known as “neovascularization.”
In the skin care industry, there’s a lot of talk these days about being “age neutral.” This is a phenomenon where people just don’t appear to age. It’s as if time stands still. They don’t necessarily look younger (or they could), but the aging process seems to be halted. Isn’t this what most of us want?
While everyone knows smoking is bad for your lungs, heart and overall health, the benefits of kicking the habit in the short term are dramatic. Any physician who specializes in facial plastic surgery or dermatology, will tell you that the one single, dramatic way to improve the quality of your skin is to stop smoking. So if you’re a smoker, take steps to kick the habit; your skin will become healthier and smoother within three to six months. If you don’t smoke, do yourself a favor and don’t start. Take an important step to feel and look great for as long as you can.
Stanley Jacobs, M.D. F.R.C.S. (C) is a facial plastic surgeon, fellowship trained and certified by the Board of Facial Plastic and Reconstructive Surgery. Jacobs has performed more than 10,000 facial surgeries, and he’s the chief executive officer of World Skin, LLC. He practices in Healdsburg and San Francisco. Jacobs can be contacted at (707) 473-0220, or at drstanleyjacobsmd.com or stanleyjacobsmd.com.
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