Eczema And Smoking


It is well known that smoking is a major cause of many health problems, both long and short-term. However, certain conditions, such as skin disorders, are likely to be overshadowed by larger, more infamous conditions. Although not immediately life-threatening, skin conditions can be unpleasant and painful, and can affect your quality of life. One of the most common skin conditions triggered by smoking is eczema. But how are they linked? 

What is eczema?

Eczema is a condition that causes your skin to become dry, rough, and itchy. It's more common in young children but can affect anyone at any age. It is an inflammatory skin condition sometimes referred to as dermatitis. It comes in several different forms, with the most common being atopic dermatitis, which is caused by an overactive immune system. Many people who live with eczema often report other conditions, such as hay fever, food allergies, and asthma. The exact cause of eczema is unknown, yet researchers believe it is a combination of certain genes predisposing individuals and environmental triggers.

Common triggers of eczema include: 

  • Exposure to extreme heat or cold 
  • Certain soaps, shampoos, and body washes 
  • Fabrics such as wool or polyester
  • Candle fragrances 
  • Metals such as nickel 
  • Dust mites. 
  • Surface cleaners and disinfectants.1


Eczema is characterised by patches of skin becoming itchy, dry, cracked, and sore. These symptoms may fluctuate between periods of improvement and flare-ups. Flare-ups vary between individuals but usually occur a few times per month. Eczema can affect any part of the body, but the hands, the inside of the elbows, behind the knees, and the face are the areas most commonly affected. 

The itching and subsequent scratching of eczema can have a negative impact on people’s life. It can disrupt your sleep, diminish your productivity, affect your self-esteem, and cause anxiety and depression. In more serious cases, it can lead to bleeding skin and infections. Signs of infection include yellow crusting, fluid oozing from the skin, having a fever, and feeling generally unwell.2

Smoking increases the risk of eczema flare-ups

It slows down healing

Smoking can cause dysregulation of the immune system. Tobacco contains nicotine, a highly addictive substance that can cause blood vessels to constrict. This reduction in the diameter of blood vessels means that less blood can travel through the vessels and reach its required destination, reducing the amount of available blood to tissues in the body. This results in slower healing of wounds and damage to previously healthy tissue. Furthermore, nicotine also reduces the number of blood cells and other important cells vital in regulating the immune system in the body.3 

Oxidative stress

Oxygen is an element that plays a crucial role in various functions in the body. It can be used to generate energy by our cells, producing unstable by-products called reactive oxygen species, or free radicals. At low levels, these reactive oxygen species can be beneficial for our immune system. However, at high levels too many of these free radicals build up in the body, causing damage to our cells in the phenomenon of oxidative stress. This process plays a major role in various immunological disorders - from cataracts to cancer, from ageing to autoimmune disorders. They are produced either normally within our cells during metabolism or from external sources, such as pollution, cigarette smoke, and radiation. Free radicals are cleared from the body by antioxidants. More common examples of these include vitamin C, vitamin E, and carotenoids.4

Decreased skin elasticity

Smoking increases the levels of certain enzymes that target important components of the skin, such as collagen and elastic fibres. These are important proteins vital for the structure and function of the skin. With tobacco causing an increased degradation of these compounds, this results in decreased skin elasticity and premature ageing of the skin.5 Smoking causes such significant ageing to the skin, that the skin of a 40-year-old heavy smoker is said to resemble the skin of a 70-year-old non-smoker.6

Second-hand smoke also increases the chance of flare-ups

Not only does smoking cigarettes increase the chance of eczema flare-ups, but even being in the presence of cigarette smoke can cause the same result. Tobacco is an irritant that can penetrate the skin. Eczema-prone skin tends to be more permeable, making it easier for tobacco and other pollutants to be absorbed. This triggers an inflammatory immune response, resulting in eczema. Studies have shown that consistent exposure to second-hand smoke significantly increases the risk of eczema.7

Tips for quitting smoking

Nicotine is a highly addictive substance, making it challenging to quit smoking for good. However, it is never too late to quit smoking, and the benefits to your health will quickly become visible. Here are some tips to help: 

  • Motivate yourself - list out your reasons to quit or tell people you’re quitting to hold yourself accountable. 
  • Use stop smoking aids - nicotine replacement therapy (NRT) is available. over-the-counter or on prescription. NRT is also available as patches, chewing gums, tablets, inhalators or as a nasal spray.  
  • Avoid your smoking triggers. 
  • Keep yourself busy. 
  • Exercise to help fight cravings. 
  • Join support groups for advice - the NHS provide a website to help find local support groups.8


Smoking can affect our health in many different ways. Despite not being life-threatening, eczema can be debilitating and uncomfortable to experience. Tobacco smoke, either consumed passively or smoked first-hand is a major trigger for eczema. If you smoke, quitting is one of the best ways to prevent eczema flare-ups. Stopping smoking can be challenging, but it will be greatly rewarding for your health in all aspects. 


  1. What is Eczema? [Internet]. National Eczema Association. 2022 [cited 2023 Jan 4]. Available from:
  2. Atopic eczema - Symptoms [Internet]. [cited 2023 Jan 3]. Available from: 
  3. Silverstein P. Smoking and wound healing. Am J Med. 1992 Jul 15;93(1A):22S – 24S. 
  4. Pham-Huy LA, He H, Pham-Huy C. Free Radicals, Antioxidants in Disease and Health. Int J Biomed Sci. 2008 Jun;4(2):89. 
  5. Yazdanparast T, Hassanzadeh H, Nasrollahi SA, Seyedmehdi SM, Jamaati H, Naimian A, 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. 
  6. Smoking and its effects on the skin [Internet]. [cited 2023 Jan 4]. Available from:
  7. Jing D, Li J, Tao J, Wang X, Shan S, Kang X, et al. Associations of second-hand smoke exposure with hand eczema and atopic dermatitis among college students in China. Sci Rep. 2020 Oct 15;10(1):1–7. 
  8. Quit smoking [Internet]. [cited 2023 Jan 4]. Available from: 

Lauren Young

Doctor of Medicine - MD, Medical University of Sofia, Bulgaria

Lauren is a newly qualified doctor, who recently returned to the UK to pursue a career as a GP. Her passions lie in public health, medical education and health advocacy. An avid reader, Lauren has found great joy in combining her love of medicine and the written word in writing health articles for Klarity. presents all health information in line with our terms and conditions. It is essential to understand that the medical information available on our platform is not intended to substitute the relationship between a patient and their physician or doctor, as well as any medical guidance they offer. Always consult with a healthcare professional before making any decisions based on the information found on our website.
Klarity is a citizen-centric health data management platform that enables citizens to securely access, control and share their own health data. Klarity Health Library aims to provide clear and evidence-based health and wellness related informative articles. 
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