Psoriasis and Smoking

Introduction

A common skin condition, psoriasis has been associated with several lifestyle choices including smoking.

What is psoriasis?

Psoriasis is a dermatological condition that causes abnormalities in the skin and can vary in severity. It is a long-term, and often chronic condition, for which there is no known cure.

The exact cause  of psoriasis remains unknown, but there are common correlations between other health conditions and lifestyle choices  with psoriasis. It is commonly suspected that the condition is due to an immune system deficiency that causes the body to make an excess of skin cells. 

Psoriasis affects 2 in 100 people in the United Kingdom, it is a treatable condition with mild symptoms in most instances.  

Symptoms

The symptoms of psoriasis vary depending on the type, severity, and extent of the condition, as well as the skin type of the person afflicted.

Commonly the condition is accompanied by red or flakey patches of skin which eventually develop into silver “scales”. For some people the condition brings about irritation and a compulsion to itch. 

The symptoms can return periodically and it is possible to have more than one type of psoriasis at a time. 

Psoriasis falls into two categories: pustular and non-pustular lesions (Meaning with or without pus filled swelling). 

Non-pustular psoriasis:

The most common form is psoriasis vulgaris, this accounts for some 90% of cases.¹ It is characterised by red blotches on the skin with sharp borders, most frequently found on the knees, elbows, and scalp. 

Guttate psoriasis is another common form of non-pustular psoriasis common in children and young adults. The onset of lesions is sudden and  will have an appearance  of small droplets.¹ Commonly found on the face and scalp, the condition dissipates as quickly as it comes about and  generally clears between 3-4 months. 

Pustular psoriasis:

This generally is a rarer form of the condition. Generalised pustular psoriasis can develop, usually in young people, as a complication with psoriasis vulgaris, (stopping treatment prematurely).¹

Smoking increases the risk of psoriasis flare-ups

There is a close connection between smoking and psoriasis. Trials have shown that smoking is likely a cause of psoriasis, amongst other conditions.² 

It slows down healing

Smoking has been shown to disrupt people’s immune system making them susceptible to illnesses like psoriasis.³

Smoking does not only  affect the immune system, but  several other physical factors that can lead to the onset of sickness. 

Cigarette smokers take longer to heal, this applies to broken bones as well as cuts, bruises and skin conditions.⁴ Chemicals in cigarette smoke cause inflammation of the body’s cells which leads to constriction of the blood vessels.⁵ This puts strain on the cardiovascular system, prolonging illness. By stymying the blood flow, regions of injury are unable to get the nutrients and blood supply that the body provides for healing.⁶ These factors result in prolonged periods of illness and longer healing times, especially for ailments on the body’s extremities such as skin conditions. 

Decreased skin elasticity

Studies have shown that the toxicity of cigarette smoke has serious implications for skin cells. Smoking reduces the elasticity of skin around the face and forehead.⁷ Smokers  develop thicker skin which reduces the overall elasticity. 

Smoke damages elastin and collagen within the body.⁸ Collagen is a common protein which maintains health and vitality throughout the body. Collagen levels reduce naturally with age but smoking speeds this process, hence the notion that smoking leads to premature ageing.⁹ Elastin, another protein, is found in the skin and is responsible for skin stretchiness and flexibility. 

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

“Exposure to second-hand smoke from cigarettes during infancy is associated with an increased prevalence of psoriasis during adolescence”¹⁰ Although the detrimental effects of smoking are  reduced in  second-hand smoking, it has been proven that second-hand cigarette smoke can also damage the skin and increase the risk of a psoriasis flare up.¹⁰

Tips for quitting smoking

Smoking, and its associated complications, are the leading cause of preventable deaths. For the sake of your skin and general health, it is never too late to quit smoking. 

Amongst the myriad of quitting methods, books, and alternatives, the NHS offers free support and guidance to help you overcome the addiction.. 

Summary

There is an established link between smoking and psoriasis, even in the second-hand instance. Smoking causes flare ups, reduces healing time, and generally worsen existing conditions. 

If you suffer from psoriasis, quitting smoking will help  alleviate the regularity and severity of flare ups.