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Part 2: Smoker's Face

As early as the mid-nineteenth century, it was observed that heavy smoking could cause visible changes in a person's complexion. This included premature wrinkling and a loss of elasticity in the skin, giving the smoker a rough, haggard appearance, and a slightly reddened or orange complexion. There was, however, little effort to back this up with scientific research.That was until 1985, when Dr. Douglas Model published an article in the British Medical Journal in which he coined the term "smoker's face". (1.) In this article, Model discussed how roughly half of the long-term smokers studied, having smoked for ten years or more, came to exhibit the same facial characteristics as a result of the damage caused by smoking. These characteristics were typical of long-term smokers and could be observed regardless of the age of the smoker, their weight, or the degree of their exposure to the sun."Smoker's face" occurs because toxins involved in the smoking process create a series of noticeable changes in skin complexion and colour. As the chemicals from cigarettes are absorbed into the bloodstream, they constrict the blood vessels, including the tiny capillaries located near the surface of the skin. The increased carbon monoxide produced by smoking reduces the amount of oxygen that is then circulated to areas of the skin. This means that even less oxygen and nutrients reach the skin through the constricted blood vessels. Combined with this is the capacity of direct exposure to cigarette smoke to irritate and dry-out skin. In the smoker's case, their skin's moisture levels may already be reduced because of the diuretic effect that nicotine has on the body. The symptoms of "Smoker's face" include a number of distinct characteristics. Prominent lines and wrinkles are usually noticeable emanating from the corners of the eyes ('crow's feet'), even extending on to the cheek. The cheeks themselves may appear sunken. Other wrinkle lines become etched perpendicular to the lips, with shallow lines forming on the cheeks and lower jaw. Some male smokers may also develop a distinctive feature referred to as 'cobblestone wrinkles', which are wrinkles that run down the back of the neck. The underlying bone structure of the face becomes more visible under drawn, taunt skin that has lost its elasticity. The skin may take on a dry, tough and leathery appearance. A mottled, slightly reddened, orange and purple complexion may occur because of inadequate oxygenation of the blood, similar to what occurs during cyanosis. On other occasions, the smoker's complexion may develop a grey, unnatural pallor because it is more atrophied than a non-smoker's skin.Other factors such as stress, insomnia, pollution, and the sun's ultra violet (UV) rays can have a negative effect on the condition of the skin and may predispose the smoker to some of the characteristics attributed to 'smoker's face'. Free radicals, which are molecules of oxygen with unpaired electrons, can also damage the skin by attacking healthy cells and damaging skin tissue. Because smoking contains a dense population of free radicals, it increases the number of damaging free radicals present in the body. Smoking can also reduce the body's store of Vitamin A, which is used in the body's repair process.(1.) Model, D. 'Smoker's face: An underrated clinical sign?' British Medical Journal, 1985. 291:1760-1762.