Melanoma (skin tumor) is not the only damage caused by cigarettes to the skin. Heavy smokers run other serious risks as far as the skin is concerned.
A relationship between smoking and skin was established as early as 1856.
The certainty that smoking is the cause behind premature aging of the face comes from Ippen and Ippen who in 1965 were the first to identify the face alterations in 79% of habitual smoking women compared to 19% of non smoking women and coined the term "smoker's face".
In 1969 Dr. Harry Daniell's double blind study proved that smokers between 40 and 49 years of age had the same wrinkle intensity of non-smokers who were twenty years older. It also said that exposure to the sun would cause less damage to the facial skin compared to that caused by smoking. Their analysis is meticulous regarding the smoker's face i.e. the typical appearance of a smoker shows marked furrows and wrinkles, radial lines around lips and eye corners, strong prominence of the bone frame and at times presents slightly flabby cheeks.
Fenske & Smith have mentioned another visible transformation caused by smoking in their article i.e. a remarkable discoloring of the fingernails holding the cigarette, which is so apparent that if someone stops smoking all of a sudden, a distinct demarcation line develops on the stained nails.
If the 4,000 toxic components of smoke are absorbed into the system they can cause damage to the epidermal tissue and cause vascular modifications.
Finally, absorbing smoke involves an alteration of the elastic fibers situated in the deeper part of the skin. This alteration is definitely stronger compared to the alteration caused by sun elastosis.
Other damage almost exclusively related to smokers is what Americans call Trench Mouth, a form of necrotizing ulcerating gingivitis (ANUG) which includes ulceration, pain, bleeding and bad breath in the mouth.