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Cigarette smoking and inflammatory skin disease. The good and the bad.

IT HAS LONG BEEN KNOWN that cigarette smoking causes lung cancer, heart disease, emphysema, and various other internal diseases and cancers. Only in recent years has it become clear that smoking also adversely affects the skin. 1 Cigarette smoke contains thousands of toxic constituents, many of which are known carcinogens, toxins, and poisons. 2 Probably the most thoroughly studied of these is nicotine, mainly because of its known pharmacological activities. Not only is nicotine a highly addictive drug but it also causes cutaneous vasoconstriction, which likely plays a role in the poor wound healing and increased wrinkling seen in smokers. 1 It has been proposed that this phenomenon of cutaneous vasoconstriction contributes to an altered inflammatory response seen in cigarette smokers. 3 This being the case, nicotine theoretically should have an inhibitory effect on inflammatory skin conditions. In this issue of theArchives, Mills et al 4 show that systemic