The Exposome || The Vices
As we have discovered throughout this series discussing the exposome, a number of environmental stressors can contribute to accelerated skin ageing. It is well known that some of our very own social habits may also be adding to this process. While we all have our guilty pleasures in life, some we know to be worse for our overall health than others. But, what you may not be aware of is just how much these vices may be affecting the health of our skin and how.
Dietary habits that include high levels of ultraprocessed food with high glyceamic indexes have been linked to increased inflammation, oxidative stress and the accumulation of end glycation products all contributing to skin ageing. We will leave this subject to our very own dietician, Eimear to explain more very soon. In the meantime, we will discuss two extrinsic ageing culprits that are common social habits.
Cigarette Smoke and the Skin
In 1985, the term “smoker’s face” was coined to describe the typical facial appearance associated with smoking . This came to light following a prospective survey on patients who smoked which demonstrated a significant association between perioral lines, deep cheek wrinkles and sallow skin.(1) Several epidemiological and molecular studies have followed and indicate that smoking is an independent, dose-dependent risk factor for premature skin ageing.
Cigarette smoke is believed to exert its adverse effects via direct action on the epidermis, but also indirectly through changes to the microcirculation (blood supply) affecting the dermis.(2) Smoking causes constriction of the small blood vessels and effects the cutaneous vasculature resulting in reduced capillary blood flow, impaired nutrient and oxygen delivery and delayed wound healing, thus compromising skin integrity leading to accelerated changes of ageing.
Several in vitro and in vivo studies have clarified the cellular processes that result in the skin changes associated with smoking. These include an increase in the presence of enzymes that break down collagen and elastin as well as defective fibroblasts that are unable to make healthy collagen.
Nowadays, avoidance of smoking is more achievable than it previously was thanks to many smoking bans across the world. The detrimental ageing effects of smoking are sometimes used in public health campaigns to inspire smoking cessation. Although vaping was heralded as a healthier alternative to smoking, there is more research needed to understand the effects that it has on our health. What we do know, however, is that vapes containing nicotine have similar impact on skin as nicotine in cigarettes. This means that vaping also contributes to loss of collagen production, skin elasticity, and an increase in dullness.(3)
Alcohol and the Skin
Heavy alcohol intake has also been found to increase the extrinsic ageing pressure on our facial appearance. In a large multinational study, it was found that drinking over 8 drinks per week was associated with an increase in lines and wrinkles, as well as a premature loss in facial volume, particularly in the cheeks, and an increase in the appearance of blood vessels. (4)
Like smoking, alcohol has a negative effect on antioxidant reserves making the skin more vulernerable to oxidative stress. As we know, alcohol consumption in excess impacts our overall health in many ways such vitamin deficiencies, inflammation and direct impact on the capacity of skin fibroblasts to produce collagen. These mechanisms can help explain the lines and wrinkles as well as the formation of vessels in the skin. It is harder to understand the association of excess alcohol with loss of volume in the midface, but alchohol dependent patients have been observed to have reduced body fat compositions in other studies which may point to a potential sensitivity of fat pads to the presence of alcohol. (5).
Maintaining Skin Health
Our skin and the structures of our faces are affected by many external influences. When it comes to skin ageing, we are in control of a great number of factors that affect our skin’s health. Understanding your personal exposome helps you minimise a large amount of these processes . By looking after our overall health, we not only feel the internal betterment and enrich our lives, but we also see the outward benefits in our skin’s appearance.
Model D. Smoker's face: an underrated clinical sign? Br Med J (Clin Res Ed). 1985;291(6511):1760-2.
Ernster VL, Grady D, Miike R, Black D, Selby J, Kerlikowske K. Facial wrinkling in men and women, by smoking status. Am J Public Health. 1995;85(1):78-82.
How does vaping affect the skin? Aesthetic Medicine, 03 April 2023.
Goodman GD, Kaufman J, Day D, Weiss R, Kawata AK, Garcia JK, et al. Impact of Smoking and Alcohol Use on Facial Aging in Women: Results of a Large Multinational, Multiracial, Cross-sectional Survey. J Clin Aesthet Dermatol. 2019;12(8):28-39
Addolorato G, Capristo E, Marini M, Santini P, Scognamiglio U, Attilia ML, et al. Body composition changes induced by chronic ethanol abuse: evaluation by dual energy X-ray absorptiometry. Am J Gastroenterol. 2000;95(9):2323-7
