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While dermatologists tend to prefer the term "condition” because it’s less frightening, acne is, by definition, a disease. It causes functional impairment and structural changes to the body, primarily through inflammation and changes to oil and skin cell production, resulting in bacterial growth and development of the lesions we all know – and hate – as “pimples.”
According to a study published in The New England Journal of Medicine, acne can actually create an emotional or psychological response similar to other systemic conditions like epilepsy and diabetes. As one of the top eight pervading conditions in the U.S., it’s crucial to maintain optimism… or risk anxiety and the possibility of self-sabotaging behaviors.
Two of the most prominent self-sabotaging behaviors include smoking cigarettes and marijuana, both widely believed to contribute to acne.
Unfortunately, studies on the health risks associated with cigarette and marijuana use are not geared explicitly towards acne; even in studies that point to connections between nicotine, THC, and acne, results have been mixed.
So, does smoking cause acne?
Here’s what the research on smoking and acne says.
There’s no denying that smoking cigarettes is unhealthy and leads to over 3 million deaths per year, including billions of dollars in preventable health care expenses. While the case against smoking is strong, there’s still somewhat limited evidence to support a direct cause-and-effect relationship between smoking and acne. However, while a causal relationship is not imprecise, speculative evidence suggests a correlation between the habit and condition.
When examining the consequences of smoking cigarettes, two issues stand out concerning acne: inflammation and delayed wound healing. Smoking cigarettes increases free radicals — unstable, oxygen-containing molecules that can cause illness and premature aging. The body’s response to the presence of free radicals in the system is the rapid production of inflammatory molecules, cytokines. Cytokines are directly related to the early stages of acne. Understanding the relationship between cytokines and acne, it’s reasonable to suspect a link between smoking and acne.
Beyond the inflammatory response to free radicals in the body, smoking might also have a connection to acne because it impairs wound healing. Acne lesions are technically wounds, and they require healthy skin cell responses and sufficient blood supply to heal correctly. Smoking is counter to each of these activities, as it restricts blood flow to the skin and interferes with the production of skin cells, leading to premature aging and slower healing. Again, this information does not necessarily speak to smoking cigarettes as a cause of acne, but it does identify links between smoking and worsening acne.
Additionally, as acne can contribute to lower self-esteem, according to researchers, patients should avoid habits that can also contribute to mental health issues. Smoking promotes hair loss, yellowed teeth, and wrinkles, which can all affect self-image. Combined with the possibility of cigarettes contributing to acne, quitting or avoiding cigarette smoking altogether is probably ideal for your skin.
Does smoking weed cause acne? Unfortunately, the research is even more sparse and possibly even conflicting about marijuana and acne. Due to the legal restrictions and ethical concerns, the direct effects of illicit drugs have not been thoroughly tested for acne response. However, researchers do understand that most drugs cause increased cortisol production, which can make acne worse. Additionally, illicit drugs can heighten the body’s inflammatory response, resulting in increased acne. Despite relevant connections, there is still limited evidence to support a direct link or clear causation.
Even with regulatory easing around THC, marijuana studies are perhaps more inconclusive than those for cigarettes; for example, one study found that marijuana users were more likely to experience acne than non-users, but other studies suggest that some aspects of the drug are anti-inflammatory, suggesting marijuana use might reduce this component of outbreaks.
Despite the conflicting research, those of us dealing with acne probably shouldn’t rush out to purchase legal marijuana. The general understanding of marijuana and the psychoactive cannabinoid THC is that it manipulates the endocrine system, responsible for hormone balance and production. Increases in certain hormones, specifically androgen hormones, can lead to worsening acne symptoms. Unfortunately, even on this basic level of understanding there are conflicting reports in the American Journal of Epidemiology and the Journal of Clinical Pharmacology about the severity of hormonal changes in marijuana users.
Does smoking cause acne? The jury is still out when it comes to marijuana. With little research and conflicting results, it’s impossible to say one way or the other how marijuana affects sebum production, hormone levels, or acne. The general consensus is to avoid drug use to minimize the risk of outbreaks or worsening acne; confidence in this is grounded in the idea that smoking anything is generally bad for your health. You have to be careful of any foreign substances you ingest or inhale. The medications prescribed by a licensed dermatologist are heavily regulated and have undergone rigorous testing to verify their efficacy in treating skin conditions, such as acne.
Instead of justifying the use of cigarettes and marijuana, consider other lifestyle choices known to reduce the likelihood of severe acne symptoms. While you have many options, some of the healthiest preventative and proactive decisions include:
Exercise is an excellent way to reduce stress and is potentially effective at reducing inflammation, too. As acne is primarily an inflammatory disease, regular exercise may have mitigating effects on the condition; however, more research is needed on the specific benefits of exercise on acne.
Specific foods can affect your hormones, which in turn can make acne worse. High-sugar foods can lead to increased insulin levels, ultimately affecting hormones that contribute to skin health. Focusing on a whole food diet and limiting processed, high-sugar foods may help reduce acne symptoms. Studies currently express an association between acne and dietary choices, not causation.
Stress produces cortisol, which can lead to a negative inflammatory cascade in the body and can result in breakouts. Reducing your stress through mindfulness or meditation may also limit acne symptoms.
Beyond other health routines or habits, committing to a healthy skin care routine is the best way to limit and reduce acne symptoms.
Thankfully, getting professional help with your skin is easier than ever.
Telehealth skincare from Nava MD means that patients can access licensed and practiced clinicians from the comfort of their homes, with prescription skincare serums sent to their door if approved.
While not all conditions lend themselves to virtual healthcare, acne is in many ways ideal.
With a few photos and some basic information, our clinicians can assess your blemishes and situation to determine the best treatment plan for you. Nava MD prescriptions are custom-made with ingredients like tretinoin – one of the most effective skincare tools used by dermatologists – and niacinamide, an anti-inflammatory also with decades of clinical utilization.
Does smoking cause acne or make it worse? The answer is not as definitive as we might like, but most dermatologists agree – what’s bad for your health is probably bad for your skin, too.
The best way to protect yourself from skin trauma is to make smart health choices, then seek professional help for ongoing skin issues.
This article is intended for informational purposes only and should not be considered medical advice.
Consult a healthcare professional or call a doctor in the case of a medical emergency