Smoking and skin.

Less oxygen, less repair: nicotine constricts the small blood vessels of the skin for hours after every cigarette. The skin receives less oxygen and fewer nutrients, waste products are removed more slowly. This shows as a dull, grey complexion and slower wound healing.

Collagen breakdown in fast-forward: tobacco smoke activates enzymes (matrix metalloproteinases) that break down collagen and elastin and at the same time inhibits new formation. Twin studies show: the smoking twin looks markedly older after ten years on average – with deeper lines around eyes, mouth and cheeks.

The typical signs: radial lines around the mouth ('smoker's lines') emphasised by pursing the lips, deepened crow's feet from squinting against smoke, hollow cheeks, uneven pigmentation and a leathery texture. Add an increased risk of skin cancer.

Consequences for treatments: in smokers hyaluronic acid and botulinum toxin often last less long, bruises take longer, and procedures relying on wound healing – microneedling, PRP – work less well. Before treatments at least a week without smoking is recommended, better more.

Quitting pays off at any age: blood flow normalises within weeks, the complexion brightens, collagen formation partly recovers. Existing lines do not disappear but deepen markedly more slowly. Anyone who quits gets more out of every treatment.