J. Soc. Cosmetic Chemists, 16, 305-308 (1965) Approaches Aging to a Prophylaxis of Skin MARGOT IPPEN, M.D., and HELLMUT IPPEN, M.D.t Synopsis--It is shown that smoking has a deleterious effect on skin condition and that this effect can be differentiatcd from that of damage by sunlight. Smoker's skin is identified as skin which suffers from loss of "turgor" and shows signs of flabbiness in addition, the color of the smoker's skin is pale, with a grayish hue. Dermatological examination of 224 women up to now showed no strong correlation between their smoking habits and the appear- ance of their skin, as defined above. By contrast, smoking seems to have only a very minor effect on the skin of male smokers. The problem of aging of the skin is an especially important area in the field of cosmetics. Numerous methods for combating and cover- ing up the aged skin are known. On the other hand, little attention has been directed until now toward investigation of the causal factors and the basic origin of skin aging--especially with reference to aging of the face. When the skin becomes slack and loose, "erow's feet" and other small wrinkles appear, and the skin becomes thinner. These develop- ments are generally regarded as a physiological process which often can be retarded but never decisively stopped by the use of appropriate cosmetics. Examination of the skin qualities of women of equal age demonstrates that the differences between the skin qualities increase with the age of the women. Such differences cannot fully account for individual or constitutional variations. Furthermore, if one examines * This coinmunication is a condensation of a paper presented before the Third Congress of the International Federation of Societies of Cosmetic Chemists on June 25, 1964, New York City. t Am Massenberger Kamp 23, 4000 Dfisselctorf-Holthausen, Germany. 305

303 JOURNAL OF THE SOCIETY OF COSMETIC CHEMISTS and compares the skin of different parts of the body of the same person, one finds in many cases great differences between the degree of aging from area to area, e.g.• between the skin of the face and that of the back. Such observations stimulated the authors to examine the state of the facial skin of women systematically and to determine possible causes which may have accelerated aging of the skin. From these investigations a remarkable parallelism between the following two factors was found: 1. Exposure to sunlight 2. Cigarette consumption There is a considerable amount of data concerning the damaging effects of long exposure to sunlight on the skin. In contrast, the authors have found no reference on the role of tobacco smoking on aging of the skin. In order to establish the relationship between smok- ing and skin aging more conclusively, these examinations were ex- tended, and the following facts were determined. 1. The longer and the more a woman has smoked, the more fre- quently poorer skin conditions are observed. Certain features of this damage could be differentiated from the sunlight-damaged skin. 2. More specifically, the skin changes resulting from long years of s.noking manifest themselves mainly through a loss of "turgot" and reduced circulation in the deeper layers of the skin. On the other hand, the light-induced skin changes are characterized by a degeneration of the superficial connective tissue and an atrophy of the epidermis. 3. Correspondingly, the skin of the smokers is pale, with a grayish hue, and without local variations of the pigmentation. Also prevalent are wrinkles and folds, which sometimes cover the whole face but are especially noticeable on the cheeks. Between these folds and wrinkles the skin is abnormally thick. It is probable that the reduction of turgor plays an important role in this development. 4. In extreme cases this loss of turgor results in a slackness and fiabbiness of the skin of the cheeks with women who had not yet reached the age of forty. The authors have examined 224 women, aged 33 to 84 years. At first the skin of the face and neck was examined. From these derma- to!ogical studies eouclusions were drawn concerning the patients' smoking habits. Subsequently, the women were asked about their cigarette smoking, and the following relations were found: In 93 (41 the characteristics of "cigarette skin" were described in 13l