EFFECT OF CIGARETTE SMOKE ON SKIN 241 panelists with slight sun exposure was not as dry as that having medium or severe UV exposure. Excessively sun-exposed smokers had 76% drier skin than non-smokers with low sun exposure. Skin dryness of non-exposed non-smokers who received minimal sun exposure was much lower than that of smokers having the same sun exposure (p = 0.078). Passive smokers exhibited a significantly drier (p = 0.026) skin than non-smokers. Many factors are involved in the wrinkling response of skin, such as genetic dominance, Fitzpatrick skin type etc. However, it is generally accepted that age and sun exposure play the most important role in skin damage manifested as wrinkles and fine lines (14). Observation of non-smokers by age and sun exposure shed further light on the subject. Contrary to expectations, age, unlike smoke, did not appear to play a significant role in skin damage. Skin wrinkling was higher in non-smokers over 56 years of age, but below 55 years of age there was no significant dose response. Sun exposure appeared to exhibit a good dose response with the intensity of wrinkling. It was observed that non-exposed non-smoking individuals exposed to mild-to-slight sun exhibited a significantly lower (p 0.001) skin wrinkling than active smokers having the same sun exposure (Figures 6a,6b). These results are consistent with the findings of Donald et aL (16) who state that cigarette smoking is an independent risk factor for development of premature wrinkling. They observed that heavy cigarette smokers (50 pack years) were 4.7 times more likely to be wrinkled than non-smokers. Sun exposure of more than 50,000 lifetime hours also increased the risk of being excessively wrinkled 3.1 fold. When excessive sun exposure and cigarette smoking occurred together, the risk for developing excessive wrinkling was multiplicative. In our experiments, excessively sun-exposed smokers had twice as much wrinkling as non-smokers with low sun exposure. CONCLUSIONS In this study, the group of non-smokers appeared to exhibit a much better barrier as compared to active and passive smokers. Passive smokers appeared to exhibit a barrier damage similar to that of active smokers. Smokers exhibited a slightly drier skin than non-smokers the difference, however, was not significant. Active smokers appeared to exhibit twice as much wrinkling as non-smokers. There was an excellent dose response of average skin wrinkling and smoking pattern. A combination of sun exposure and cigarette smoke play a stronger role in the manifestation of wrinkles and damage of skin barrier functions than age. A combination of excessive sun exposure and cigarette smoking occurring together exhibited a 62% higher rate of TEWL and a 76% drier skin. Excessively sun-exposed smokers had twice as much wrinkling as non-smokers with low sun exposure. REFERENCES (1) IARC, Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans: Tobacco Smoking, International Agency for Research on Cancer, Lyon (1986). (2) J. E. Fielding, Smoking: Health effects and control (first of two parts), N. Engl. J. Med., 313,491-498 (1985).
242 JOURNAL OF THE SOCIETY OF COSMETIC CHEMISTS (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) L.A. Loeb, V.L. Ernster, K. E. Warner, J. Abbots, and J. Laszlo, Smoking and lung cancer: An overview, Cancer Res., 44, 5940-5958 (1984). E. Randerath, D. Mittal, and K. Randerath, Tissue distribution of covalent DNA damage in mice treated derreally with cigarette "tar": Preference for lung and heart DNA, Carcinogenesis, 9, 75-80 (1988). W.A. Pryor, M. Tamura, and D. F. Church, ESR spin trapping study of the radicals produced in NOx/olefin reactions: A mechanism for the production of the apparently long-lived radicals in AS phase cigarette smoke,,/. Am. Chem. Soc., 106, 5073-5079 (1984). D. T. Dowling, M. E. Stewart, P. W. Wertz, S. W. Colton, W. Abraham, and J. S. Strauss, Skin lipids, an update, J. Invest. Dermatol., 88(3), 02s-06s (1987). P.M. Elias, Epidermal lipids, barrier function and desquamation, J. Invest. Dermatol., 80(6), 044s- 049s (1983). H. W. Daniell, Smoker's wrinkles. A study in the epidemiology of "crow's feet," Ann. Intern. Med., 75(6), 873-880 (1971). D. P. Kadunce, R. Gress, R. Kanner, J. L. Lyone, and J. Zone, Cigarette smoking: Risk factor for premature facial wrinkling, Ann. Intern. Med., 114(10), 840-844 (1991). T. B. Fitzpatrick, Ultraviolet-induced pigmentary changes: Benefits and hazards, Curr. Probl. Derma- tol., 15, 25-38 (1986). J. Pinnagoda, R. A. Tupker, T. Agner, and J. Serup, Guidelines for trans epidermal water loss (TEWL) measurement, Contact Dermatitis, 22, 164-178 (1990). G. Grove, "Age Related Differences in Healing of Superficial Skin Wounds in Humans," in The Efj½cts of Aging in Oral Mutvsa andSkin, C. A. Squier and M. W. Hill, Eds. (CRC Press, 1994), pp. 124-125. J. Serup, A. Winther, and C. Blichmann. A simple method for the study of scale pattern and effects of a moisturizer--Qualitative and quantitative evaluation by D-Squame tape compared with parameter of epidermal hydration, Clin. Exper. Dermatol., 14, 277-282 (1989). T. D. Donald, M. E. Stewart, P. W. Wertz, S. W. Colton, W. Abraham and J. S. Straus, Skin lipids. an update. J Invest Dematol, 88(3), 02s-06s (1987). J. L. Leveque, P. Corcuff, J. De Rigal, and P. Agache, In vivo studies of the evolution of physical properties of the human skin with age, Int. J. Dermatol., 23, 322-329 (1984). P. K. Donald, R. Burr, R. Guss, R. Kanner, J. L. Lyon and D. Zone. Cigarette Smoking Risk factor for Premature Facial Wrinkling. Ann Int Med, 114, 840-844 (1991)
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