NICOTINE AND YOUR SKIN

In the last 10 years, research has consistently shown that cigarette use is generally bad for our skin byslowing wound healing, dehydrating the epidermis, increasing carcinogen exposure, and causing inflammation [1–4]. Although many of us are aware of the negative effects of smoking, much less research has been done on how vaping affects our skin. In 2021, a Gallup poll estimated that 18% of adults aged 18-29 are vaping [5]. This is more than 3X the national average. As cigarette use declines and vaping use increases, we are now asking: does nicotine vaping affect our skin in the same way that traditional cigarette use does?

EFFECTS OF VAPING

The most researched effect of vaping on the skin is dehydration. Nicotine, whether obtained through inhaling, chewing, or a patch, is a diuretic. Diuretics include any substance that causes increased frequency of urination which depletes the body’s water supply. On top of that, one of the chemicals found in all e-cigarette liquids is propylene glycol (PG) [6]. PG is a humectant which absorbs water away from the mouth's mucosa, or skin, and lung tissues and once exhaled, sends that water out of the body. Together, nicotine and PG form a powerful combination for dehydration. This effect extends to our skin, not to mention the cloud of aerosolized and modified compounds released right next to the face, containing many reactive molecules like aldehydes and free radicals [7]. The toxicology report by the National Academies of Sciences, Engineering, and Medicine cites hundreds of studies that have characterized the compounds present in nicotine-based e-liquid, many of which are well understood to have harmful effects on the skin [6]. However, large-scale clinical research clearly demonstrating the dermatological effects of consistent e-cigarette use has not yet been completed. 

COMBATTING SKIN DEHYDRATION

While we know vaping isn’t good for us, it’s still a habit that many adolescents and adults are picking up or struggling to minimize. To help alleviate the negative effects of vaping on the skin, build a multi-layer moisturizing routine that includes antioxidant active ingredients. 

There are 3 main types of moisturizing ingredients that should be included: humectants, emollients, and occlusives [8]. 

• Humectants, defined above, include hyaluronic acid, Alpha Hydroxy Acids (AHAs), and urea. When applied topically on damp skin, they help transfer water to the epidermis. 
• Emollients are lipid-based compounds that encourage skin barrier flexibility and strength. Squalene and ceramides are excellent examples. 
• Lastly, occlusives are oily or waxy and form a physical barrier on top of the skin to block transepidermal water loss. Common examples include jojoba oil, beeswax, silicone, and lanolin. 

A great moisturizing routine includes the following 3 steps: 

1. Anantioxidant-containing serum (e.g.vitamin C, vitamin E, resveratrol, plant polyphenols)
2. Awater-based moisturizer with humectant and emollient ingredients 
3. Aheavier moisturizer or face oil to create a physical barrier that locks in moisture. 

While the effects of vaping on skin are still being investigated, prioritizing a skin care routine rich in moisturizing ingredients and components that fight oxidative damage will help preserve skin elasticity and appearance across all populations. 

Sources:

[1] Capitanio B, Sinagra JL, Ottaviani M, Bordignon V, Amantea A, Picardo M (2009) Acne and smoking.Dermatoendocrinol 1, 129–135.

[2] Lipa K, Zając N, Owczarek W, Ciechanowicz P, Szymaǹska E, Walecka I (2021) Does smoking affect your skin?Postepy Dermatol Alergol 38, 371–376.

[3] Armstrong AW, Harskamp CT, Dhillon JS, Armstrong EJ (2014) Psoriasis and smoking: a systematic review and meta-analysis.Br J Dermatol 170, 304–314.

[4] Kantor R, Kim A, Thyssen JP, Silverberg JI (2016) Association of atopic dermatitis with smoking: A systematic review and meta-analysis.J Am Acad Dermatol 75, 1119-1125.e1.

[5] Gallup.com, What Percentage of Americans Vape?, Last updated August 19, 2021, Accessed on August 19, 2021.

[6] National Academies of Sciences E, Division H and M, Practice B on PH and PH, Systems C on the R of the HE of END, Eaton DL, Kwan LY, Stratton K (2018)Toxicology of E-Cigarette Constituents, National Academies Press (US).

[7] Mitri A, Lin G, Waldman RA, Grant-Kels JM (2021) Effects of tobacco and vaping on the skin.Clin Dermatol 39, 762–771.

[8] Sethi A, Kaur T, Malhotra S, Gambhir M (2016) Moisturizers: The Slippery Road.Indian J Dermatol 61, 279–287.