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Plastic Surgeon Cautions Against Smoking Before Surgery - 

Concerned about studies that indicate a link between smoking and complications during and after breast augmentation, Boston, MA area plastic surgeon Dr. Michael Tantillo is urging women to kick their cigarette habits prior to surgical procedures. He's so concerned, in fact, that he's using Facebook to spread the word about the connection between smoking and surgical complications.

"Despite so many studies showing the risks of smoking, it's still a widespread habit," Dr. Tantillo says. "Many people do not even know about the potential affect it can have on surgery. To help spread the word on the risks of smoking when it comes to surgical procedures, I decided to use my Facebook Page (http://www.facebook.com/MichaelTantilloMD?v=wall) to call attention to an ABC News report on the correlation between cigarettes and surgical complications.

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Smoking and Risk of Incident Psoriasis Among Women and Men in the United States: A Combined Analysis 

The authors observed a graded reduction of risk with an increase in time since smoking cessation (Ptrend <0.0001). In this study, smoking was found to be an independent risk factor for psoriasis in both women and men. Psoriasis risk was particularly augmented for heavy smokers and persons with longer durations of smoking.

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• Smoking tied to higher psoriasis risk  

But most have studied people at only one time-point, which makes it hard to be sure the smoking came before the psoriasis.

So for the new study, researchers used data from three large, long-running studies of U.S. health professionals.

Of nearly 186,000 men and women followed for 12 to 20 years, 2,410 developed psoriasis during that time. And the risk was greater among both current smokers and former smokers.

People who were current smokers at the study's start were almost twice as likely as lifelong non-smokers to develop psoriasis. And past smokers had a 39 percent higher risk than non-smokers.

The findings, reported in the American Journal of Epidemiology, do not prove that smoking, itself, causes psoriasis in some people.

But it is clear that the smoking came before the psoriasis, said senior researcher Dr. Abrar A. Qureshi, of Harvard Medical School and Brigham and Women's Hospital in Boston.

Past studies have found links between psoriasis and both obesity and heavy drinking. But after accounting for those factors, the smoking-psoriasis link remained, Qureshi told Reuters Health.

"I think if there's one message, it's that for now, smoking seems to be a risk factor for new-onset psoriasis," Qureshi said.

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The relationship between basal and squamous cell skin cancer and smoking related cancers 

Background

We compared the risk of being diagnosed with smoking-related cancers (lung, oral cavity, upper digestive and respiratory organs, bladder, kidney, anogenital cancers and myeloid leukaemia) among people with squamous cell carcinoma (SCC) or basal cell carcinoma of the skin (BCC), with risks found in the general population using data from an Australian population-based cancer registry. . . .

Conclusions

Individuals with a history of SCC having an increased risk of developing smoking related cancers cancer suggests smoking as a common etiology. The relationship between BCC and smoking-related cancers is less certain.

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Smoking Linked to Skin Cancer in Women 

A new study has found a link between tobacco use and skin cancer.

The study found that women who had squamous cell skin cancer were more likely to have smoked than those who were free from the disease. And those who smoked at least 20 years were twice as likely to develop squamous cell skin cancer, a less aggressive form of skin cancer than melanoma.

Men who smoked had a modest risk for the two types of non-melanoma skin cancer -- basal cell and squamous cell cancer -- but the results weren't statistically significant, the study authors noted.

"We don't know why," said study lead author Dana Rollison, referring to the difference between women's and men's risk. Both men and women get a lot of exposure to the sun, the main risk factor for skin cancer, she noted.

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Case–control study of smoking and non-melanoma skin cancer 

Objective

To investigate the association between cigarette smoking and basal and squamous cell carcinomas (BCC and SCC) of the skin, a clinic-based case–control study was conducted in Tampa, FL. . . .

Cigarette smoking is more strongly associated with SCC than BCC, particularly among women.

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Plastic surgeon's bizarre breast lift warning spotlights smokers' risks 

Is there any truth to this cautionary tale? Can smoking really cause breast lift recipient's nipples to fall off?

Definitely, says Dr. Jennifer Walden, an Austin-Texas based plastic surgeon.

"Even though it sounds graphic and kind of gross, it's important to talk about this complication so patients consider themselves forewarned," Walden told CBS News.

Walden said smoking causes blood vessel constriction, which cuts off the blood supply around breast, resulting in nipple death. Youn described smoke's toxins as a "virtual tourniquet."

But Walden warns there are plenty of other risks plastic surgery patients face if they smoke.

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YOUN: Smoking can make your nipples fall off  

I cringe every time I see a patient for a breast lift who is a smoker. I’m deathly afraid that despite my warnings, she will smoke before or after surgery and cause her nipples to turn black and fall off.

Yes. Smokers who undergo breast lifts are at great risk of losing their nipples.

I’ve seen it before.

The nicotine in cigarettes and the carbon monoxide contained in cigarette smoke can diminish blood flow to various parts of the body. . . .

Not long ago, during a consultation for a breast lift, a patient, Susan, admitted to being a pack-a-day smoker. I informed her that smoking can cause difficulty in healing and instructed her to quit smoking at least one month before surgery and to stay off cigarettes for at least a month afterward. Several months later, when she arrived at the hospital for her breast lift, she smelled like an ashtray. . . .

Yes. Seriously. Susan blamed me for the inconvenience.

Thanks to her, I’ve changed my policy. In addition to the Surgeon General’s Warning that appears on cigarette packages, I now offer the Plastic Surgeon’s Warning to all my patients who smoke: If you are having a breast lift or reduction and you smoke, your nipples could turn black and fall off. If you are having a tummy tuck and you smoke, you may get an infection resulting in a big gross open wound that will take three months to heal. If you are having a facelift and you smoke, the skin of your cheek could turn black and slough off, leaving exposed fat.

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Smoking can also make you look older than you are  

But if chronic breathing difficulties and cancer aren't scary enough, know that smoking also can damage your looks.

Skin

Wrinkles: A 40-year-old smoker may have the same number of facial wrinkles as a 60-year-old. Smoke from cigarettes can stick to the skin, yellowing it and creating a lasting odor. Chemicals in smoke can suck moisture and vitamins out of skin, making it dry and brittle. . . .

Mouth

Teeth stains: Nicotine can stick to your teeth and turn them yellow, brown or black.

Tooth loss

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Genes, lifestyle factors influence skin aging 

European scientists have identified a range of factors that influence skin aging, confirming that heavy smoking promotes aging whereas use of sunscreen has a protective effect.

They also found that a gene that controls skin pigmentation can either promote or protect against aging, depending on which form of the gene the person has.

Dr Mariano Suppa (University of Leeds, UK) and co-workers studied facial photographs of 1341 middle-aged men and women. All gave detailed information about their lifestyles and medical history and had blood samples analyzed for genetic variations. . . .

Dr Suppa and colleagues found that wrinkles, vascularity, and blotchy pigmentation were all associated with older age, and wrinkles in particular were worse in older individuals and heavy smokers.

Moderate smokers did not have worse wrinkles than nonsmokers, however.

Vascularity - or the presence of "spider" or "thread" veins on the surface of the skin - tended to be worse in men, older individuals, people who spent longer in the sun each day, people who were overweight, and smokers.

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Smoke signals  

The effects of smoking on skin aging have been recognized for years. A 1965 study first identified what came to be known as "smoker's face"- gray, pale and wrinkled skin. Are you trying to quit but craving a smoke? Nicholas Perricone investigates . . .

As a smoker, you are used to having a certain level of nicotine in your body. You control that level of nicotine in your body. You control that level by how much you smoke, how deeply you inhale the smoke, and the kind of tobacco you use. When you quit, cravings develop when the body wants more nicotine.

When you are exposed to smoking triggers or even when you use a small amount of nicotine, your mood changes, and cravings for tobacco can go up as well as your heart rate and blood pressure. Cravings are not "just in your head."

What to expect

* Cravings usually begin within an hour or two after you stop smoking, peak for several days, and may last several weeks . .

One final note on the skin-damaging effects of smoking. A study conducted in 2002 showed that facial wrinkling, while not yet visible, can be seen under a microscope in smokers as young as 20 years of age.

The horrors of smoking for your skin

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Smoking reduces risk for psoriatic arthritis in psoriasis patients 

Smoking may reduce the risk for psoriatic arthritis (PsA) in patients with psoriasis, say researchers, but not in patients who are positive for the human leukocyte antigen (HLA) allele HLA-C*06.

Around one-third of all patients with psoriasis subsequently develop PsA, a debilitating inflammatory condition.

Smoking has been shown to suppress inflammation and have a protective effect against the symptoms of disorders such as ulcerative colitis. Dafna Gladman (University of Toronto, Ontario, Canada) and colleagues therefore investigated whether it may also have a protective effect against PsA in psoriasis patients.

In total, 728 patients with PsA and psoriasis and 404 patients with psoriasis alone were included in the study.

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The association between smoking and the development of psoriatic arthritis among psoriasis patients 

Conclusion

Smoking may be inversely associated with PsA among psoriasis patients. This association is not present among HLA-C*06-positive individuals.

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Work-associated hand dermatitis exacerbated by smoking 

Birgitta Kütting (Friedrich-Alexander University of Erlangen-Nuremberg, Germany) and colleagues interviewed and examined the hands of 1355 German metal workers, aged 17-64 years, 96.7% of whom were men. Of these, 1020 men agreed to be followed-up at 1 year.

In comparison to the general adult German population, the percentage of smokers at baseline in the cohort was high at 41.7%.

Significantly more smokers reported suffering from dyshidrotic vesicles than nonsmokers, at 25.5% versus 19.3%. Smokers also had a significantly higher erythema score value than nonsmokers, at 6.16/5.00 versus 5.33/4.00.

Total skin score, encompassing all parameters was not significantly different between the two groups, however, at 17.80/16.00 versus 17.03/15.00.

In addition, no significant differences between smokers and nonsmokers were observed for prevalence of atopic dermatitis, prior or current hand eczema and associated disability, topical application of steroids on the hands, or dermatological consultations.

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Does Smoking Have a Significant Impact on Early Irritant Hand Dermatitis in Metal Workers? 

Background: Although they know the long-term complications of smoking, many smokers require additional motivation for entering a smoking cessation programme. At the same time, smoking is considered a possible promoting factor for various skin diseases.

Objective: The present study assesses the impact of smoking on occupational hand dermatitis in a high-risk population. . . .

Results: Compared to the general German adult population the percentage of smokers was increased (41.7% at baseline). Probably due to self-selection bias and to a higher drop-out rate, the proportion of smokers was significantly lower at follow-up. Compared to nonsmokers, smokers had significantly higher score values for both erythematous lesions and vesicles.

Conclusion: The present data might give additional support for occupational physicians or dermatologists to convince workers to quit smoking.

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