Rosacea is a condition affecting several million people in France and around the world. It is said that certain habits may promote the development of rosacea symptoms, including smoking. Is this really the case? Let's examine this claim more closely.
Smoking, an exacerbating factor for rosacea?
Published on March 6, 2024, by Kahina, Scientific Editor — 3 min of reading
Themes:
Does smoking have consequences on rosacea?
In a study conducted by Wen-Qing LI in 2017 on 95,809 women, researchers sought to verify a possible association between rosacea and smoking. PCompared to never having smoked, researchers observed an increased risk of rosacea associated with previous smoking (risk ratio = 1.09), but a reduced risk associated with current smoking (risk ratio = 0.65). These results therefore suggest that current female smokers had a reduced risk of rosacea, but former smokers had a higher risk. Furthermore, an increase in the number of packs smoked per year of smoking was associated with a decrease in the risk of rosacea in current smokers and an increase in risk in former smokers.
Other studies align with these findings, however, some confusion remains. Indeed, Chen-Yi WU and his colleagues noted, during an experiment involving 59,973 participants, a significant reduction in the risk of rosacea among current smokers. However, no significant association was observed between former smoking and the risk of rosacea, revealing inconsistencies between studies. Furthermore, the validity of the results from the study conducted by LI was limited by self-reported rosacea diagnosis and uncontrolled confounding factors, particularly comorbidities.
Although the mechanisms underlying the reduced risk of rosacea in current smokers have not yet been elucidated, several hypotheses are being considered. Studies have found a higher prevalence of erythematotelangiectatic rosacea in active smokers, the pathogenesis of which involves vasodilation. The nicotine contained in tobacco can cause a microvascular contraction, which could reduce the vasodilation associated with rosacea. Furthermore, its anti-inflammatory effects could alleviate inflammation in the case of rosacea.
However, the angiogenic effects of nicotine could also induce the development of the disease. Moreover, cigarette smoke could accelerate the degradation of collagen and elastic fibres, which could damage the skin barrier. Thus, according to these hypotheses, the reduced risk of rosacea in current smokers could be temporary and the observation of an increased risk of rosacea in former smokers becomes more coherent.
Given the confusion of scientific data, it is challenging to take a stance. More studies on this subject are currently underway.
Sources
LI W. Q. & et al. Cigarette smoking and the risk of developing rosacea in women. American Journal of Epidemiology (2017).
WU C. Y. & al. Cigarette smoking and risk of rosacea: A nationwide population-based cohort study. Journal of the European Academy of Dermatology and Venereology (2020).
YUAN X. & et al. Association between rosacea and smoking: A systematic review and meta-analysis. Dermatologic Therapy (2021).
