Pollution, smoking and how they age your skin

Key takeaways

• Smoking ages skin visibly. Identical twin studies show the longer a twin smoked, the older they looked.
• Traffic pollution was linked to about 20% more pigment spots on the face in one large study.
• Smoke from cooking on solid fuel was linked to more facial wrinkles and fine wrinkles on the backs of the hands.
• Sun remains a major cause of pigment and wrinkles, so daily sunscreen matters even more in a city.
• Stopping smoking still helps your skin after years of smoking. It is never too late.

How does smoking age the skin?

Patients who smoke sometimes ask me for something to fix their lines, and I'm happy to discuss it. But I tell them honestly what is causing them, because otherwise we are filling a bucket with a hole in it.

See, what happens is, cigarette smoke reduces blood flow to the skin and fills it with chemicals that damage collagen and elastin, the fibres that keep skin firm and springy. The skin repairs itself more slowly. Over the years this shows as: - Fine lines around the lips, from both the chemicals and the repeated pursing. - Lines around the eyes and a greyish, dull tone. - Loose skin and slower wound healing.

The most convincing evidence comes from identical twins, who share the same genes. A 2009 study in Plastic and Reconstructive Surgery photographed 186 pairs of identical twins and had a panel judge their age. The longer a twin had smoked, the older they looked. Wrinkles were more evident in twins who smoked. Sun exposure and not using sunscreen also made twins look older.

The Mayo Clinic lists smoking and pollution among the causes that speed up skin ageing, and notes that quitting can still improve your skin even after years of smoking.

What does air pollution do to the skin?

This is the question I get more in Thane and Mumbai now. Traffic, construction dust, burning garbage. People want to know if it is showing on their face.

The research so far: - Traffic pollution and pigment spots. A study of 400 older women in Germany, published in the Journal of Investigative Dermatology in 2010, found that higher exposure to soot and traffic particles was associated with about 20% more pigment spots on the forehead and cheeks. The link with wrinkles was weaker. - Indoor smoke from cooking. Two studies of more than 1,200 women in China found that cooking with solid fuels such as coal was associated with 5 to 8% more severe facial wrinkles and a 74% higher risk of fine wrinkles on the backs of the hands, independent of age. - The bigger picture. A 2026 systematic review of 77 population studies in the American Journal of Clinical Dermatology found most studies support a harmful effect of air pollution on several skin conditions, including skin ageing, while noting that study quality varies.

Basically, pollution seems to push pigment more than it pushes wrinkles. For Indian skin, which already tends towards pigmentation, that is very important to understand.

Is chulha or agarbatti smoke a problem too?

The Chinese studies were about cooking with solid fuel indoors, which is close to what many Indian homes used for generations: wood, coal or dung cakes on a chulha. If you or your mother cooked that way for years, it may be part of what you see on the face and hands now.

I have not seen good studies specifically on incense or agarbatti and skin ageing, so I won't make claims there. Good ventilation in the kitchen and the pooja room is sensible for your lungs anyway.

Smoking versus pollution: how do they compare?

What can I actually do about it?

For smoking: - Stop. It is the single change that helps skin, heart and lungs together. Your family doctor can help with medicines and support if you have tried before and failed. That is not a weakness; nicotine is hard to leave. - Expect slow improvement. The skin does not reset in a month, but it stops getting worse at the same rate.

For pollution: - Cleanse gently in the evening. A mild face wash to remove the day's dust and grime. No scrubbing; harsh scrubs make pigmentation worse in our skin. - Daily broad-spectrum sunscreen. Sun is the other big driver of pigment and wrinkles, so sunscreen is your main daily shield. - An antioxidant serum, if you like one. Vitamin C or niacinamide serums are reasonable additions. The Mayo Clinic notes such ingredients may help. They are not essential. - Reduce exposure where you can. Keep car windows closed in heavy traffic, use a kitchen chimney or exhaust fan, and avoid walking along the busiest roads at peak hours when you have a choice. - Treat pigment properly. If spots have already formed, they can be treated with prescription creams, peels or laser therapy, chosen carefully for Indian skin. My article on sun damage and ageing explains more.

Can treatments undo smoking or pollution damage?

Partly. Lines can be softened, pigment can be lightened, texture can be improved. But I will be straightforward: if you are still smoking twenty a day, the results of any treatment fade faster and healing is slower. With surgery, smoking is a well-known reason for poor healing. I'd rather spend your money where it lasts.

How I approach this at Dr Tvacha

At a face assessment I ask about smoking, where you live, how you commute and what your skincare is, because it changes the plan. I tell you which changes are yours to make and which treatments, if any, make sense, and the plan and fee are written down before you pay. You can read about the Long Game Anti-ageing Plan or find our centres in Thane and Mumbai. If you are early in this journey, see an evidence-based anti-ageing routine.

Written by

Dr Amit KarkhanisAesthetic Physician · MBBS, Dip. Dermatology (UK) · Reg. No. 2001/02/1124

Founder of Dr Tvacha, practising in Thane since 2005. Leads the weight loss and hair programmes.