We Know Smoking Causes Cancer, But it is Also Harmful to Your Skin

Dermatologist Dr. Suzanne Friedler with Advanced Dermatology Provides Tips on the Skin Risks Associated with Smoking.

Smoking affects nearly every organ in the body and puts your overall health at risk. It damages your heart, your lungs, your bones, even your fertility. What does it do to the largest organ in the body – your skin?

Smoking is related to the development of several skin disorders and if you already have a skin condition, smoking will make it worse. And while it is true that everyone’s skin eventually shows the effects of age, smoking accelerates the development of wrinkles, sagging skin, puffiness under the eyes, uneven complexion, and thinning lips. Along with sun exposure, smoking is a primary culprit in premature aging of the skin.

Dr. Suzanne J. Friedler

Smoking causes premature aging in two key ways. First, the toxins in cigarette smoke destroy collagen and elastin, the fibrous components of skin that give it strength and elasticity. As these building blocks of the skin become progressively damaged, the skin sags and develops deep wrinkles.

The more you smoke, the sooner you’ll see these effects and the longer you smoke, the more pronounced they’ll be. Even exposure to secondhand smoke will cause this damage.

Dr. Suzanne J. Friedler

The second essential effect of smoking on the skin is to deprive it of oxygen and nutrients. Smoking causes narrowing of the blood vessels that deliver these elements that are essential to healthy skin. Their lack contributes to uneven complexion, poor skin tone and the development of a wide array of skin conditions.

Skin cancer: Smokers are at greater risk of developing squamous cell carcinoma, the second most common form of skin cancer. It is thought that tobacco suppresses the immune response that would prevent squamous cells from proliferating on the outermost layer of skin. Squamous cell carcinoma is easily treated when caught early but can metastasize if undetected and can potentially be life-threatening. Smoking is also the primary cause of several types of oral cancer.

Pigmentation: Smoking increases melanin in the skin leading to dark spots particularly on the face and hands. These spots can be caused by sun exposure but research suggests that smokers are more susceptible to them. Stained fingers and nails are also common in smokers.

Psoriasis: Smoking is a risk factor for this chronic inflammatory condition characterized by itchy, scaly patches, usually on the elbows, knees, scalp, hands, and feet. The culprit may be the nicotine in cigarettes which affects the immune system, inflammation, and skin cell growth, all of which contribute to the development of psoriasis.

Wound healing: Narrowing of the blood vessels caused by smoking constricts circulation making it harder for even minor cuts and scrapes to heal and contributing to scarring. Patients are advised to stop smoking before a surgical procedure to reduce the risk of impaired healing of an incision in the skin.

According to the Centers for Disease Control and Prevention, more than 30 million American adults smoke. But more than 50 million Americans have quit smoking. “There are many reasons to quit smoking,” says Dr. Friedler. “Any skin condition you have that is related to smoking will be more manageable when you quit and further damage will be avoided. While not all the damage to your skin will be reversible, there are topical retinoids and vitamin C and E creams that can help and cosmetic procedures like laser skin resurfacing and chemical peels can improve the appearance of the outer layers of skin where damage is most visible. You can quit smoking. Ask your doctor which cessation strategy would be best for you”.

About Dr. Suzanne J. Friedler

Suzanne J. Friedler, M.D. F.A.A.D., is a board-certified fellow of the American Academy of Dermatology, with expertise in many areas of medical and cosmetic dermatology. She has been with Advanced Dermatology PC since 2002.

Come into the beautiful world of Suzanne Friedler, MD.

Dermatologist Dr. Suzanne Friedler with Advanced Dermatology PC with tips on wide array of options for treating a double chin

You don’t have to live with a confidence-zapping double chin. A strong jawline can inspire confidence at any age, but double chins are a sad fact of aging and genetics for many. Fortunately, an expanding number of treatments can target this dreaded profile-buster, says Suzanne Friedler, MD, of Advanced Dermatology P.C.

Patients with double or saggy chins now have multiple effective options that empower them to strengthen their jawline and regain their confidence.

Influenced by a variety of factors that also include weight, anatomy and even the position of your airway, double chins usually show up as excess fat in that area – a condition known medically as submental fullness. And it’s very common: 68% of adults have a double chin they’re unhappy about, according to the American Society for Dermatologic Surgery.

“Even if people aren’t overweight, they can still develop a double chin,” explains Dr. Friedler. “For many, it’s the first area of their body and face that shows deterioration, distorting their self-image. But a wide variety of treatments – both minimally invasive and surgical – can minimize these effects or completely eliminate double chins.”

Minimally invasive options. The number of non-surgical treatments targeting double chins has rapidly grown in recent years, Dr. Friedler points out. These include:

CoolSculpting Mini

How it works: A device that freezes fat cells, CoolSculpting Mini causes ice crystals to form that kill these cells, which are then broken down and reabsorbed into the body.
What to expect: The device is held under your chin by a strap for about 45 minutes, with some patients requiring more than one session for full results. The cold temperature may seem uncomfortable at first, but that feeling generally passes. Only fat cells are frozen and no other cells are harmed.
Results: Within 8 to 12 weeks after a treatment session, your body has broken down and reabsorbed excess chin fat, better defining your jawline.


How it works: Ultrasound waves administered with a hand-held device lift and tighten the skin under the chin and neck. The heat energy causes the skin to contract while also stimulating the growth of collagen. It’s an especially good option for those whose sagging skin – vs. accumulated fat – has led to a double chin, Dr. Friedler notes.
What to expect: Ultherapy takes about one hour and results are very long lasting. The new collagen and elastin that the procedure produces are yours to keep.
Results: Clinical studies revealed that 90% of patients undergoing Ultherapy experienced significant changes in their appearance, reporting a tightened jawline.

Pixel CO2 Laser

How it works: Pixelated beams of light are focused on the face, jawline and neck resulting in tightening, wrinkle reduction and improved skin texture. Skin appears renewed and the treatment stimulates jaw-firming collagen production.
What to expect: Less aggressive than traditional CO2 lasers, Pixel results in much less patient downtime, Dr. Friedler says. It also carries a lower risk of discoloring the skin or producing prolonged redness.
Results: One Pixel CO2 laser session can visibly improve the angle of the jaw, lessening jowls and double chins.


How it works: A chemical called deoxycholic acid, which the gallbladder uses to dissolve dietary fat, is injected into the skin beneath the chin, melting fat in the area that the body then reabsorbs.
What to expect: Between 2 and 6 treatments are needed over several weeks, depending on the amount of excess fat in the chin. The injections can be painful, and you may have a swollen neck for several days after each session.
Results: Many patients see about a 50% improvement in their double chin after 2 treatment sessions and 70% reduction in chin fat after 4 sessions. After 6 sessions, excess chin fat is eliminated, chiseling their jawline.


How it works: This laser-assisted liposuction procedure removes fat in the chin by breaking down fat cells. The destroyed fat cells turn into liquid, which is suctioned out.
What to expect: A tiny tube called a cannula will be inserted through a small incision in the chin after it’s been numbed with a local anesthetic. SmartLipo is less invasive than traditional liposuction, with a quicker recovery time.
Results: For those who don’t gain weight after the procedure, chin-chiseling results should be long-lasting after just one treatment, Dr. Friedler says.

Surgical treatments

In addition to less-invasive techniques, plastic surgeons can also utilize surgery to eliminate a double chin. According to Dr. Friedler, these procedures include:

  • Neck lift: Surgery known as cervicoplasty can remove extra skin in the neck, while platysmaplasty surgery can tighten neck muscles. One or both combined can improve the contour of the jaw, she says.
  • Face lift: This more traditional surgery doesn’t just focus on the jaw, but – as the name suggests – the entire face. It does, however, remove fat and saggy skin around the chin and neck, eliminating a double chin. As with neck lift surgery, recovery involves swelling and bruising that will resolve over weeks.

Whether you choose minimally invasive or surgical treatment, Dr. Friedler says, the decision to tighten your jawline is firmly in your hands.

“Patients with double or saggy chins now have multiple effective options that empower them to strengthen their jawline and regain their confidence,” says Dr. Friedler.

About Dr. Suzanne J. Friedler

Suzanne J. Friedler, M.D. F.A.A.D., is a board-certified fellow of the American Academy of Dermatology, with expertise in many areas of medical and cosmetic dermatology. She has been with Advanced Dermatology PC since 2002.

Come into the beautiful world of Suzanne Friedler, MD.

Dermatologist Dr. Suzanne Friedler with Advanced Dermatology PC with tips on treatment options for younger hands

Anti-aging efforts usually focus on our faces, but it’s actually the hands – our most-used body part – that can age us most. Fortunately, treatment options for younger hands are only expanding, according to Suzanne Friedler, MD, of Advanced Dermatology P.C.

How do our hands give away our age? First, they begin to look bony and fragile as “plumpness” under the skin diminishes, Dr. Friedler explains. As time passes, veins in our hands also become more prominent and the skin starts to thin, looking crepe-y.

“Sun exposure only magnifies these effects, speckling our hands with brown spots,” she says. “Fine lines and wrinkles add up as well. But there are ways to rejuvenate our hands so they look more youthful – and more in line with a relatively young-looking face that’s received more age-averting attention.”

Cosmetic procedures for the hands

Many of us slather on hand cream each day in hopes of smoothing out rough skin and fine lines. But treatments to combat aging hands took a giant step forward a few years ago when the US Food and Drug Administration (FDA) approved the cosmetic filler Radiesse. This injectable dermal filler tackles one of aging’s biggest clues, returning fullness and softness to the backs of the hands, Dr. Friedler says.

“By injecting Radiesse into the skin on the backs of the hands, lost volume is quickly restored,” she adds. In addition, the dermal fill injections help stimulate the body’s own production of collagen, enhancing the end result. Radiesse treatment effects can last from 1 to 2 years.

Another winning procedure to achieve younger-looking hands is laser treatment. This tackles the brown pigment in age spots and freckles, breaking it down and sloughing it off a short time later.

“Most older adults have some sun damage on the tops of their hands, which can be unsightly and even embarrassing,” Dr. Friedler explains. “Laser treatments, which usually require 3 to 5 sessions to attain full effect, do an amazing job of getting rid of the sun’s worst damage.”

At-home hand tips

Cosmetic treatments for younger-looking hands will work even better if you also take easy, everyday steps to slow the hands of time. Dr. Friedler suggests these at-home tips:

  • Use soap-free cleansers, which aren’t as drying.
  • Wear cotton gloves inside rubber gloves while doing wet work such as dishwashing and use work gloves when doing hand-intense chores such as gardening.
  • Moisturize each time you wash your hands or use hand sanitizer with rich creams or emollients. “Bonus points for using moisturizers with retinol or hydroquinone in them, which help lighten age spots,” Dr. Friedler says.
  • Give yourself moisturizing hand and cuticle massages, which can help nutrient-rich blood circulate to the hands and nails more efficiently.
  • Get manicures but keep fingernails short and avoid cutting cuticles

Most importantly, Dr. Friedler urges us to apply sunscreen on our hands (as well as other exposed skin areas) every day, even in colder months. “Even ultraviolet light exposure on our hands through our car windshields adds up over time, freckling and spotting our hands,” she says.

Ultimately, the best approach to younger-looking hands is to treat your hands as you would your face, Dr. Friedler says. “Whatever combination of anti-aging tactics you use, be diligent and consistent,” she adds.

Come into the beautiful world of Suzanne Friedler, MD.