Clearing the smoke on why Cigarettes harm your skin ASK DR. H MITCHELL HECHT

Q: It’s not too hard to see that smoking causes skin to get wrinkled and age faster. But can you explain why?

Q: It’s not too hard to see that smoking causes skin to get wrinkled and age faster. But can you explain why? A: Smoking affects the skin both from direct toxic effects of the 4,000+ chemicals in cigarette smoke on skin and from facial wrinkles it causes by chronic squinting of the eyes to keep out smoke and pursing/puckering of the lips while holding a cigarette. Cigarette smoke contains carbon monoxide and many other oxidants that promote the formation of age-inducing, skin toxic free-radicals. Nicotine is a stimulant that causes blood vessel constriction that Reduces the supply of oxygen to the tissues of the skin. Smoking also depletes vitamin C, which is important for collagen production in the skin. Smoking also induces changes at the cellular level to interfere with the formation of fibroblasts — cells that form connective tissue in the skin. All these biochemical changes occur as a result of the direct toxic effect of the thousands of chemicals contained in cigarette smoke. These include toxic gases like carbon monoxide, formaldehyde, hydrogen cyanide, nitric oxide and acrolein. Other compounds include: acetone; ammonia; benzene; lead; mercury; cadmium; arsenic; and, of course, tar. Microscopic changes in the skin can already be seen in smokers as young as 20 years of age. The good news is that if one quits smoking (and protects the skin against ultraviolet sun damage), this accelerated aging of the skin can stop and skin can gradually take on a healthier appearance as the body purges itself of the 4,000+ chemicals contained in cigarette smoke. Q: I’m about an inch and a half shorter than I was in my younger days. Is that normal for a 78-year-old guy like me? I’ve got chronic low back pain from arthritis. Do you think that caused me to lose so much height? A: People shrink not only with age, but over the course of a single day. We’re at our tallest when we first get out of bed in the morning, shrinking in height by as much as three-fourths of an inch due to the effects of gravity on our spine. Beginning approximately at age 50, we start shrinking, mainly as a result of a gradual compression, drying out or degeneration of the discs that cushion the bones of our spinal column. By age 80, we can lose an average of 1 ?-2 inches. Your loss of height is therefore not surprising. Another important cause for losing height is the loss of bone density with age. Osteoporosis (and osteopenia) can increase the risk of compression fractures that’ll further diminish one’s height. Since women have bones that are generally less dense than a man’s, bone density studies are important in all women older than 50 (younger than 50 if bone loss is suspected) to assess and monitor bone loss. Men should ask their doctor if there are any past or present risk factors that would warrant a bone density study. Other factors that can cause one to lose height with age are changes in posture caused by scoliosis or kyphosis; herniated or bulging discs; degenerative disease of the lumbar spine; flattening of the arches; and increased curvature of the hips and knees. Dr. Mitchell Hecht is a physician specializing in internal medicine. Send questions to him at: “Ask Dr. H,” P.O. Box 767787, Atlanta, GA 30076. Due to the large volume of mail received, personal replies are not possible. J.P., Newberry, S.C. R.Y., Lima, Ohio

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