TOBACCO AND SKIN Mini Lecture 1 Module Tobacco

TOBACCO AND SKIN Mini Lecture 1 Module: Tobacco and Sensory Organs

Objectives of the Mini Lecture GOAL OF MINI LECTURE: Provide students with knowledge about the relationship between tobacco use and changes in the skin. LEARNING OBJECTIVES Students will be able to: • Identify how tobacco use is a risk factor for changes in the skin. • Understand how tobacco causes aging and acts detrimentally on wound healing. • Understand the value of cessation in the prevention of premature aging and poor wound healing.

Contents Core slides 1. Tobacco and Premature Aging of Skin 2. Tobacco and Premature Aging: Mechanisms 3. Cessation and Premature Aging 4. Tobacco and Wound Healing 5. Tobacco and Wound Healing: Mechanism 6. Cessation and Wound Healing Optional slides 1. Host Factors that Affect Wound Healing

CORE SLIDES Tobacco and Skin Mini Lecture 1 Module: Tobacco and Sensory Organs

Tobacco and Premature Aging of Skin • Tobacco smoke and UVA cause wrinkle formation independently of each other. 1, 2 • Unquestionable sequelae of cigarette smoking are: • Occurrence of yellow fingers • Enhanced wrinkling, especially in the faces of females • Vasospasms and obliterations of large arteries as well as of small skin vessels. 1. Yin et al. 2001; 2. Partsch et al. 1994

Tobacco and Premature Aging: Mechanisms • Thickening and fragmentation of the elastic fibers of skin and decrease in collagen formation that maintains a healthy and supple skin. 1, 4 • Enhanced elastase activity, and the degradation of elastin in the dermis. 2 • More MMP-1 m. RNA in the skin of smokers than non-smoker. 3 • Oxygen supply and the water content of skin is also reduced. 4 http: //review. surreyhealth. nhs. uk/article. aspx? id_Content=5279 1. Yin et al. 2000; 2. Sela 2002; 3. Lahmann et al. 2003; 4. http: //www. medindia. net/patients/patientinfo/smoking_hazards_skin. htm#ixzz 0 l. LMlfka. B

Cessation and Premature Aging • Smoking and facial wrinkling is important evidence for convincing young people not to begin smoking and older smokers to quit. 1 • Dermatologists can play an integral role in promoting smoking cessation by providing expert opinion and educating the public on the harmful effects of smoking on the skin. 2 1. Grady et al. 1992; 2. Freiman et al. 2004

Tobacco and Wound Healing • Smokers are at increased risk for complications at surgery sites or following skin grafts. 1 • In patients with intraoral bone grafts, wound healing was impaired in 33% of patients, of whom http: //www. surgeryencyclopedia. com/images/gesu_01_img 0009. jpg 80% were smokers. 2 • Second hand smoke can inhibit cell migration that may result in abnormal repair and remodeling and/or lead to excess scarring. 3 1. Reus et al. 1992; 2. Jones and Triplett 1992; 3. Wong et al. 2004

Tobacco and Wound Healing Mechanism • Changes in the rheologic characteristics of the blood, increased vasoconstriction, and damage to the epithelial layer of the vessel. • Interactions with collagen metabolism. • Induction of an inflammation reaction by nicotine. • Immunosuppression caused by nicotine may also contribute. Krug et al. 2004 http: //www. my-varicose-veins. com/venous-stasis-ulcers. html

Cessation and Wound Healing Smoking cessation: • Three months or more before surgery, cessation reduces risk of wound complication. 1 • Several weeks before surgery, cessation resulted in a substantial benefit in the rate of wound-related complications in orthopedic surgery. 2 • If preoperative smoking interventions can reduce complications, the savings in personal suffering and financial expense would be substantial. 3 1. Ahn et al. 2002; 2. Warner 2005; 3. Møller et al. 2002

OPTIONAL SLIDES Tobacco and Skin Mini lecture 1 Module: Tobacco and Sensory Organs

Host Factors That Affect Wound Healing Local Factors: • Chronic edema • Vascular diseases • Extensive scarring • Previous radiation • Tissue loss Systemic Factors • Malnutrition • Immune deficiencies • Organ failures • Diabetes • Old age • Cancers • Obesity • Use of Tobacco Products • Steroids, other medications http: //www. osteomyelitis. com/images/classification 2 -big. jpg

The most important health message a doctor can give to patients is to quit smoking.