It's no secret that smoking hurts the heart and lungs, but the damage doesn't stop there. Smoking has been linked to psoriasis as well.

“Since the 1970s, many studies have linked psoriasis and smoking," says Natasha Mesinkovska, MD, PhD, a dermatologist at the Cleveland Clinic in Ohio. “Smoking may trigger psoriasis, and the more you smoke, the worse your psoriasis can be."

According to a study published in 2012 in the American Journal of Epidemiology, smokers have almost double the risk of developing psoriasis compared with people who’ve never smoked.

The Link Between Psoriasis and Smoking

“In people who have a genetic tendency for psoriasis, smoking may trigger the genes to become active," Dr. Mesinkovska says. "People who smoke may also have more stress, and stress is a trigger for psoriasis."

Psoriasis is an autoimmune disease, which means that the immune system — the body’s defense system — attacks normal tissues instead of invaders like germs. “Nicotine alters the immune system, which may partially explain the link between psoriasis and smoking,” Mesinkovska says.

But nicotine may not be the only link. “There are thousands of ingredients in tobacco smoke that may cause a type of cell damage called oxidative damage," Mesinkovska says. "This may be why smoking makes psoriasis worse."

For people that also have psoriatic arthritis, the effects of smoking can be even more pronounced. Those with psoriatic arthritis who smoke are less likely to get the best response from treatments such as biologic medications, according to a Danish study published online in July 2014 in the journal Annals of the Rheumatic Diseases.

Avoiding Cigarettes to Improve Outcomes

One of the most important studies to link smoking and psoriasis was the Nurses’ Health Study II. In this landmark study, more than 78,000 nurses were followed for 14 years. Researchers found that current and past smoking increased the risk for psoriasis, that nurses who had been exposed to secondhand smoke as children had an increased risk for psoriasis, and that quitting smoking gradually reduced the odds of developing psoriasis.

Women who smoke have a higher risk of developing psoriasis than men who smoke, according to the National Psoriasis Foundation, so if you're a female smoker, you have even greater motivation to quit.

Take these steps to improve your outcomes:

  • If you smoke, quit.
  • Warn your children to never start smoking. If psoriasis runs in your family, those genes can be triggered by smoking.
  • Make sure you and your children avoid secondhand smoke.

Finding Success With Smoking Cessation

Most people with psoriasis can use all the same smoking cessation tools as people who don't have psoriasis, Mesinkovska says. These include nicotine products, medications, and smoking cessation classes. Work with your doctor to find the best smoking cessation plan for you. For example, depending on the extent of your psoriasis, a nicotine skin patch may not be the best choice, according to the American Academy of Dermatology.

“Doctors are increasingly aware of how important healthy lifestyle habits are for psoriasis," Mesinkovska says. "Smoking cessation is a must for people with psoriasis. Start by reducing the number of cigarettes until you get down to none,” she says. “Quitting smoking is one of the best things you can do for psoriasis and your overall health.”