Ask a doctor

Does Smoking Cause Dark Circles Around the Eyes?

I have dark circles around my eyes and have had this problem for a long time.  Is it because of smoking? What can I do about it?

Doctor Answers (4)

Smoking can cause dark circles around eyes

+2

Daniell in 1971 in the Annals of Internal Medicine, first linked smoking and periorbital wrinkling. Later, the term smoker's face was coined by Model and he mentioned dark circles under the eyes. Various other studies have implicated smoking as a cause of facial aging, though not specifically mentioning dark circles.

A recent article in the Archives of Dermatology shows a striking picture of twin women. In fact the ladies were the Cover Girls of the December 2007 issue (good thing if you are a model, not so good if they are showing your medical condition.) It seems they are identical, and lived only 40 miles apart. They both worked driving delivery trucks. One twin was a heavy smoker the other a non-smoker. Access those pictures and wow!! what a difference. The smoker looks about 15 years older. The authors feel (and I agree) this would make a great anti-smoking campaign.

How does smoking cause skin aging? The authors state "the pathophysiologic process of wrinkling in smokers is not exact, it may be multifactorial and may be convergent with other causes of skin aging."

It seems that smoking induces the production of matrix metalloproteinases (MMP) much like the sun. The MMP's break down collagen. Studies have also found deleterious changes in the elastic fibers of smokers.

The nicotine found in cigarettes increases the level of vasopressin ( a protein emitted by the pituitary gland..used to induce pregnancies too) in the blood. This causes a vasoconstriction of the blood vessels (clamping down) and less blood flow into the dermis (ischemia). Postischemic reperfusion is a well known cause of the production of reactive oxygen species (ROS) or oxidants. As many of you reading this know, oxidants can cause aging of the skin. Thus, a cause of aging in the smoker. Cigarette smoke itself has chemicals in it that produces oxidants.

As the oxidants around the eyes breaks down the collagen and elastin, the delicate tissue gets wasted and the contents of the dermis with its prominent blood supply becomes more apparent. This results in the tell-tale darkening..smoker's face.

In Dr. Gentile's answer below, he mentions skin thinning being caused by the interference of blood flow. The above scientific exertions that I made should second his words, although I am a bit perplexed by the Orbicularis Oris part.

Dr. Rand also presented a very interesting and plausible explanation which I had not heard before. I would appreciate it if he would kindly E Mail with the paper or journal this hypothesis is drawn from. Perhaps, before our March 19th radio show. Thanks.

Hopefully, this has clarified the reason one gets dark circles under the eyes and the even more significant answer as to why smoking ages the skin.


Virginia Beach Dermatologist
4.5 out of 5 stars 10 reviews

Smoking aggravates dark circles under eyes.

+2

The skin damage that can be promoted by smoking includes a thinning of skin due to interference with blood flow to the skin. This thinning can lead to a increased visibility of the orbicularis oculi muscle under the skin of the lower eyelid which makes the dark circles look more pronounced.

Richard Gentile, MD
Youngstown Facial Plastic Surgeon
4.5 out of 5 stars 22 reviews

Smoking prematurely ages the skin

+2

Smoking per se won't create dark circles. However, smoking prematurely ages the skin and can exacerbate wrinkles and thinning of the tissues. The dark circles may be more prevalent because the overlying skin thins out a bit.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Smoking certainly makes your eyes look worse

+2

Aside from the other well known health risks of smoking, there are cosmetic problems associated with this habit. One is that the irritant effect of the plume of smoke in your eyes causes squinting and accentuates the lines around your eyes. The deeper the lines are, the more shadowing there is in the lower eyelid region causing darker circles.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 51 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.