1. ¹Medical Corps, Israel Defense Forces, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
2. ²Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

Correspondence: Dr Itay Klaz, Department of Dermatology, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv 64239, Israel. E-mail: Itay.klaz@gmail.com

Received 18 September 2005; Revised 8 March 2006; Accepted 8 March 2006; Published online 27 April 2006.

Abstract

As the relationship between tobacco smoking and acne remains unclear, we examined the relationship between cigarette smoking and severe acne in a large cohort of young men. Trained nurses interviewed subjects upon discharge from compulsory military service, regarding family history, habits, and tobacco smoking habits. Data was correlated with severe acne status, as diagnosed and coded by board-certified dermatologists. In total, 27,083 male subjects participated in the study from 1983 to 2003, of which 237 (0.88%) had severe acne, 11,718 (43.27%) were active smokers, and 15,365 (56.73%) were nonsmokers at the time of interviews. Active smokers showed a significantly lower prevalence of severe acne (0.71%) than nonsmokers (1.01%) (P=0.0078). An inverse dose-dependent relationship between severe acne prevalence and daily cigarette consumption became significant from 21 cigarettes a day (² and trend test: P<0.0001), odds ratio: 0.2 (95% CI: 0.06–0.63). The study did not aim to establish a temporal correlation, and passive smoking and acne treatments were not measured. Previous in vitro and clinical studies strongly support an association with nicotine. We suggest a trial with topical nicotine treatment for acne to further investigate this association.