What effect does smoking have on breasts?

In 2003 the Chief Medical Officer highlighted a definite link between smoking and skin damage in his annual report, estimating that regular smoking can add between ten and twenty years to your age in terms of appearance.

Most people are familiar with the yellow, nicotine-stained fingers and nails of a smoker, likewise the telltale puckering and wrinkles round the mouth. So how does this habit affect breasts and breast health?

Premature skin ageing

Heavy smokers tend to have a tired, greyish or sallow complexion for three main reasons:

  1. Tobacco smoke has a drying effect on the epidermis, which struggles to regain moisture when constantly in close proximity to the fumes. Drier skin typically results in more wrinkles.
  2. Regular smoking restricts blood vessels, thereby reducing the blood flow to the skin, and starving it of both oxygen and essential nutrients, leading to a less-than-rosy glow.
  3. Smoking may encourage production of a hormone that breaks down collagen, the protein that is responsible for regenerating skin and sustaining its elasticity and youthful appearance.

Initially a smoker will start to show the side effects of her habit in her face, but over time the consequences of constant nicotine use will be seen all over her body, including the breasts, where the skin may likewise appear grey and prematurely wrinkled due to the loss of elasticity.


Smoking is also a key factor in ptosis, or breast sagging, as it breaks down the elastin protein in skin, which is necessary for giving support and a more youthful appearance. With both the vital elements of elastin and collagen under attack, smokers really do run the risk of a prematurely droopy bust.

But there is another, less obvious reason for breast sagging in smokers. It is well known that nicotine acts as an appetite suppressant and also increases the body’s metabolic rate, meaning that calories are burned up more quickly. Studies have shown that when people quit smoking, they typically gain around 2 to 3 kg in weight. As smokers are more likely to be thinner, there is a certain logic that their plumper non-smoking counterparts are more likely to have a fuller bust. Either way, a woman who continually starts and stops her smoking habit, is likely to experience rapid weight gain and loss in a similar manner to a yo-yo dieter. This is bad news for her breasts, as the delicate skin supporting them will be overly stretched.

Periductal mastitis

Periductal mastitis is an unpleasant condition in which the ducts underneath the nipple become infected. Symptoms include a non-cancerous lump behind the nipple, tenderness, redness and a raised temperature, a discharge from the nipple that may be bloody or contain pus, and occasionally the nipple itself may become inverted.

Smokers have an increased risk of periductal mastitis, because the harmful substances in cigarette smoke can damage the ducts behind the nipple. If you are concerned you may have periductal mastitis, consult your GP, who will probably refer you to a breast clinic. Treatment includes antibiotics, over-the-counter pain relief such as paracetamol, aspirating the pus if necessary, and potentially surgery to remove the affected duct if the infection doesn’t clear up. In the event you were to undergo a microdochectomy (surgical removal of the problematic duct/s), continued smoking could also slow down the healing process.

Clearly it’s a good idea to quit smoking, not just for the sake of your health, but also for the overall appearance of your breasts and décolletage. As smoking is also directly linked to an increased risk of developing breast cancer, this is surely one habit you could do without.

For more information on how to quit smoking, visit NHS Stop Smoking service.

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