Smoking Warnings: Can We Add Hand Eczema and Contact Dermatitis to the List?
Smoking has a well-documented impact on the skin, but are contact dermatitis and hand eczema part of that list?
A recent review looked at studies examining the association between smoking and contact dermatitis or hand eczema. The authors were able to find 59 articles that met their criteria of focusing on the relationship between smoking and hand eczema and/or contact dermatitis. Seven articles found an association between contact dermatitis and smoking. Of note, there was a dose–response relationship between the amount smoked in pack-years and nickel contact allergy in women. There was one article that could not find an association between smoking and contact dermatitis. There were nineteen original articles found on the relationship between hand eczema and smoking. Nine of those articles showed an association between hand eczema and smoking. Three more articles were unable to draw a clear relationship between hand eczema and smoking and seven studies showed no association between hand eczema and smoking.
The authors conclude that based on their review study, smoking may indeed be a risk factor for both allergic and irritant contact dermatitis, as well as hand eczema. Due to the limitation of a small sample size, they note that despite statistically significant data showing a relationship between smoking and contact dermatitis, a definitive statement on the possible link between smoking and contact dermatitis cannot be made. Similarly, no definitive link can be made for hand eczema and smoking; more studies are needed on the topic of smoking and its relationship with contact dermatitis and hand eczema. Nonetheless, the authors suggest advising patients with contact dermatitis and hand eczema to refrain from using tobacco products.