Smoking, Alcoholism, and Use of Illicit Drugs

Tobacco smoking, one of the main modifiable risk factors for mortality, is associated with cutaneous neoplasias and cutaneous aging, besides worsening of the postsurgical scarring process. It is also involved with the pathogenesis and the worsening of some dermatoses, such as Buerger’s disease, lupus, psoriasis, and hidradenitis suppurativa. Alcoholism is a chronic, progressive, and lethal disease that leads to multiple organ dysfunction and skin manifestations associated with endocrinologic changes, with nutritional deficiencies and signs of hepatopathy. Alcoholism is associated with the triggering or worsening of dermatoses, such as psoriasis, porphyria, seborrheic dermatitis, rosacea, urticaria, contact dermatitis, and eczema. Advice to patients on quitting smoking and drinking should be part of the routine general directions about general health and the skin health. Cocaine, one of the world’s oldest drugs, causes euphoria accompanied by serious side effects including cardiac disorders, skin necrosis, and nasal septum perforation, among others. This chapter discusses the main manifestations of tobacco smoking, alcoholism, and drug addiction (particularly cocaine use, also when mixed with adjuvant drugs such as levamisole).