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November 12, 1973

Smokers' Wrinkles

Author Affiliations

Philadelphia, Pa

JAMA. 1973;226(7):788. doi:10.1001/jama.1973.03230070048016

To the Editor.—  In 1971 Daniell1 reported a relationship between "crow's feet" wrinkles and smoking in a large population of which more than 98% was white. Allen et al (225:1067, 1973) concluded that wrinkles in the crow's foot area are caused by actinic exposure and not by smoking, because black patients had no such wrinkles whether they smoked or not and also because histologic sections of skin in white patients showed changes only of actinic elastosis, whether they smoked or not. I believe this conclusion is not warranted by the data presented.It may be true that blacks do not develop wrinkles, but this does not refute a relationship between smoking and wrinkles in whites. And even if it were uncontrovertible that histologic abnormalities of elastosis were caused by actinic exposure, this does not eliminate smoking as an important factor that determines who wrinkles in response to sunlight.Their concept