Heavy smokers are at risk of aggravating several cutaneous diseases. The main adverse effects of cigarette smoking on the skin are associated with psoriasis, with squamous cell carcinoma and with the poorer outcome of malignant melanoma. One of the main concerns to smokers is the well-documented effect of smoking on premature face aging due to excessive wrinkling, which may follow enhanced elastase activity, and the degradation of elastin in the dermis. Recently, evidence has emerged indicating that smoking induces in the skin the activity of the metallo-proteinase MMP-1 that specifically degrades collagen, the most abundant protein in the cutaneous matrix.