Background: Cigarette smoking significantly alters the inflammatory re
sponse in the skin following application of irritants and rubefacients
. The mechanism of this effect is unknown. There are thousands of comp
onents in cigarette smoke that may be pharmacologically important, but
there is evidence to suggest that nice tine may play an important rol
e in the observed effect on the inflammatory process. Design: This was
an interventional study to assess cutaneous responsiveness to differe
nt stimuli after transdermal nicotine administration in volunteer subj
ects. Cutaneous testing was performed at baseline and at weeks 2 and 4
(the end) of the study. Setting: The Department of Dermatology, Unive
rsity Hospital of Wales, Cardiff.Participants: Ten lifelong nonsmokers
were recruited for the study. Intervention: Nicotine patches were app
lied daily for 1 month. Main Outcome Measures: The following tests wer
e performed: application of 2 times the minimal irritancy dose of sodi
um lauryl sulfate, irradiation with 2 times the minimal erythema dose
of UV-B, measurement of cutaneous vasodilation following application o
f ethyl and hexyl nicotinate, and reactive hyperemia following arteria
l occlusion. Results: There was a significant reduction in the cutaneo
us inflammatory response to sodium lauryl sulfate (P<.001) and irradia
tion with UV-B (P<.003) and a reduction in reactive hyperemia (P<.03)
after 2 weeks of treatment, which returned values to normal at 4 weeks
. There was no change in blood flow following application of topical n
icotinates. Conclusions: Nicotine administration via a transdermal del
ivery system suppresses the cutaneous inflammatory response to sodium
lauryl sulfate and W-B, as well as triggers a transient suppression of
reactive hyperemia following arterial occlusion. The apparent anti-in
flammatory effects of smoking cigarettes can therefore only partially
be explained as a long-term effect of nicotine.