Women who smoke are more likely to develop a form of acne than those who do not, research from Italy suggests.
This type of acne is characterised by white heads and small cysts
A study of 1,000 women found over 40% those who smoked had non-inflammatory acne, characterised by blocked pores, large white heads and small cysts.
This compared with 10% of non-smokers, the study published in the British Journal of Dermatology found.
However, the link between smoking and spots is controversial, and the authors admit other factors may play a role.
Nevertheless, the team from the San Gallicano Dermatological Institute in Rome said they felt their findings could lead to non-inflammatory acne (NIA) being seen as "a new entity among smoking-related cutaneous diseases".
They dubbed it "smokers' acne face".
The study was carried out on women because the condition appears to affect more women than men.
Of the 1,000 subjects, just under 30% were smokers. Of these 42.2% developed acne, predominantly the non-inflammatory form rather than the one featuring red and swollen spots.
The researchers said the smokers in the group had half the levels of skin secretions of vitamin E compared with non-smokers, as well as other variations in skin make-up.
Those who had experienced acne in their teens were found to be four times more likely to suffer acne than non-smokers who had also suffered teenage spots.
Other factors have however already been identified in the development of NIA, including hormonal alterations, stress, occupational and environmental factors.
Environmental factors were found in half of the 10% of non-smokers with the condition. Such factors included the skin being exposed for instance to intense smoke or steam, usually in a place of work such as a kitchen.
It is unclear the extent to which these factors may also have influenced the development of NIA in non-smokers.
Nonetheless, the study fitted into a trend of linking smoking with acne, said the president of the British Association of Dermatologists, Colin Holden.
"All of these findings will hopefully provide people with an extra incentive to quit."