Middle aged smokers whose faces are heavily lined with wrinkles are five times more likely to have COPD than smokers without wrinkles, suggests research published ahead of print in Thorax.

It is well known that smoking causes premature ageing of the skin, and that most cases of COPD are caused by smoking. Not all smokers go on to develop COPD, however, and the researchers wanted to know if the extent of facial wrinkling might provide a clue as to a smoker’s likelihood of having the disease.

The researchers studied 149 current and former middle-aged smokers from 78 families. In all, 68 people had COPD. More than 80% (124) of the total sample had no or very few facial lines, and 25 had widespread wrinkles.

Forced expiratory volume in 1 second, which measures lung strength, was significantly lower in those with extensive wrinkling than it was in those whose faces were only minimally lined. And those with lined faces were five times more likely to have COPD than those without, after taking into account the age and the number of years as a smoker. Facial wrinkling was also associate with triple the risk of more severe emphysema.