Can smoking cause hair loss?

Quick Summary: Can Smoking Cause Hair Loss?

The Link Between Smoking and Hair Loss: Smoking contributes to hair loss by damaging hair follicles, reducing blood flow to the scalp, and increasing oxidative stress.
Does Smoking Increase the Risk of Hair Loss? Multiple studies have shown a strong correlation between smoking and increased hair loss, including specific hair loss patterns.
Other Effects of Smoking on Hair: Besides hair loss, smoking can lead to premature greying, increased risk of hair transplant complications, and dry hair.
Journey to Quit Smoking: Quitting smoking involves avoiding triggers, and using nicotine replacement therapies or medications to manage cravings. Behavioural support, exercise, mindfulness, and connecting with support groups can also help. For personalised advice, individuals can consult healthcare providers or use national quitlines.
Can Hair Regrow After Quitting Smoking? While quitting smoking can improve overall hair health, hair regrowth is not guaranteed. Hair transplantation might be a viable option for persistent hair loss.

The detrimental effects of smoking extend far beyond the well-documented impact on lung function. Recent research suggests a significant link between cigarette use and hair loss. This article explores the scientific evidence behind this connection and offers insights for those seeking solutions.

The Impact of Smoking on Hair Growth

Healthy hair growth relies on a well-nourished and well-oxygenated environment within the scalp’s follicles. Unfortunately, smoking disrupts this delicate ecosystem in multiple ways:

Reduced Blood Flow: Nicotine, a primary component of cigarettes, acts as a vasoconstrictor, reducing blood flow to the scalp¹. This vital flow delivers essential nutrients and oxygen to hair follicles for optimal hair growth. When restricted, this flow starves the follicles, hindering their ability to function properly.
Effects to the immune system: Smoking has been implicated in exacerbating autoimmune conditions. In the context of hair loss, this can manifest in conditions like alopecia areata. Research suggests a correlation between smoking intensity and the risk of developing this autoimmune hair loss condition. Individuals with a long-term smoking habit or those who consume a high number of cigarettes daily appear to have a heightened risk of alopecia areata⁵.
Oxidative Stress: Smoking generates harmful free radicals, molecules that damage cells throughout the body². Oxidative stress occurs when free radicals build up faster than our body’s antioxidants can neutralise them. In the case of alopecia areata, oxidative stress exacerbates the situation by causing damage to hair follicles, especially since these individuals already have an overactive immune system. This leads to the hair growth cycle being prematurely pushed into the resting phase, making it difficult for hair to re-enter the growth phase thereby contributing to hair loss³.
DNA and Enzymatic Damage: Cigarette smoke contains cancerous compounds that have been shown to cause DNA damage. Given the critical role of DNA in cellular processes, including hair follicle regeneration, this damage can impede normal hair growth⁴. Furthermore, smoking disrupts the equilibrium of certain enzymes involved in the hair growth cycle, potentially leading to irregularities in the catagen phase, when hair follicles transition from growth to rest.
Hormonal Imbalance: Nicotine in cigarettes has also been linked to elevated cortisol levels. Cortisol, often referred to as “the stress hormone”, can disrupt the normal hair growth cycle, potentially leading to telogen effluvium, a type of hair loss characterised by excessive shedding⁶. Furthermore, studies have shown that smoking can influence hormone levels, particularly in women, which can contribute to hair thinning and loss⁷.

Studies on the association of hair loss and smoking

A recent study⁸ examined the correlation between smoking and early-onset androgenetic alopecia in male young adults aged 20 to 35. The findings showed that a significantly higher percentage of smokers exhibited signs of hair loss compared to non-smokers. Moreover, the severity of hair loss, as measured by the Norwood scale, was notably more pronounced in the smoking group. While these results suggest a strong association between smoking and accelerated hair loss, further research is necessary to definitively establish a causal link between nicotine and the specific mechanisms underlying androgenic alopecia.

Another study involving over 900 Korean patients (male and female) with androgenetic alopecia found that current smokers experienced more severe hair loss compared to non-smokers. Specifically, smokers were more likely to have a distinctive U-shaped pattern of hair loss⁹.

Similar results have been observed among other studies as well, showing that smoking can cause different types of hair loss, in both men and women.¹⁰¹¹

Smoking and Hair Health: Beyond Hair Loss

Smoking negatively impacts hair health in various ways beyond causing hair loss. These include,

Premature Greying: Research suggests a link between smoking and early onset of grey hair¹².
Hair Transplant Complications: Smokers are at a higher risk of complications during hair transplant procedures¹³. One of the more severe effects of smoking related to hair loss is necrosis, particularly in the context of surgical procedures like hair transplants. Necrosis refers to the death of tissue, which can occur when the blood supply to an area is significantly reduced or cut off. In smokers, the risk of necrosis increases due to the compromised circulation and reduced healing capacity of the skin. This can lead to the death of transplanted hair follicles, poor healing of the donor and recipient areas, and ultimately a lower success rate of hair restoration procedures.
Dry Hair: The ageing process naturally decreases hair oil production. Smoking may accelerate this process, leading to drier hair at a young age¹⁴.

Navigating the Journey to Quit Smoking

Quitting smoking can be challenging, but with the right strategies and support, it is achievable. One of the most effective ways to quit is by setting a quit date and creating a plan that includes avoiding triggers, such as certain social situations or stressors that prompt the urge to smoke. Nicotine replacement therapies (NRT) like patches, gums, lozenges, or prescription medications such as varenicline (Chantix) or bupropion (Zyban) can help reduce withdrawal symptoms and cravings. Additionally, behavioural support through counselling, whether in-person, over the phone, or online, provides valuable encouragement and strategies to stay on track.

It’s also helpful to replace smoking with healthier habits, such as exercise, which can help manage stress and improve mood, or practising mindfulness and deep breathing techniques to curb cravings. Joining support groups, either in-person or online, can connect you with others who are also trying to quit, offering mutual encouragement and sharing of tips. For personalised advice and support, individuals can turn to healthcare providers, who can guide them through the quitting process and suggest appropriate treatments. National quitlines, such as the NHS Smokefree Helpline or the American Cancer Society’s Quitline, are also valuable resources that provide expert advice and support.

The Path to Healthier Hair: Quitting Smoking and Beyond

While quitting smoking can improve overall health and potentially contribute to some hair regrowth, it’s important to understand that hair loss is not always reversible. For many people, hair thinning or baldness persists even after giving up cigarettes.

If you’re experiencing ongoing hair loss despite quitting smoking, hair transplantation might be a viable option. A Hair Transplant is a surgical procedure that involves taking healthy hair follicles from a donor area on the scalp and placing them into bald or thinning areas like the hairline, temples or crown. This procedure provides results that are long-lasting, effectively restoring hair growth and improving appearance and self-confidence. At The Treatment Rooms London, our experienced surgeons specialise in hair restoration procedures. We offer personalised consultations to assess your specific needs and recommend the most suitable treatment plan.

Conclusion

Smoking is a significant contributor to hair loss. By understanding the scientific mechanisms behind this connection, you can take proactive steps to protect your hair health. Quitting smoking is the first and most important step toward healthier hair. If you’re struggling with hair loss, consulting with our qualified hair transplant specialists can provide you with effective treatment options and a personalised approach to hair restoration.

References

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Salem, A.S. et al. (2020) ‘Implications of cigarette smoking on early‐onset androgenetic alopecia: A cross‐sectional study’, Journal of Cosmetic Dermatology, 20(4), pp. 1318–1324. Available at: https://onlinelibrary.wiley.com/doi/10.1111/jocd.13727
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Diagram of Impacts of smoking that may lead to hair loss illustrated using biorender.com