How Smoking Can Lead to Hair Loss

How Smoking Can Lead to Hair Loss

Smoking tobacco and even electronic cigarettes such as vaping devices has negative impacts on health. It has also been associated with impotence in men and has been linked to skin problems. Other studies have also drawn an association between smoking and hair loss.

The Link Between Smoking and Hair Loss According to Research

An earlier study by researcher Ralph M. Trüeb noted that the mechanism by which smoking causes hair loss is multifactorial that includes the vascular effects on hair follicles, damage to the follicles and specific DNA, imbalance to systems controlling tissue remodeling during the hair growth cycle, inflammation, and oxidation, among others.

The systematic review by researchers A. Babadjouni et al. published in 2021 concluded that there is a strong association between exposure to chemicals in cigarette smoke and negative hair health. Take note that this study reviewed 32 previous studies that investigated the association between smoking, premature hair graying, and alopecia.

Ahmed S. Salem et al. also conducted a cross-sectional study that investigated the implications of cigarette smoking on early-onset androgenetic alopecia in healthy males between the age of 20 and 35. Results revealed that 425 out of 500 smokers had some degree of hair loss while only 200 of 500 nonsmokers showed signs of hair loss

It is also important to note that ambient exposure to tobacco smoke results in nicotine accumulation in hair follicles and the hair shaft. Even exposure to second-hand and third-hand smoke can also affect hair health. W. K. Al-Delaimy showed that the hair nicotine biomarker can be used for assessing exposure to environmental tobacco smoke.

Smoking is indeed one of the causes or risk factors of hair loss. Direct and indirect exposure to chemicals from smoking such as nicotine has been linked to the development of more specific types of hair loss such as androgenetic alopecia and alopecia areata Take note of the following effects of smoking and how they affect hair health:

• Reduces Blood Flow and Oxygen Supply: One of the observed mechanisms behind hair loss due to smoking centers on how chemicals such as nicotine narrow the blood vessels and reduce the oxygen supply in the hair follicles. Nicotine is a vasoconstrictor. Prolonged exposure to vasoconstrictors results in weaker and thinner hair.

• Increases Oxidative Stress and Inflammation: Nicotine and other chemicals in tobacco smoke can increase the levels of free radicals or reactive oxygen species which increase oxidative stress. Oxidative stress can damage hair follicles. Continuous oxidative stress also triggers inflammation that forces follicles to become dormant.

• Stimulates Further Localized Inflammation: It is also important to highlight the fact that smoking can straight-up stimulate the release of pro-inflammatory cytokines. Increased levels of these signaling molecules can arrest the natural hair growth cycle due to follicle scarring or follicular micro-inflammation and fibrosis.

• Induces Internal Imbalances and Disruptions: Smoking disrupts the follicular protease/antiprotease systems controlling tissue remodeling during the hair growth cycle. It can also induce an imbalance or disruption in hormones such as cortisol that can knock off the levels of other hormones such as androgens or sex hormones.

Nevertheless, considering the aforesaid mechanisms that explain describes how smoking can lead to hair loss, smoking cessation or exposure avoidance has been considered as one of the management and treatment options for individuals who suffer from alopecia and at-risk people who want to maintain their hair health or prevent hair loss.


  • Al-Delaimy, W. K. 2002. “Hair as a Biomarker for Exposure to Tobacco Smoke. Tobacco Control. 11(3): 176-182. DOI: 1136/tc.11.3.176
  • Babadjouni, A., Pouldar Foulad, D., Hedayati, B., Evron, E., and Mesinkovska, N. 2021. “The Effects of Smoking on Hair Health: A Systematic Review.” Skin Appendage Disorders. 7(4): 251-264. DOI: 1159/000512865
  • Salem, A. S., Ibrahim, H. S., Abdelaziz, H. H., and Elsaie, M. L. 2020. “Implications of Cigarette Smoking on Early‐Onset Androgenetic Alopecia: A Cross‐Sectional Study.” Journal of Cosmetic Dermatology. 20(4): 1318-1324. DOI: 1111/jocd.13727
  • Trüeb, R. M. 2003. “Association Between Smoking and Hair Loss: Another Opportunity for Health Education Against Smoking?” Dermatology. 206(3): 189-191. DOI: 1159/000068894
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