Does Smoking Cause Hair Loss?

The connection between smoking and hair loss has been hotly debated for many years now. While there are many studies showing a positive relationship between the two, there’s also some conflicting evidence.

Still, it cannot be denied that there are a number of ways in which smoking can end up causing hair loss, if not directly then at least indirectly. And it might do more than make you lose your hair, as it’s also been correlated with premature greying of hair.

It’s also important to know that smoking hasn’t only been linked to temporary alopecia but permanent one as well. Therefore, you might not always be able to undo the damage caused by it. In this guide, we’ll answer a question that’s very frequently asked: does smoking cause hair loss?

How Does Smoking Cause Hair Loss?

According to a review published in the International Journal of Trichology, there are different ways in which smoking can cause hair loss, some of which include:

  • Narrowing of the blood vessels and reduced blood flow to the scalp.
  • Generating free radicals and causing oxidative stress.
  • Causing an imbalance of the hormones.

Other than that, smoking can also damage the DNA, affecting the cycle of hair growth and increasing the ageing of the cells. Let’s take a closer look at the different ways in which smoking might cause hair loss.

Poor Blood Flow

With reduced blood flow to the scalp, your hair won’t be able to get sufficient oxygen and nutrients, which will, in turn, affect its growth. It’s also one of the reasons why surgeons advise against smoking before and after a hair transplant surgery.

Before surgery, you’ll likely be asked to quit smoking because there can be a concern of excessive bleeding because of it. Afterwards, it can affect the recovery and your final results. It can increase the risk of side effects (like scabbing) and more serious complications, such as infection, increased scarring, and even necrosis (skin death).

Oxidative Stress

Oxidative stress can not only affect the growth of the hair follicles but it’s also believed to be a significant contributor to the process of hair greying. In oxidative stress, there are more free radicals in the body than antioxidants, and this can damage the cells and the DNA.

Hormonal Imbalance

Hormonal imbalance can also work in a number of ways to indirectly cause hair loss due to smoking. According to a study published in Physiological Research, “nicotine has an anti-estrogen effect,” and it increases the amount of androgens in the body, compared to the estrogens. This has been linked to the development of androgenetic alopecia in smokers.

Androgenetic alopecia, as its name suggests, is caused by the androgens in the body (although it’s not solely to blame). A byproduct of testosterone caused dihydrotestosterone causes shrinking or miniaturisation of hair follicles.

With more androgens in the body due to smoking, you might become more susceptible to this kind of hair loss. A higher prevalence of androgenetic alopecia was reported in smokers compared to nonsmokers in research published in the Journal of Cosmetic Dermatology.

There are other ways in which smoking can cause hormonal imbalance and, in turn, hair loss. A study in Environmental Health Perspectives suggested that chemicals in smoke can affect the reproductive system, causing issues such as “menstrual dysfunction, infertility and earlier menopause.”

Poor Health

Other than cancer, many illnesses can be caused by smoking. The Centers for Disease Control and Prevention (CDC) has outlined the following:

  • Heart, lung and eye diseases
  • Diabetes
  • Stroke
  • Chronic obstructive pulmonary disease
  • Tuberculosis
  • Immune issues

Poor health can indirectly cause hair loss in several ways. For instance, it can shock your system and cause a type of hair loss known as “telogen effluvium.” Hair loss can also occur from the medications used to treat some of these illnesses.

But smoking has also been linked to a type of autoimmune condition that directly affects the hair follicles called alopecia areata. One study published in the American Journal of Clinical Dermatology found that the risk of developing alopecia areata was higher in smokers.

Increased Stress

One myth about smoking is that it helps relieve stress. However, research has found that it’s not the case. In fact, smoking can worsen stress, and stress can also cause hair loss.

A study in the American Psychologist suggests that dependency on nicotine can worsen stress. It’s been noted that smokers have “normal moods during smoking,” but it worsens during the time between smokes.

Does Smoking Increase Hair Loss?

There are a number of ways in which smoking can exacerbate existing hair loss. As mentioned above, smoking can contribute to hair loss by affecting blood flow, causing an imbalance between free radicals and antioxidants, hormonal changes, poor health, more stress, etc.

If you’re already losing hair due to another stressor in your life, smoking may end up making things worse for your hair. Even if you’re losing hair due to genetic pattern baldness, smoking might exacerbate hair loss in a number of ways.

Does Quitting Smoking Stop Hair Loss?

Quitting smoking might help improve the condition of your hair. However, it’s hard to say if it will completely stop hair loss. That’s because hair loss can occur due to a number of reasons.

Take androgenetic alopecia, for instance, which has a genetic component, so it’s not primarily affected by smoking. It’s the kind of hair loss that’s permanent, and it has no cure.

However, it can be treated to slow down hair loss (e.g. through drugs like finasteride) or regrow hair in bald spots (with a surgery like hair transplant).

Can Hair Loss From Smoking Be Reversed?

Whether or not smoking hair loss can be reversed will depend on the kind of hair loss you’re experiencing. For instance, if it’s telogen effluvium, which is generally reversible, hair loss due to smoking might make a comeback.

However, again, if the hair loss you’re experiencing is due to a more permanent condition like androgenetic alopecia, reversal might not always be possible.

How Is Smoking-Related Hair Loss Treated?

Since smoking is what’s can cause “smoking-related hair loss,” that habit needs to be addressed. You need to quit smoking for hair loss resulting from it. This is not to say that it will undo all the damage that’s already been done. However, it might help in stopping your hair loss from worsening.

Depending on the kind of hair loss you’re experiencing, your doctor might prescribe medication, such as minoxidil or finasteride. There are some other non-surgical treatments for hair loss as well such as low-level laser therapy, platelet-rich plasma injections, etc. In any case, make sure to consult your doctor, including about how to quit smoking.


Can smoking cause hair loss? While there’s still no conclusive answer to this, many researches report an association between smoking and different types of alopecia.

And as far as the answer to “Does smoking affect hair loss” goes, it might also be yes because smoking can affect your body in a number of ways, which can consequently impact the hair.

If you’re experiencing hair loss, make sure to get in touch with a board-certified professional for a diagnosis of your alopecia. They’ll prepare a suitable treatment plan for you based on the underlying cause of the problem.

Reviewed and approved by Trichologist Yaprak Yazan

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