Does Smoking Cause Hair Loss?

Patches of circular hair loss on the scalp of a man with alopecia areata

If you’re one of the 23 percent of people in the world who smokes cigarettes, you’ll likely be displeased to hear that smoking can cause hair loss. But you’re probably not surprised: The negative effects that smoking cigarettes have on people’s health has been well known since the mid-20th century. And smoking remains one of the leading causes of preventable deaths in several countries, including the USA. (1)

But the relationship between hair loss and smoking isn’t just isolated to cigarette use. If you regularly smoke cigars, electronic cigarettes (usually called e-cigarettes or vapes), hookahs, or pipes, or use smokeless or chewing tobacco, your hair health is also likely to be affected.

Smoking and Hair Loss: Understanding the Relationship

These days, it’s pretty well-known that smoking causes health issues. Regular smoking and even secondhand smoking have been tied to a number of cardiovascular and respiratory illnesses, including coronary artery disease and chronic obstructive pulmonary disease. Tobacco smoke also negatively impacts reproductive health and increases your risk of 17 different types of cancer. (1)

Toxic Compounds in Tobacco

Most people are familiar with nicotine – the naturally-occurring toxic compound found in tobacco products. Nicotine is an extremely addictive compound that stimulates the central nervous system. But over 7,000 chemical compounds have been identified in cigarettes and cigarette smoke, 4,000 of which specifically belong to cigarette smoke and 69 of which are well-known carcinogens. (1-3)

Some of tobacco’s carcinogens, like tar, are specific to smoked tobacco as they occur during the combustion process of lighting a product like a cigarette, cigar, or hookah. Besides nicotine, other toxic compounds found in cigarette smoke include (4):

  • Carbon monoxide
  • Carbon dioxide
  • Nitrogen oxides
  • Acetone 
  • Hydrogen cyanide
  • Acrolein
  • Ammonium
  • Pyridine
  • 3-vinyl pyridine
  • Formaldehyde 
  • N-nitrosodimethyamine
  • N-nitrosopyrrolidine
  • Methyl and ethyl alcohol
  • Hydrogen sulfide

As you’d likely expect, repeated exposure to these toxic chemicals is harmful to your body. And when it comes to your hair, smoking or inhaling these toxic substances through secondhand smoke affects you in two main ways: internally, directly affecting a number of bodily systems and functions, and externally, acting as an environmental pollutant.

How Does Smoking Cause Hair Loss?

Smoking causes hair loss through a number of different actions on the body. Some of these actions are specifically related to nicotine, while others are linked to the compounds released by smoking in general. (5)

Smoking has been linked to changes in levels of nutrients and metals in the human body. Essential metals like copper and essential minerals like selenium, iron, and zinc have been reported in reduced rates in smokers. Conversely, smoking seems to increase rates of toxic metals like manganese and chromium in the body – as well as the build-up of chromium in hair. (6)

The hair growth cycle is well-known to be affected by free radicals, which are chemically-unstable particles. Free radicals are commonly found in pollution – and cigarette smoke is also a type of pollution. Even if you’re smoking alone at home or in your car, you’re polluting your immediate environment through cigarette smoke. (5,12)

Free radicals cause oxidative stress – which literally stresses out your cells, causing them to release small immunomodulatory proteins that inhibit hair growth. The free radicals in cigarette smoke can also damage the walls of your body’s cells, particularly affecting skin and hair follicle cells. Some of these skin and hair follicle cells may die earlier than expected – which in turn stops follicles from producing hair for as long as they normally would – because free radicals can upregulate genes related to spontaneous cell death. (5)

Free radicals also interact with nucleic acids, causing mutations and damaging both nuclear and mitochondrial DNA. This damage is thought to have a knock-on effect that directly influences the hair growth cycle. (5)

Smoking is also thought to potentially affect levels of androgens, the main type of hormone involved in the most common type of alopecia: pattern hair loss. Some hair loss medications, like finasteride, work by reducing levels of androgens. If smoking increases androgen levels, it’s essentially acting as a hair loss accelerant – speeding up and worsening hormonal hair loss. (5)

Does Nicotine Cause Hair Loss?

Nicotine definitely causes hair loss – and both nicotine and its derivative, cotinine, may accelerate the progression of androgenetic alopecia. However, it’s not entirely clear exactly how nicotine is responsible for hair loss. Studies show that multiple pathways can be affected by exposure to this compound. (5,7)

Nicotine is known to act as a vasoconstrictor – and in the skin, this also affects the tiny microvasculature leading to the scalp’s hair follicles. One of the most common hair loss treatments, minoxidil, works by increasing blood flow to the scalp. Nicotine does the opposite, restricting blood flow – which also stops oxygen and nutrients from reaching the scalp and consequently prevents hair follicles from producing strong, healthy hair strands. (5)

Nicotine also causes sustained microinflammation of the hair follicle, which overstimulates certain receptors and can activate cell death pathways. If this occurs, it results in the destruction of hair follicles – permanently preventing them from producing new hairs. (5)

Nicotine products – both smoked and orally consumed (like chewing tobacco) – have also been linked to hair graying. Smokers are also likely to suffer premature hair graying, which is generally defined as going gray before the age of 30. (7)

​​Nicotine may also be partly responsible for the detrimental effects of secondhand smoke and hair loss. In one study that exposed mice to environmental tobacco smoke for 4 months, the hair of the mice started to turn gray and fall out after 3 months. Their hair graying and hair loss continued to increase over time. Regardless of whether or not you smoke, if you were regularly exposed to heavy smoking as a child growing up, or if someone in your household regularly smokes around you now, your hair health may still be affected. (7)

Does Vaping Cause Hair Loss?

When people talk about hair loss from smoking, they’re usually referring to smoking tobacco. E-cigarettes and other types of vape pens aren’t necessarily made with any tobacco products – but they do usually contain nicotine. (8) And nicotine is one of the main culprits behind smokers’ hair loss. 

When vapes and e-cigarettes don’t contain nicotine, they often contain nicotine salts – which allow high levels of nicotine to be inhaled without causing as much throat irritation. When the heating element in your device turns on, you breathe in the nicotine and other chemicals via an inhalable aerosol. This may be better for your respiratory system, but it doesn’t mean that it helps with hair loss and other issues. (8)

E-cigarettes and vapes are usually considered to be healthier alternatives to cigarettes and other tobacco products – at least, as long as you’re only using them and avoiding all other tobacco products. (8) But these products typically contain liquids with flavorings, nicotine, and other chemicals. And smoking them has been shown to increase levels of indoor pollutants like propylene glycol, formaldehyde, acetaldehyde, and acetone. (14) Additionally, vapes and similar products may even contain marijuana or synthetic variations of this drug. The additional chemicals and drugs in these liquids also have the potential to be harmful to your health.

Can Weed Cause Hair Loss?

If you live in a region where marijuana is legal, you may have considered switching from smoking cigarettes to smoking weed (also commonly known as pot or cannabis). Or, you may simply believe that smoking or vaping cannabis is healthier for you and your hair. 

Cannabis products don’t contain nicotine – unless you combine them with tobacco products. And, of course, removing nicotine from your day-to-day routine is a healthy choice. But cannabis contains almost 500 compounds – and not all of them are good for you. (9)

Like tobacco, marijuana can also contain many toxic compounds that are harmful to human health, including acetaldehyde, ammonia, arsenic, benzene, carbon monoxide, copper sulfate, hydrogen cyanide, mercury-containing compounds, N-nitrosamines (from insecticides and fertilizers used during the cultivation process), polycyclic hydrocarbons, and sulfur. (9)

Like with tobacco, some of the harmful compounds in marijuana are primarily an issue due to the combustion process – which means they’re mainly problematic when weed is smoked. However, the exact impact these compounds have on your hair’s health is unclear. (9)

While smoking in general may not be ideal for your health, this doesn’t mean that all marijuana products are harmful. While there haven’t been studies looking at all cannabis products’ effects on hair health, there has been a growing interest in exploring the effects of a specific type of cannabis product: cannabidiol (CBD).  

Cannabidiol, a phytocannabinoid, is thought to cause hair growth. In fact, there are even case studies and clinical trials exploring its effectiveness in treating multiple types of hair loss, particularly androgenetic alopecia. (10-11)

Of course, this still doesn’t mean that weed is good for your hair. It doesn’t seem like smoking or using any random type of cannabis product will help, since several other phytocannabinoids in marijuana can actually lead to hair loss. And even then, using or applying CBD-specific products may need to be done with restraint as CBD for hair loss seems to be highly dose-dependent: too much can also be bad for your hair. (10) 

Can Smoking Cause Hair Loss?

Smoking can definitely cause hair loss – but the use of any tobacco product is just as likely to be harmful. Nicotine and other compounds found in cigarettes, hookahs, smokeless tobacco, and other similar products negatively affect your skin and hair. And vaping-related hair loss can also occur, since nicotine, nicotine salts, and other toxic compounds are in e-cigarettes, too.

The combustion process that occurs when you smoke a cigarette or inhale the aerosol from a vape pen is partly to blame for its negative effects on your health. Unfortunately, this means that smoking other plants – like cannabis products – can also be harmful, even though cannabis contains beneficial compounds, too. 

If you suspect that smoking is affecting your hair, you might have started to notice issues like dry, brittle hair or an increase in the number of gray hairs you have. Over time, you’ll notice symptoms like excessive hair fall, thinning, and hairs not growing back on certain parts of your scalp. This is particularly likely if you are genetically predisposed to androgenetic alopecia, since smoking can accelerate the progression of this type of hair loss. 

Some of the damage smoking does to your health can be reversed if you stop. And hair loss drugs like minoxidil and finasteride can also help people with pattern hair loss. 

Just be aware that the use of tobacco products and nicotine-containing alternatives have the potential to cause permanent damage to your hair follicles. After a certain point, those hair follicles won’t be able to produce hair strands anymore. At this stage, only a hair transplant may be able to restore hair growth to these parts of your scalp.

References

  1. Adams, T. N., & Morris, J. (2019). Smoking (Tobacco).
  2. Mendel, J. R., Baig, S. A., Hall, M. G., Jeong, M., Byron, M. J., Morgan, J. C., … & Brewer, N. T. (2018). Brand switching and toxic chemicals in cigarette smoke: A national study. PLoS One, 13(1), e0189928.
  3. https://pubchem.ncbi.nlm.nih.gov/compound/Nicotine
  4. Muchacka, R., Kapusta, E., Greń, A., Formicki, G., Kopańska, M., Kraska, K., … & Sosnówka-Czajka, E. (2021). Accumulation Of Metals In Hair And Nails Of Women Smoking Cigarettes. Journal of Microbiology, Biotechnology and Food Sciences, 2021, 22.
  5. Kavadya, Y., & Mysore, V. (2022). Role of smoking in androgenetic alopecia: A systematic review. International Journal of Trichology, 14(2), 41.
  6. Salem, A. S., Ibrahim, H. S., Abdelaziz, H. H., & Elsaie, M. L. (2021). Implications of cigarette smoking on early‐onset androgenetic alopecia: A cross‐sectional Study. Journal of Cosmetic Dermatology, 20(4), 1318-1324.
  7. Babadjouni, A., Foulad, D. P., Hedayati, B., Evron, E., & Mesinkovska, N. (2021). The effects of smoking on hair health: A systematic review. Skin Appendage Disorders, 7(4), 251-264.
  8. https://www.cdc.gov/tobacco/sgr/2020-smoking-cessation/fact-sheets/pdfs/adult-smoking-cessation-e-cigarettes-use-h.pdf
  9. Subramaniam, V. N., Menezes, A. R., DeSchutter, A., & Lavie, C. J. (2019). The cardiovascular effects of marijuana: are the potential adverse effects worth the high?. Missouri medicine, 116(2), 146.
  10. Gupta, A. K., & Talukder, M. (2022). A cannabinoid Hairy‐Tale: Hair loss or hair gain?. Journal of Cosmetic Dermatology.
  11. MPH, G. L. S., MD. (2021). Androgenetic Alopecia Treatment Using Varin and Cannabidiol-rich Topical Hemp Oil—A Case Series (Clinical Trial Registration No. NCT04842383). clinicaltrials.gov.
  12. Schober, W., Fembacher, L., Frenzen, A., & Fromme, H. (2019). Passive exposure to pollutants from conventional cigarettes and new electronic smoking devices (IQOS, e-cigarette) in passenger cars. International journal of hygiene and environmental health, 222(3), 486-493.
Published on March 15, 2023

Last updated March 2023

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