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Hair Health

Smoking and Hair Loss: The Truth You Need to Know

If you’re a smoker, you’re probably already well aware of why you should quit. Between your family using every scare tactic in the book and chilling public service announcements featuring people suffering from various types of cancers and lung diseases, you know the risks more than anyone. Beating the addiction is hard, though. In fact, it’s so difficult that 80 percent of people who try to quit smoking on their own start again within a month. (01)

Just in case you need a little more incentive to kick the habit for good, consider this: according to several research studies, nicotine can induce hair loss. Sure, you know how harmful cigarettes and vapes are to your body, but you probably didn’t expect to go bald from them. What else do you need to know about the effects of smoking on your hair? Keep reading, and we’ll fill you in on the latest.

Nicotine Accelerates Hair Loss

Not only can continual use of nicotine lead to a heart attack, but it is also believed that smoking may be responsible for accelerating hair loss. One study found that 85 percent of men who smoked had a form of androgenic alopecia, male pattern baldness. Among the men in the non-smokers’ group, only 40 percent exhibited signs of male pattern hair loss. The difference in hair loss was significant.  The study used the Hamilton-Norwood Scale, which categorizes hair loss on a scale of one to seven, with one being the least amount of hair loss. In the smoker group, 71 percent had grade III or grade IV hair loss. However, in the non-smoker group, only ten percent of the participants reached grade III or IV. (02)

Smoking Ages Your Scalp

So the next question is, why do experts believe smoking leads to hair loss? You know how smoking is known for giving people leathery alligator skin? It has the same effect on your hair. The reason why stems from a few different factors.

Smoking reduces the blood flow to your hair follicles.

When you smoke, your blood vessels constrict, limiting how much blood flows to your organs. Over time, the continual constriction stiffens the blood vessels and makes them less elastic. When this happens, your cells don’t get the amount of oxygen and nutrients needed to thrive. When your hair follicles are deprived of oxygen, miniaturization occurs, disrupting your hair’s growth cycle. The hair follicle shrinks and eventually blocks the growth of new hair.

Breathing in smoke can damage your hair’s DNA.

Smoke causes environmental effects that inhibit hair growth. DNA contains genetic material that serves as our hair’s building blocks. When carcinogens from cigarette smoke damage the DNA, keratin, a protein that makes-up 95 percent of your hair, cannot be produced.

Smoking causes inflammation.

Smoking stimulates follicular inflammation, a key feature in male and female pattern hair loss. In a 2020 research study on androgenic alopecia, approximately 71 percent of biopsy samples of patients with male or female pattern baldness showed signs of inflammation. (03)

Smoking decreases estrogen levels.

It is well documented that smoking decreases estrogen levels in women, which can lead to earlier onset of menopause. When estrogen levels drop, hair grows slower and thinner. Lower estrogen levels also lead to an increase in androgens which cause female pattern baldness. (04)

Smoking prematurely turns your hair gray.

In an observational research study, people who smoked were two and a half times more likely to have gray hair before age 30 than non-smokers. (05) The study mentioned that the cause of premature graying is not yet known. One hypothesis is that melanocytes, the cells responsible for producing color, are damaged in people who smoke.

If You’re Thinking About Getting a Hair Transplant, Stop Smoking

Many reputable dermatologists and hair specialists refuse to perform hair transplants on patients who smoke. The reason why is because oxygen is critical to the survival of transplanted follicles and helping the wounds heal. Smoking causes poor blood circulation, which could result in the death of the skin tissue on the scalp and even post-operative infections. (06) Another reason why is because nicotine in the blood vessels increases bleeding and inhibits clotting during the healing process.

Vaping Can Cause More Damage Than Traditional Cigarettes

What about vaping? It’s safer than smoking cigarettes, right? Not exactly. Vaping has skyrocketed in popularity across all ages groups in the past few years due to the sweet taste and lack of stale smell. What many people don’t realize, however, is that JUUL, MarkTen Elite, PAX Era, and most other types of e-cigarettes contain more nicotine than traditional cigarettes.

Although no studies are available, anecdotally, one can make the connection that nicotine from vape pens is equally harmful, if not worse, for your hair than traditional cigarettes. Regardless of the source, nicotine has been proven to cause oxidative stress, which can impair your hair’s growth and cause hair loss. (07)

The Jury is Out on Marijuana

Recreational marijuana is currently legal in 19 states, Washington D.C., and Guam. (08) Marijuana must not be harmful if it’s legal, right? Well, the jury is out. A study conducted in 2007 by the University of Debrecen indicates that the THC in marijuana can lead to hair loss. (09)

Marijuana contains cannabinoid compounds. Tetrahydrocannabinol (THC) and Cannabidiol (CBD) are the most well-known. THC is the main psychoactive compound. It’s the one that makes people feel high.  CBD is derived from hemp plants and does not cause a high or lead to addiction. When it comes to your hair, THC is the troublemaker. According to the study, the THC in marijuana can attach to receptors in your body, including your hair follicles, which causes hair loss. Not much research has been conducted since to qualify or negate the study.

We believe that the study is accurate because marijuana and other drugs can be detected in hair samples for up to 90 days prior to the test. (10)  It makes sense that if the THC attaches to the follicles and sticks around for a while, it could cause damage.

Treatment is Available to Reverse Hair Loss Caused By Smoking

Treatment is available if you’re experiencing hair loss from cigarettes, vapes, or marijuana. The first step is to stop smoking to prevent further damage. The next step is to consult with a dermatologist who is also a hair specialist.  Although many hair loss remedies are available over the counter, the most effective ones are only available by prescription. A variety of medications can be prescribed to stimulate regrowth including:


As mentioned previously, smoking can cause androgenic alopecia in people who are predisposed. When people get male or female pattern hair loss, their hair follicles shrink. Minoxidil enlarges miniaturized hair follicles to allow stronger, healthier hair to go to the surface of your scalp.


People who smoke and have male or female pattern baldness produce a chemical called Dihydrotestosterone (DHT) that is converted from Testosterone. DHT attacks the hair follicles and causes the hair to fall out. Finasteride is a DHT blocker that prevents testosterone from converting to DHT.


Sprionolactone is a DHT blocker.  The medication works similarly to Finasteride but is a bit stronger.


Retinoids are often used in conjunction with Minoxidil and Finasteride to increase absorption of medications that treat androgenic alopecia.

In many cases, combinations of these medications are most effective in promoting hair growth among former smokers.  For example, Minoxidil combined with Finasteride and Retinol for absorption has been proven more effective than Minoxidil alone.

Quitting is the Best Way to Preserve Your Hair

If you’re really worried about losing your hair, the best route is to quit smoking. Kicking the habit isn’t always easy, but it’s worth it. You’ll look better and your health will improve.

According to the American Cancer Society, the best strategy is to quit one day at a time. A day turns into a week, a week turns into a month, the months turn into years, and before you know it, you’ll have broken the habit. Sure, it sounds simple, but we realistically know it’s not.  Here are some other helpful tips:

  • Stay busy and spend time in public places where smoking is prohibited
  • Replace the feeling of holding a cigarette or joint with a paper clip, marble, or coin
  • Chew gum or eat lollipops as a substitute
  • Avoid places, activities, and people that you associate with smoking
  • Exercise
  • Create a support system of family members and friends who you can call when you have a craving

Many good resources and programs are available to help you as well. Here are three that we recommend. All of these organizations provide trusted information and support.

American Cancer Society

If you’re considering quitting, you don’t have to do it alone. During The Great American Smokeout annual event, thousands of people commit to a smoking cessation program on the third Thursday in November.

American Lung Association

The American Lung Association offers a Lung Helpline & Tobacco Quitline staffed by licensed registered nurses, respiratory therapists, and certified tobacco treatment specialists. The staff is a wealth of knowledge and can help connect you with a support group, find a doctor, and even answer questions about health insurance.

National Cancer Institute

Smokefree.gov, sponsored by the National Cancer Institute, offers free tech programs to help you go smokefree. One innovative program is a texting service that gives encouragement, advice, and tips to help you quit. The organization also offers apps that allow you to tag locations and time of day you need support, as well as social media support.

If you are a current or former smoker and your hair is thinning or balding as a result, Happy Head is here to help. Contact us so we can review your history and customize a prescription-grade hair loss solution for you.


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