Does Smoking Cause Hair Loss?

Katelyn Brenner FNP

Reviewed by Katelyn Hagerty, FNP

Written by Our Editorial Team

Published 03/11/2021

Updated 03/12/2021

To put things mildly, there isn't a lot of good smoking tobacco does for your health. Routinely blowing through that cigarette, cigar, or pipe has been proven to cause cancer, heart disease, stroke, lung disease, diabetes, and chronic obstructive pulmonary disease — and that’s only a fraction of the bad stuff.

On the outside, a smoking habit may lead to the early appearance of wrinkles, fine lines, and sagging skin. In some instances, as we'll be checking out, smoking may even lead to hair loss.

If you're a smoker who has noticed changes to your hair: reduced density, a thinning hairline, or perhaps the appearance of a bald spot where a decent coverage of hair once was — this may be connected to your frequent exposure to tobacco smoke.

To understand the connection between hair loss and smoking, we'll be breaking down the many ways smoking tobacco can cause the loss of hair. We'll also be sorting through possible treatment options to manage hair loss caused by smoking.

If you know anything about formaldehyde, arsenic, hydrogen cyanide, lead and ammonia, you're probably aware that these are toxic chemicals that can cause harm to your health.

These compounds, together with a number of others are produced when smoking tobacco. Their combined effects can lead to hair loss in the following ways:

Smoking can disrupt blood flow to hair follicles

The hair on the surface of your scalp may be dead, but right underneath it are blood vessels which ensure that your hair gets the oxygen and nutrients required to grow. They are also responsible for eliminating waste from the scalp.

The toxins present when smoking tobacco may harm these blood vessels, and damage their structure. If that isn't bad enough, these toxins can also prevent your heart from properly functioning while also impeding the vessels from carrying out their roles.

Overtime, these toxins can cause a buildup of plaque around the arteries in a condition known as atherosclerosis. When this plaque hardens, it can narrow the arteries.

This damage can restrict the flow of oxygen and nutrients to the hair, both of which are necessary for follicle development.

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Tobacco smoke may affect immune response

It’s common knowledge that tobacco smoke contributes to a long chain of diseases. Not as common is the fact that smoking could also play a role in preventing your ability to fight against harmful pathogens. 

Cigarette smoke may affect the immune system by being pro-inflammatory and immunosuppressive, and it takes these roles seriously. Cytokines and chemokines  which promote inflammation are released when smoking.

Likewise, the effectiveness of T-cells, T-helper cells, B-cells etc — all of which make up your immune system, is affected by cigarette smoke.

Alopecia areata, a common form of hair loss, is an autoimmune disease linked to smoking tobacco, along with androgenetic alopecia.

Smoking can lead to oxidative stress

Contributing to smoking’s bad PR is the fact that it may lead to oxidative stress in the hair. Oxidative stress occurs when there is an imbalance between free radicals (unstable atoms that can damage cells) and your body’s antioxidant defence mechanism.

Smoking-induced oxidative stress may lead to something called lipid peroxidation, which can be worrying because lipids make up the building blocks of living cells, the hair cells inclusive. Lipid peroxidation occurs when free radicals attack lipids,  which can lead to the death of hair cells.

Smoking is linked to endocrine diseases that can cause hair loss

Getting your body to work at top form is regulated by a well-connected network of glands called the endocrine system. Well, that is until external factors like tobacco smoke shake things up.

Smoking cigarettes may cause Grave's hyperthyroidism, a condition where the thyroid gland — a part of the endocrine system — produces excess amounts of the thyroid hormone. This condition can lead to hair loss.

Smoking is also linked to other endocrine diseases like diabetes, a known cause of hair loss.

Cortisol levels are increased through smoking

To help you manage the stress of juggling work deadlines, daily traffic, or those simply overwhelming days, your body produces a hormone called cortisol. This hormone primarily helps you deal with stress triggers, but is also important for the function and regulation of hair follicles.

If you're a chronic smoker, nicotine may cause your cortisol levels to increase overtime. 

This build-up can degrade compounds which are necessary for hair follicle development like hyaluronan and proteoglycan. This can cause stress-related hair loss in the form of telogen effluvium and androgenetic alopecia.

Smoking may lead to major forms of hair loss like androgenetic alopecia and alopecia areata. To help manage its effects, the following can be used:


Applied topically as a liquid solution or a foam formulation, minoxidil may be able to improve hair loss. It does this by acting as a vasodilator, which simply means it dilates the blood vessels in the location where it is applied. This allows for increased blood flow to the area which can prompt hair growth.

While its mechanism of action isn't 100 percent understood, minoxidil is also able to somehow push your hair out of its resting (telogen) stage, right before it falls out. It does this to induce the growth or anagen phase prematurely.

Minoxidil is also able to elongate the growth phase, making it possible to grow fuller and thicker hair for longer.

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This medication works to improve hair growth by preventing testosterone from breaking down into DHT or dihydrotestosterone.

DHT is a hormone known to lead to hair loss by causing hair follicles to miniaturize. This may eventually prevent them from growing.

Finasteride is approved for use as an oral remedy. It requires consistent use to see results for hair growth.


As you’ll remember, tobacco smoke has pro-inflammatory effects which can cause hair loss.

Corticosteroids are steroid hormones which have anti-inflammatory properties. They may help to reduce hair loss, while highly potent corticosteroids may even improve hair regrowth.

Corticosteroids may be applied topically through creams gels, ointments and foams. Oral corticosteroids may also be used and are equally effective in treating alopecia areata.

While there is little proof that quitting smoking may help with hair regrowth, putting an end to the habit may be able to prevent the further loss of hair.

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Smoking does a lot of damage to your health, and in some instances that damage can be extended to your hairline and hair density.

There are many crafty ways through which smoking tobacco prompts hair loss: oxidative stress, increase in cortisol levels etc. To help manage its effects, quitting smoking may be a great place to start.

Countering the effects of smoking on hair loss can be achieved through hair growth therapies like minoxidil, finasteride and corticosteroids. Consulting with a trusted healthcare professional is important when determining the best option for you. 

4 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. Yamada, T., Hara, K., Umematsu, H., & Kadowaki, T. (2013). Male pattern baldness and its association with coronary heart disease: a meta-analysis. BMJ open, 3(4), e002537.
  2. Qiu, F., Liang, C. L., Liu, H., Zeng, Y. Q., Hou, S., Huang, S., Lai, X., & Dai, Z. (2017). Impacts of cigarette smoking on immune responsiveness: Up and down or upside down?. Oncotarget, 8(1), 268–284.
  3. Badri T, Nessel TA, Kumar D D. Minoxidil. [Updated 2020 May 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Retrieved from:
  4. Zito PM, Bistas KG, Syed K. Finasteride. [Updated 2020 Oct 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from:
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.