What Is the Main Idea?

Smoking, apart from affecting the internal organs, can also affect skin and hair health. In the article “The Effects of Smoking on Hair Health: A Systematic Review” published in the journal Skin Appendage Disorders, the authors collate 32 different research studies and show that there is a positive association between those who have male or female pattern baldness or premature hair graying, and their smoking behavior.

What Else Can You Learn?

From the various studies they discuss, it is found that it is not just the act of smoking but the quantity and history of smoking that directly affect this correlation with hair loss and graying. Therefore, when patients go to doctors regarding these hair issues, environmental factors like smoking or exposure to smoke should be addressed. Conversely, people can be discouraged from smoking by discussing the ill effects on their hair health.

Smoking: A Factor in Hair Health

Among other hair problems, male or female pattern baldness and premature hair graying are issues that can start affecting people at an early age, even below 30 years. At that early age, these hair problems can lead to issues of self-esteem and interfere with social communication. Genetics and hormones play a major role in these hair-related issues. But understanding the external factors, like smoking, can help bring in an additional level of treatment. Smoking affects different organs and systems within the body, including lungs and heart, but can also affect skin health and hair growth. Multiple studies have now looked at how smoking and related molecules like nicotine particles affect the hair. In humans, to understand if there is a correlation between hair loss or premature graying and smoking, research groups around the world have conducted studies in different settings and demography. In the free access review article, the authors have collated information from 32 individual studies to get a more holistic picture of this association; the results are described below.

Male or Female Pattern Baldness and Smoking

Male or female pattern baldness is one of the most common types of hair loss. However, it differs from men to women. In men, there is hair loss in the front, mid-scalp and/or crown of the head. For women, there is a more diffused hair loss and thinning of the hair. To assess the effect of smoking on this type of hair loss, studies from various demographics, including Asia and the UK, showed a strong correlation between the quantity (packs per day) of smoking and hair loss. These studies were corroborated in different settings, including a study that had 1,000 men, half of whom smoked more than 10 cigarettes per day. In this study, about 85% of those who smoked had male pattern baldness, compared to only 40% of those who did not smoke. Some studies did not show a significant correlation between hair loss of smokers and non-smokers. The issues with these studies are that they were limited by the number of participants or lack of information of smoking history or age, and in some cases, lower age of participants with shorter smoking history.

Premature Hair Graying and Smoking

Premature hair graying occurs when a person has gray hair below the age of 30. It occurs because the molecules that impart color to the hair become defective. This could be due to an imbalance between the molecules that cause cellular damage and ‘antioxidants’ that can protect from the damage. The authors of the article describe seven studies that showed a positive association between smoking and premature hair graying, including one study which showed that there is two times more risk of graying prematurely in smokers. In another study, patients with premature hair graying had a history of smoking compared to non-smokers. There were a few studies that did not show a correlation between premature hair graying and smoking but here, again, the age of participants was low, potentially without enough history of smoking.


While the different studies described above show an association between smoking and hair health, the exact mechanism of how smoking affects hair loss or graying is not understood yet. Despite this, when going to a dermatologist regarding issues with the hair, especially regarding premature graying and hair loss, it is important to consider and discuss the patient’s smoking history or exposure to cigarette smoke. This can factor into the treatment given for hair health. Alternatively, smoking which is harmful to general health can be discouraged further by explaining the ill effects on hair health and potential social implications.

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