The Effects of Smoking on Hair Health: A Systematic Review

January 2021 in “ Skin appendage disorders ”

Arash Babadjouni, Delila Pouldar Foulad, Bobak Hedayati, Evyatar Evron, Natasha Atanaskova Mesinkovska

premature hair graying alopecia androgenetic alopecia frontal fibrosing alopecia alopecia areata PHG AGA FFA

Studysummary This review summarizes evidence suggesting that smoking is associated with alopecia and premature hair graying, with smokers showing higher prevalence than nonsmokers.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

The systematic review from January 1, 2021, analyzed 32 studies with a total of 23,685 patients to assess the effects of smoking on hair health, specifically looking at the relationship with premature hair graying (PHG) and alopecia, including androgenetic alopecia (AGA) and frontal fibrosing alopecia (FFA). The review found that smokers had a higher prevalence of hair loss and PHG compared to nonsmokers, with a higher risk of moderate or severe AGA and a higher frequency of alopecia areata in current or past smokers. However, the evidence was mixed, as some studies did not find a significant correlation between smoking and hair health issues. The review concluded that smoking status should be considered in patients with hair loss and PHG and highlighted the need for further research, including randomized controlled trials, to establish causality and understand the mechanisms involved.

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research Implications of Cigarette Smoking on Early-Onset Androgenetic Alopecia: A Cross-Sectional Study

7 citations , September 2020 in “Journal of Cosmetic Dermatology”

This study found that the prevalence of androgenetic alopecia was significantly higher among smokers compared to nonsmokers, though the severity wasn't linked to smoking intensity.

research Premature Graying of Hair: Risk Factors, Co-Morbid Conditions, Pharmacotherapy and Reversal—A Systematic Review and Meta-Analysis

7 citations , July 2020 in “Dermatologic therapy”

This review discusses premature graying of hair, highlighting risk factors like smoking and vitamin deficiencies, and suggests that addressing underlying conditions may reverse the graying process.

research Frontal Fibrosing Alopecia: A Retrospective Study of 75 Patients

12 citations , July 2020 in “Actas Dermo-Sifiliográficas”

This study found that facial papules and rosacea in patients with frontal fibrosing alopecia were linked to a greater need for oral treatment, with most cases involving postmenopausal women.

research Androgenetic Alopecia: Relationship to Anthropometric Indices, Blood Pressure and Lifestyle Habits

13 citations , February 2020 in “Clinical, Cosmetic and Investigational Dermatology”

In this study, men with androgenetic alopecia had lower BMI and waist-to-hip ratios than controls, but no significant association with hypertension or other lifestyle factors was observed.

research Clinical Profile of Androgenic Alopecia and Its Association with Cardiovascular Risk Factors

13 citations , January 2019 in “Indian Journal of Dermatology”

This study found that men with early-onset androgenic alopecia had a higher prevalence of cardiovascular risk factors, indicating that early screening for metabolic syndrome may be beneficial in this population.

research Relationship Between Diet, Atopy, Family History, and Premature Hair Graying

7 citations , December 2018 in “Journal of Cosmetic Dermatology”

This study found that a vegetarian diet preference, atopy history, and paternal family history were associated with a higher likelihood of premature hair graying in young adults.

research Association of Epidemiological and Biochemical Factors with Premature Graying of Hair: A Case-Control Study

16 citations , January 2018 in “International journal of trichology”

This study observed that individuals with premature hair graying had lower levels of certain serum nutrients and lifestyle factors like stress and smoking may contribute; hair oiling appeared protective.

research Mediterranean Diet: Fresh Herbs And Fresh Vegetables Decrease The Risk Of Androgenetic Alopecia In Males

12 citations , November 2017 in “Archives of Dermatological Research”

This study suggests that high consumption of raw vegetables and fresh herbs, which are part of the Mediterranean diet, may reduce the risk of androgenetic alopecia in genetically predisposed men.

research Hair Loss: Common Causes and Treatment

35 citations , September 2017 in “PubMed”

This article reviews different types of alopecia, their diagnosis, and treatment options available in a family physician's practice, but it reports no new research findings.

research The Combination of Overweight and Smoking Increases the Severity of Androgenetic Alopecia

21 citations , May 2017 in “International Journal of Dermatology”

This study found that among Caucasian individuals with androgenetic alopecia, being overweight and smoking were associated with greater severity of the condition.

Frequency, Severity, and Related Factors of Androgenetic Alopecia in Dermatology Outpatient Clinic: Hospital-Based Cross-Sectional Study in Turkey

research Frequency, Severity, and Related Factors of Androgenetic Alopecia in Dermatology Outpatient Clinic: Hospital-Based Cross-Sectional Study in Turkey

37 citations , February 2017 in “Anais Brasileiros De Dermatologia”

In this study, researchers found that the prevalence of androgenetic alopecia was higher in their sample compared to other studies in Asian and Caucasian populations, and it was linked with age-related severity.

research Risk Factors for Premature Hair Graying in Young Turkish Adults

26 citations , June 2016 in “Pediatric Dermatology”

This study found that premature hair graying in young Turkish men and women is associated with emotional stress, alcohol consumption, chronic diseases, and a family history of graying.

research Cardiovascular Risk in Patients with Alopecia Areata: A Propensity-Matched Retrospective Analysis

29 citations , May 2016 in “Journal of the American Academy of Dermatology”

This study observed that patients with alopecia areata had decreased odds of developing stroke and a potential decreased risk of acute myocardial infarction, though the latter was not statistically significant.

research Relationship Between Androgenetic Alopecia and Cardiovascular Risk Factors According to BASP Classification in Koreans

14 citations , March 2016 in “Journal of Dermatology”

This study found that Korean patients with androgenetic alopecia had higher rates of cardiovascular diseases and related risk factors than those without the condition, with variations by severity and type of hair loss.

research Association of Premature Hair Graying with Family History, Smoking, and Obesity: A Cross-Sectional Study

46 citations , December 2014 in “Journal of The American Academy of Dermatology”

This study found that smoking, obesity, and family history are significant risk factors for premature hair graying in young men.

research Frontal Fibrosing Alopecia: A Multicenter Review of 355 Patients

339 citations , February 2014 in “Journal of The American Academy of Dermatology”

This study found that eyelash loss, facial papules, and body hair involvement were linked to severe frontal fibrosing alopecia, and antiandrogens were the most effective treatment.

Androgenic Alopecia Is Associated With Less Dietary Soy, Higher Blood Vanadium, and rs1160312 Polymorphism in Taiwanese Communities

research Androgenic Alopecia Is Associated With Less Dietary Soy, Higher Blood Vanadium, and rs1160312 Polymorphism in Taiwanese Communities

15 citations , December 2013

This study found that in men with androgenic alopecia, moderate to severe cases were associated with the AA genotype of rs1160312, blood vanadium concentrations, and regular consumption of soy bean drinks.

research An Epidemiological Study of Androgenic Alopecia in 3114 Korean Patients

20 citations , December 2013 in “Clinical and Experimental Dermatology”

This study found that among Korean men with AGA, drinking and smoking were associated with greater hair loss severity, while family history was linked to more severe hair loss and earlier onset.

Acute Telogen Effluvium Onset Event Is Associated With The Presence Of Female Androgenetic Alopecia: Potential Therapeutic Implications

research Acute Telogen Effluvium Onset Event Is Associated With The Presence Of Female Androgenetic Alopecia: Potential Therapeutic Implications

13 citations , October 2013 in “Dermatologic Therapy”

This study found that severe diets, iron deficiency, and thyroid dysfunction are significant predictors of acute telogen effluvium's association with female androgenetic alopecia.

research The Contribution of Endogenous and Exogenous Factors to Male Alopecia

37 citations , April 2013 in “Plastic and Reconstructive Surgery”

This study found that environmental factors such as smoking, alcohol consumption, exercise, and testosterone levels may significantly influence various forms of hair loss in male identical twins.

research The Contribution of Endogenous and Exogenous Factors to Female Alopecia

21 citations , November 2012 in “Plastic and Reconstructive Surgery”

The researchers reported that various environmental factors and higher testosterone levels were linked to different patterns of hair loss in women with androgenic alopecia.

research Frontal Fibrosing Alopecia: A Review of 60 Cases

166 citations , April 2012 in “Journal of The American Academy of Dermatology”

This study reviewed clinical data from 60 patients with frontal fibrosing alopecia and found increasing prevalence and generally poor response to treatment, with the cause remaining unclear.

research Androgenetic Alopecia and Cardiovascular Risk Factors in Men and Women: A Comparative Study

110 citations , July 2010 in “Journal of The American Academy of Dermatology”

Hair loss linked to higher heart disease risk in both men and women.

research Association of Androgenetic Alopecia With Smoking and Its Prevalence Among Asian Men

91 citations , November 2007 in “Archives of Dermatology”

In this study, smoking status and intensity were significantly associated with moderate or severe androgenetic alopecia among Asian men, after accounting for age and family history.

research Pharmacologic Interventions in Aging Hair

80 citations , April 2006 in “Clinical Interventions in Aging”

This review discusses factors affecting hair aging and the current pharmacological treatments for androgenetic alopecia, mentioning topical minoxidil and oral finasteride, but does not present new clinical findings.

research Distinguishing Androgenetic Alopecia From Chronic Telogen Effluvium When Associated in the Same Patient

63 citations , October 2005 in “Archives of Dermatology”

This study reports that a hair shedding threshold of 100 hairs or more may provide the best concordance with clinical diagnosis for distinguishing chronic telogen effluvium from androgenetic alopecia.

research Chronic Telogen Effluvium or Early Androgenetic Alopecia?

12 citations , March 2004 in “International Journal of Dermatology”

This case report describes a 16-year-old girl initially diagnosed with chronic telogen effluvium, later reassessed with Ludwig Stage 1 androgenetic alopecia, for which she began spironolactone treatment.

research Androgenetic Alopecia in Men Aged 40-69 Years: Prevalence and Risk Factors

155 citations , December 2003 in “British Journal of Dermatology”

In this study, the researchers did not confirm previously reported links between AGA and smoking or benign prostatic hypertrophy, but found potential associations with alcohol consumption and lean body mass at age 21 that merit further investigation.

research Hair Loss, Insulin Resistance, and Heredity in Middle-Aged Women: A Population-Based Study

49 citations , June 2003 in “European journal of cardiovascular prevention & rehabilitation”

In this study, female androgenic alopecia (grade II or III on Ludwig's scale) was found to be common among Finnish women aged 63, and several markers of insulin resistance, along with paternal history of alopecia, were associated with an increased risk.

research Association Between Smoking and Hair Loss: Another Opportunity for Health Education Against Smoking?

102 citations , January 2003 in “Dermatology”

This review discusses the potential link between smoking and hair loss and suggests that raising awareness about this association could enhance anti-smoking education efforts.

research Chronic Telogen Effluvium: Increased Scalp Hair Shedding in Middle-Aged Women

234 citations , December 1996 in “Journal of The American Academy of Dermatology”

The authors concluded that chronic telogen effluvium in middle-aged women presents distinct clinical and histological features that differ from androgenetic alopecia and acute telogen effluvium.

research Psychological Effects of Androgenetic Alopecia on Women: Comparisons with Balding Men and Female Control Subjects

222 citations , October 1993 in “Journal of The American Academy of Dermatology”

This study found that androgenetic alopecia causes significant psychological distress, particularly in women, who exhibit a more negative body image and less adaptive functioning compared to controls.

research The Psychological Effects of Androgenetic Alopecia in Men

192 citations , June 1992 in “Journal of The American Academy of Dermatology”

Hair loss can cause low self-esteem, anxiety, and depression in men.

research Human Hair Follicle Benzo[a]pyrene and Benzo[a]pyrene 7,8-diol Metabolism: Effect of Exposure to a Coal Tar-Containing Shampoo

66 citations , January 1987 in “Journal of Investigative Dermatology”

This study found that enzyme activity critical to cancer induction by polycyclic aromatic hydrocarbons in human hair follicles increased after using a crude coal tar-containing shampoo for four days and was substantially inhibited by imidazole compounds.