Does smoking cause hair loss and/or premature hair graying?

Cigarettes remains a global health problem that continues to contribute to both mortality and morbidity all around the world. Commonly linked to lung disease, heart disease and cancers, for decades now smoking has also been proven to impart negative effects on hair too. Researchers in fact believe cigarette smoking to be a significant culprit in accelerating premature graying of hair, as well as being responsible for the early onset of hair loss.

Smoking and Premature Graying of Hair

The mechanism that links premature hair graying to cigarette smoking is similar to a stress reaction. Also, the free radicals produced by smoking tobacco are known to damage the melanin cells responsible for hair pigmentation. To further support the connection between cigarettes and hair graying, melanocytes in gray hair bulbs are frequently observed to be highly vacuolated, a common response to increased oxidative stress.

A 2010 cross-sectional observational study analyzed 207 participants, classified into two groups: premature hair graying (PHG) and senile hair graying. Here, the PHG stands as the first appearance of gray hair before the age of 30. It was found, that of the 207 subjects, 104 (50.2%) had the first appearance of gray hair before the age of 30 (PHG group), and the other 103 (49.8%) observed graying of hair after this age.

The participants were questioned about smoking, and it was recorded that the prevalence of smokers in the “PHG” group was higher (40.2% vs. 24.7). From the data collected, the study calculated the incidence of smokers to be two and half times more prone to develop PHG, confirming that there is a relationship between premature graying of hair and cigarette smoking.

Smoking and Early Hair Loss

Smoking cigarettes is associated with both temporary hair loss (for example, Telogen Effluvium), and permanent hair loss (for example, male-patterned baldness and female pattern hair loss). Multiple factors linked to smoking that can cause early and extensive shedding of scalp hair include:

  • Damage to the blood vessels that supply nourishment to the dermal hair papilla,
  • Damage to the DNA of the hair follicle by the toxins and carcinogens released by smoking,
  • Smoke-induced imbalance of the enzymes that regulate proteins needed during the hair growth cycle,
  • Increased Dihydrotestosterone (DHT) production in the body, which leads to an increased risk of hair loss and a receding hairline,
  • Activation by nicotine of the dopaminergic system, which results in excessive oil secretion in the scalp that then clogs the hair follicles,
  • Lastly, smoking causes pro-oxidant effects that lead to the release of toxic chemicals, resulting in follicular inflammation and ultimately fibrosis.

A study conducted in 2007 in Taiwan, followed a group of 740 men, aged 40 to 91 years old to evaluate the risk to hair loss posed by smoking. After checking age and family histories, researchers found a higher rate of hair loss among smokers.

Another analytical study conducted in Pakistan on 398 male subjects concluded similar results, with 73% of active smokers found to be suffering from premature hair loss




Zayed AA, Shahait AD, Ayoub MN, Yousef AM. Smokers’ hair: Does smoking cause premature hair graying?. Indian dermatology online journal. 2013 Apr;4(2):90.

Ghayas Sidra and Ayesha. Awareness about the graying of hair at an early age especially in smokers and tobacco users. Int J Adv Res Biol Sci. 2016;3(8):50-6.


Freiman A, Bird G, Metelitsa AI, Barankin B, Lauzon GJ. Cutaneous effects of smoking. Journal of cutaneous medicine and surgery. 2004 Dec 1;8(6):415-23.

Mosley JG, Gibbs AC. Premature grey hair and hair loss among smokers: a new opportunity for health education?. Bmj. 1996 Dec 21;313(7072):1616.

Trüeb RM. Association between smoking and hair loss: another opportunity for health education against smoking?. Dermatology. 2003;206(3):189-91.

Shin H, Ryu HH, Yoon J, Jo S, Jang S, Choi M, Kwon O, Jo SJ. Association of premature hair graying with family history, smoking, and obesity: A cross-sectional study. Journal of the American Academy of Dermatology. 2015 Feb 1;72(2):321-7.

Jo SJ, Paik SH, Choi JW, Lee JH, Cho S, Kim KH, Eun HC, Kwon OS. Hair graying pattern depends on gender, onset age and smoking habits. Acta dermato-venereologica. 2012 Mar 1;92(2):160-1.

Sabharwal R, Gupta A, Moon N, Mahendra A, Sargaiyan V, Subudhi SK, Gupta S. Association between use of tobacco and age on graying of hair. Nigerian Journal of Surgery. 2014 Aug 22;20(2):83-6.

Su LH, Chen TH. Association of androgenetic alopecia with smoking and its prevalence among Asian men: a community-based survey. Archives of dermatology. 2007 Nov 1;143(11):1401-6.