Nicotine and Hair Loss: How Smoking Can Affect Hair Health

Nearly 1 in 5 adults in the U.S. smoke or use tobacco-containing products. And it’s no secret that smoking can take a toll on your health. Tobacco products contain harmful chemicals that can damage almost every part of your body — and your hair follicles are no exception. Here’s what to know about smoking and hair loss.

Does nicotine cause hair loss?

Nicotine can cause hair loss. Researchers think that nicotine is one of the main culprits that contributes to hair loss from smoking. 

Most research on smoking and hair health has looked at whether smoking can increase the risk of androgenic alopecia, the most common type of hair loss. It’s often called “male pattern baldness” — though anyone can develop it. People with androgenic alopecia have an inherited tendency to lose hair when exposed to excess hormones called androgens. Androgenic alopecia affects 80% of men and 50% of women. 

Nicotine exposure increases the risk of developing androgenic alopecia. Research suggests that males who smoke are also more likely to develop severe forms of androgenic alopecia. A recent review found that smoking increased the risk of androgenic alopecia and was associated with premature graying. 

Do all nicotine products cause hair loss?

Research is limited on newer products with nicotine, like e-cigarettes and vaping pens. But the evidence suggests that any product containing nicotine can contribute to hair loss.

Why does nicotine cause hair loss?

There are several ways that nicotine may contribute to hair loss. Researchers have found that nicotine can:

• Reduce blood flow to the scalp

• Overstimulate and damage hair follicles

• Interrupt the hair growth cycle 

• Increase androgen levels 

Researchers are looking at these effects to fully understand smoking-related hair loss. But the overall impact of nicotine on hair health is clear: People who smoke are more likely to lose their hair.

Can you reverse nicotine-related hair loss?

You may be able to reverse nicotine-related hair loss if you cut back or stop using nicotine-containing products. Many of the negative effects of nicotine improve once you quit. 

For example, your circulation will improve. This means it’s easier for oxygen and nutrients to reach your skin. And there will be less inflammation and damage to hair follicles. 

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But hair regrowth will vary from person to person, even if you stop using nicotine. How much your hair grows back depends on other factors, such as:

• Family history and genetic factors

• The severity of hair loss

• Additional medical conditions or treatments

• Other environmental exposures

Talk with your healthcare team about hair-loss treatment options. They can help you find the right combination of treatments to give you the best chance at success. You can also try programs like GoodRx for Hair Loss, which provides access to clinically proven treatments at affordable price points.

How to find help if you’re trying to quit smoking

Quitting smoking is hard. That’s why lots of tools have been developed to help with smoking cessation, such as:

• Smoking cessation programs: Smoking cessation programs can provide education and support to help you quit. There are in-person and online programs available to help. Many insurance companies will cover the cost associated with smoking cessation programs. 

• Nicotine replacement therapy: Nicotine replacement therapy works to lower your dependency on nicotine. It helps you stop smoking. You can get some nicotine replacement products over the counter or by prescription. These include nicotine patches, gum, and nasal sprays. Some of these products are covered by insurance. You may be able to use your flexible spending account (FSA) and health savings account (HSA) to cover any associated costs. Some insurance companies even provide free nicotine patches. 

• Prescription medication: Some prescription medications can also help you stop smoking. Bupropion (Wellbutrin, Zyban) and varenicline (Chantix) are medications proven to help with smoking cessation. These treatments are usually covered by insurance. 

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Written by:

Brian Clista, MD

Dr. Clista is a board-certified pediatrician who works in private practice in Pittsburgh, Pennsylvania. He previously served as a National Health Service Corporation Scholar in the inner city of Pittsburgh for 11 years.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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