Smoking and Androgenetic Alopecia: Why I ask and Why I Encourage Patients to Quit

Smoking and Androgenetic Alopecia:

For many years, researchers have been examining whether smoking speeds up the process of genetic balding (also called "androgenetic alopecia").  The studies have been somewhat inconsistent but point to the possibility that smoking accelerates the process of male balding.

An important study examing the relationship between smoking and hair loss was a 2007 study by the Taiwanese group of Dr. Su and Dr Chen.  These researchers examined 740 patients between the ages of 40 and 91 over a 2 month period.  They found that smokers generally had worse androgenetic alopecia compared to non-smokers. In fact, smokers had nearly a two-fold increased risk of having moderate or severe genetic hair loss compared to non-smokers. In addition, the early development of male balding was more likely in smokers.

Why Would Smoking Speed Up the Development of Male Balding?

No one knows for sure. It may be that smoking is damaging to the tiny blood vessels and the there are toxic substances in cigarette smoke that damage the cells in the hair follicles. It's also possible that smoking causes inflammation which speeds up the process of genetic hair loss. Certainly, more research is needed to figure out why.

Why I Encourage my Young Patients with Androgenetic Alopecia to Quit Smoking

There is yet another reason why I encourage young men and women with androgenetic alopecia to quit smoking.  We know from carefully done studies that young men with balding have an increased risk of cardiovascular disease later in life.  The same seems to be true for women as well. Furthermore, it's well know that smoking is one of the key risk factors for cardiovascular disease.  Taken together, it's of paramount importance to help patients stop smoking. (For additional articles, on the interplay between smoking, hair loss and cardiovascular disease click here).

Reference

Su LH and Chen T H-H. Association of Androgenetic Alopecia with Smoking and Its Prevalance Among Asian Men. Archives of Dermatology 2007 143; 1401-1406.

Mosley JG and Gibbs AC. Premature grey hair and hair loss among smokers: a new opportunity for heatlh education? British Medical Journal 1996; 313: 1616.

Severi G et al Androgenetic alopecia in men 40-69 years: prevalence and risk factors.British Journal of Dermatology 2003; 149: 1207-1213