Lifestyle Habits and Hair Loss: How Do Smoking and Drinking Affect Hair Health?

As we go through life, some things are visible, while others slowly build up inside our bodies in silence. Hair loss is one of them.

It is often said that genetics play a major role, but a recent study also looked at how lifestyle habits are related to the severity of hair loss.

Smoking, drinking, body mass index (the ratio of body weight to height, BMI), and stress.

The study examined the relationship between these four factors and hair loss.

100 men aged 18 to 55 participated in this study.

The average age was 28.78, with younger adults making up the majority.

Looking at the experimental results, as the severity of hair loss increased, smoking volume and alcohol consumption also increased.

For example, the average Alcohol Use Disorders Identification Test (AUDIT) score in the earliest stage, grade 1, was 2.8, but it rose to 13.2 in the most severe grade 7.

Smoking showed a similar pattern.

As the group moved from a lower smoking index to a higher one, hair loss became more severe.

On the other hand, BMI and stress scores did not show a significant correlation with severity.

Why did this difference occur?

Smoking constricts blood vessels and increases reactive oxygen species, which interferes with blood flow to the hair follicles.

As a result, the supply of nutrients needed for hair growth decreases, and dermal papilla cells may be damaged.

Alcohol disrupts the balance of trace elements such as zinc, selenium, and copper,

which interferes with protein synthesis needed for hair growth.

If these changes continue over a long period, the hair follicles gradually weaken,

and the hair becomes thinner before eventually falling out.

What is notable in this study is that stress and BMI did not show a clear association with severity.

Of course, this may be because most of the study participants were young and had BMI values within the normal range.

Stress may also have produced different results if it had been measured more precisely, since the survey tool included only a stress subscale.

How can these results be used in clinical practice?

For patients starting treatment for hair loss, it would be a good idea to ask about drinking and smoking habits along with family history.

Rather than a simple interview, calculating the Alcohol Use Disorders Identification Test (AUDIT) score and smoking index and showing them numerically can help patients recognize their lifestyle habits more objectively.

In addition, combining medication treatment (finasteride, dutasteride, minoxidil, etc.) with smoking cessation and alcohol reduction counseling may help improve treatment outcomes.

Lifestyle habits are not easy to change overnight.

But hair loss does not happen overnight either.

If we can catch the changes that build up slowly but steadily, we may be able to sufficiently slow the rate at which hair falls out.

Written by: Kim Jin-oh of New Hair Plastic Surgery Clinic (Public Affairs Director, Korean Society of Plastic and Reconstructive Surgeons / Academic Director, Korean Laser Dermatology and Hair Society)

Lifestyle factors that may affect male pattern hair loss

Study summary table

Variable	Relationship with hair loss severity	Statistical significance
Smoking	Smoking index increases as severity increases	p=0.016
Drinking	AUDIT score increases as severity increases	p=0.0006
BMI (body mass index)	Tendency observed, but not significant	p=0.056
Stress	No relationship	p=0.351

It is now time to hairhair, Kim Jin-oh.

필생신모(必生新毛).

References

Verma, A., Sharma, R., Chauhan, P., & Sinha, A. (2025). Association of lifestyle factors with severity of androgenetic alopecia: A cross-sectional study. Journal of Clinical and Diagnostic Research, 19(7), WC01-WC05

[This post is written directly by a board-certified plastic surgeon for informational purposes in accordance with Article 56, Paragraph 1 of the Medical Service Act. Hair transplant surgery and treatment may have side effects, and please make a careful decision after consulting with a specialist.]