1. Smoking and vaping
This habit is expensive, unhealthy, and terrible for your skin and hair. A 2007 study found a possible link between smoking and hair loss in Asian men. A 2016 study suggested that vaping may cause even more genetic changes than smoking.
Alcohol use is not directly linked to hair loss, but many of its side effects have been. If you are going to drink, consider moderate amounts of red wine, which at least has antioxidants in it.
- Alcohol users often eat unhealthy foods while drinking. Empty calories may keep you from getting nutrients needed for hair growth, including
- Folic acid
- Alcohol dries out the skin and hair, which can affect the quality and growth cycle of hair.
- High glycemic index foods and beverages are linked to hair loss. This includes alcohol, sugary mixers, and processed grains found in a lot of junk food eaten with alcohol.
- Heavy alcohol use like binge drinking and chronic overconsumption disrupt sleep. A 2019 study looked at the association between alopecia areata and sleep quality. Many people use alcohol to self-medicate when stressed, but heavy use can add more stress.
- Alcohol use can cause changes to your hormones levels, since alcohol and hormones are both processed in the liver. Hormones have a powerful effect on hair loss.
- Drinking can affect your pH levels, which are important to maintain to keep hair from getting too dry or too oily.
Liver damage / higher toxins
- If the liver is overloaded with hormones and alcohol, it has a harder time removing toxins from your blood.
3. Grooming and styling
Blow-drying or styling hair with heat
Combs (especially narrow-tooth combs)
Tight ponytails, pigtails, braids, or cornrows
Significant stress causes many hair follicles to go into a resting phase called telogen effluvium.
High glycemic index foods (especially processed grains and refined sugar)
High selenium foods (especially processed grains and many meats)
6. Rapid weight change
The following have all been shown to contribute to hair loss.
- weight loss from fasting
- body mass index below 18.5 (underweight)
- body mass index above 30 (obese)
- eating disorders like anorexia, bulimia, binge eating, and food addiction
Maintaining a healthy weight with a BMI between 18.5 – 24.9 is the best way to reduce weight-related hair loss. For more, see my section on diet and exercise.
7. Sun damage
While getting some sunlight is important for absorbing nutrients your hair needs, it’s best to minimize the sun on your scalp. The easiest way is to wear a head covering like a hat or scarf.
There are also clear sunblock sprays that can be used on hair, but many do not like what it does to their hairstyle.
Sunlight can cause oxidative stress on the hair, and people with hair loss gave been found to have decreased total antioxidant activity and increased malondialdehyde levels.
If you take an antidepressant, one side effect for some of them is hair loss. Some are more likely to cause hair loss than others. A large 2018 study found that bupropion has the highest risk of hair loss, while fluoxetine and paroxetine have the lowest risk. This needs to be done cautiously in close consultation with your doctor.
Su LH, Chen TH-H (2007). Association of Androgenetic Alopecia With Smoking and Its Prevalence Among Asian Men: A Community-Based Survey Arch Dermatol. 2007;143(11):1401-1406. doi:10.1001/archderm.143.11.1401
Martin EM, Clapp PW, Rebuli ME, Pawlak EA, Glista-Baker E, Benowitz NL, Fry RC, Jaspers I (2016). E-cigarette use results in suppression of immune and inflammatory-response genes in nasal epithelial cells similar to cigarette smoke. Am J Physiol Lung Cell Mol Physiol. Volume 311 Issue Pages L135-L144 https://doi.org/10.1152/ajplung.00170.2016
Xerfan EMS, Andersen ML, Facina AS, Tufik S, Tomimori J (2019). Alopecia areata and sleep quality: is there an interaction? J Eur Acad Dermatol Venereol. 2019 May 23. doi: 10.1111/jdv.15705. [Epub ahead of print]
Prie BE, Iosif L, Tivig, I, Stoian I, Giurcaneanu C (2016). Oxidative stress in androgenetic alopecia. J Med Life. 2016 Jan-Mar; 9(1): 79–83. PMID: 27974920