Smoking significantly reduces hair transplant success by slowing healing, increasing infection risk, limiting oxygen to grafts, and worsening ongoing hair loss. Quitting smoking several weeks before a hair transplant (and remaining smoke-free afterwards) can improve graft survival, recovery speed, and long-term results.
This article explains why surgeons strongly advise quitting smoking around a hair transplant. It outlines the science behind how smoking affects healing, graft survival, and long-term hair growth, and offers clear guidance on when to stop, safer alternatives, and how quitting can maximise your investment and results.
Key takeaways
Wimpole Clinic surgeons Dr Peter Barron and Dr Ricardo Correia share their expert insights into the effects of smoking on hair transplant healing and outcomes.
Multiple studies have linked smoking to poor hair transplant outcomes compared with non-smokers [1-2]. Wimpole Clinic surgeon Dr Ricardo Correia reveals why it’s normally advised that you quit smoking before getting a hair transplant:
“Smoking delays wound healing, increases infection risk and may reduce graft survival. Ideally this should be stopped prior to the procedure, or at least reduced.”
So if you’re spending thousands of pounds on a hair transplant, it’s important to stop smoking ahead of your procedure to give it the best chances of success. Let’s take a look at 8 science-backed ways smoking can hinder your hair transplant growth.
Smoking can affect your body’s ability to grow new cells and repair damaged tissue. It limits the formation of connective tissue, as well as hindering red and white blood cell production. It can also alter the body’s immune and inflammatory response [4].
The average cigarette contains over 4000 toxic substances. Of these, nicotine, carbon monoxide and hydrogen cyanide have all been associated with slower healing rates because they inhibit oxygen supply in the blood [5-6]. Here’s how they work:
Dr Barron explains more about the impact of nicotine on wound healing in particular:
“Nicotine, whether inhaled or through nicotine replacement therapy, is pro-inflammatory and may increase post-operative swelling and redness. Nicotine is a vasoconstrictor as well, meaning it could lead to reduced blood flow to the scalp and grafts, potentially affecting healing.”
Hair transplants involve the extraction of hair grafts from your donor area via the FUE or FUT method. In FUE, each graft is harvested individually, leaving a small round wound. In FUT, a strip of follicle-bearing skin is removed from the scalp. The area is stitched up afterwards. After the grafts have been harvested they’re implanted into small cuts in the balding areas.
While they are minimally invasive compared to other types of surgery, hair transplants leave a significant number of small wounds across the scalp. Lack of oxygen to the follicles can lead to delayed hair transplant healing for both FUE and FUT patients. Studies have shown that smoking can also lead to spontaneous bleeding at the hair transplant site [1].
It’s possible for hair transplant wounds to become infected if they’re exposed to bacteria and other harmful microbes on your hands or other surfaces, which is why it’s really important not to rub your hair transplant while it’s healing. But smoking can also increase the risk of hair transplant infection [5].
Because smoking restricts oxygen in the blood supply, white blood cells called neutrophils can’t fight bacteria as effectively [5]. This leaves you prone to infection.
If you suspect your hair grafts or donor area are infected, due to the presence of pus, fever, or unexpected bleeding at the surgical site, seek medical advice from your clinic. You may need treatment to stop the infection progressing to sepsis, which can be life-threatening.
Tissue necrosis — also known as tissue death — is another complication that may be more likely for smokers, although it is still rare. Necrosis happens when blood flow (and therefore oxygen) is restricted, and is characterised by black sunken skin in the affected area. One review of hair transplant complications found that all three patients who experienced necrosis were smokers [2].
If you suspect you may have necrosis, you should seek urgent medical attention.
Hair follicles require oxygen and nutrients from your blood to grow healthy hair. This is even more important when it comes to transplanted follicles, as they need to reattach to the blood supply before they can start to produce hair. Dr Peter Barron explains more:
“Smoking any recreational substance can decrease the oxygen-carrying capacity in your blood, meaning that the transplanted grafts and extraction sites aren’t receiving as much oxygen needed to heal properly.”
This diagram shows how the blood supply feeds the follicle, stimulating hair growth:
One study comparing hair transplant outcomes between smokers and non-smokers found that smokers had significantly lower hair count than non-smokers at every stage of assessment [1]. This suggests that even in the absence of complications like delayed wound healing and infection, smoking can have a negative effect on your results.
Studies show that smokers require higher amounts of local anaesthetic to undergo minor surgeries [7]. While your surgeon and anaesthetist should take care to ensure your dose is still within the safe limits, this can put you at greater risk of anaesthetic side effects.
Higher doses of local anaesthetic may lead to:
One study has found that local anaesthetic had a significantly longer duration in smokers compared with non-smokers [8]. While prolonged numbness isn’t harmful itself, it can increase the risk of knocking your head and dislodging your grafts after a hair transplant.
Smoking can worsen your native hair loss, meaning the effects of your hair transplant may not last as long. In addition to limiting the oxygen and nutrients reaching your hair follicles, smoking can contribute to hair loss in the following ways [9]:
Quitting smoking can help your native hair thrive, so it’s a good idea to stop or significantly reduce how much you smoke several months before getting a hair transplant. This can give a more accurate picture of how many hair grafts you need. Use our hair transplant graft calculator for an estimate.
Smoking can worsen androgenetic alopecia, but it can lead to other types of hair loss too. In severe cases, this may compromise your donor area and limit your surgical restoration options.
For example, smoking puts you at higher risk of developing alopecia areata, an autoimmune hair loss condition associated with oxidative stress [13]. Hair transplants for alopecia areata patients are usually ineffective, thanks to the high rate of spontaneous remission. So if you develop alopecia areata — whether you’re a smoker or not — most surgeons will recommend that you don’t have a hair transplant.
Continuing to smoke after you’ve had a hair transplant puts your long-term results at risk. Decreased blood supply and increased oxidative stress on your follicles can affect both native and transplanted hair, so your results may look and feel a little thinner than you’d hoped.
Natural ageing processes mean everyone’s hair gets thinner over time. But for smokers, this process may be sped up, ageing your hair prematurely. A second hair transplant can sometimes help with this, provided you have sufficient healthy hair follicles left in your donor area. But bear in mind that the process may repeat if you continue smoking.
Recovering from a hair transplant can be uncomfortable at the best of times, and simultaneous smoking withdrawal can make it even harder. Quitting a few weeks before your scheduled hair transplant means you can undergo the hardest part of withdrawal (normally the first week) without also worrying about hair transplant healing.
Slow healing also means it takes longer to get back to your normal routine, including work, sleep, and exercise. So it’s a good idea to quit smoking ahead of time if you want to get back to normal as quickly as possible post-transplant.
Ideally, it’s best not to restart smoking for the reasons mentioned above. But if you do plan to smoke again, allow at least 4 weeks post-hair transplant before restarting. This will give your follicles time to attach to the blood supply in their new position and establish themselves, as well as lowering your risk of infection in the early healing stages.
While vaping may be preferable to smoking when it comes to your overall health, it’s still not ideal pre- and post-surgery. That’s because vape liquids contain nicotine, which can contribute to many of the problems associated with smoking.
That said, it’s important to have a plan in place to help you reduce cigarette smoking as much as possible. Switching to a low-nicotine vape may be preferable to smoking. Discuss this with your surgeon before scheduling your hair transplant so you know what the safest course of action is.
Ideally, you shouldn’t use nicotine patches before or after your hair transplant. Nicotine patches release nicotine into your bloodstream, causing your blood vessels to constrict which can limit healing and hair growth. Dr Barron says:
“In the grand scheme of things, nicotine replacement therapy would be better than smoking, however no nicotine or the lowest possible amount is better than the rest. If you want to cut down, then 3-4 weeks before your hair transplant would be good. Recovery can be tricky enough without having cravings or withdrawal symptoms.”
If you can, it’s best to quit smoking well in advance of your hair transplant and use nicotine patches to taper off cigarettes, so you don’t need any nicotine replacement products immediately before or after your hair transplant.
The NHS offers tons of free advice and resources to help you quit smoking, whether it’s for a hair transplant or for better overall health. Here’s a round up of their top tips:
If you decide not to quit or cut down on smoking, you may still be able to get a hair transplant. But due to the increased risks during the healing process, it’s important to watch for signs of potential complications. Here’s what to look for:
Smoking can also compromise long-term growth, though it will take at least a year to see your final results. At the Wimpole Clinic, we offer reviews at regular intervals throughout the first year to check your progress and offer advice if needed.
There are no studies into the effects of secondhand or passive smoking on hair transplant recovery and regrowth, so it’s unclear exactly what impact this can have. It’s likely to depend on the extent of your exposure (for example, living with someone who frequently smokes indoors is likely to have a different impact to infrequent exposure to cigarette smoke outside).
In general, studies show that passive smoking can impede wound healing [14]. So it’s important to limit your exposure to secondhand smoke as much as possible both before and after your hair transplant.
Just like any type of surgery, it’s important to get plenty of downtime after a hair transplant. That means you’ll need to put other activities on hold as well as smoking. These include:
Learn more about resuming your normal activities in our guide to hair transplant recovery.
Getting a hair transplant can boost your confidence and self-esteem. At the award-winning Wimpole Clinic, we specialise in providing the highest quality hair transplants along with optimal patient care and advice. So if you’re a smoker interested in getting a hair transplant, we’ll answer all your questions so you can decide on the best course of action.Book a consultation at your nearest Wimpole Clinic location and find out more about getting a hair transplant.
Learn more about smoking and hair loss in these frequently asked questions.
Smoking can impede hair growth, due to the effects of nicotine and other harmful chemicals in cigarettes and other recreational substances. So quitting can have a positive effect on your hair.
But hair loss often happens due to a combination of factors, including genetics, diet, and overall health. So quitting smoking isn’t necessarily a magic bullet. Treatments like finasteride and/or minoxidil may help slow hair loss alongside reducing or quitting smoking.
Smokers’ hair isn’t a clinical concept, so there’s no single definition of what it looks like. But studies show that smoking can impact the look and feel of your hair.
Smoking is linked with premature greying (i.e. going grey when you’re under 30), as well as nicotine staining [15-16]. This makes your hair look yellow, and is often more noticeable in light or grey hair.
A few studies have examined the link between the number of cigarettes smoked per day and the impact on hair health [15]. One study found that smoking 5 or more cigarettes a day is associated with increased rates of pattern baldness in men. Others have shown that smoking 10+ cigarettes per day is associated with moderate to severe cases of androgenetic alopecia.
According to the NHS, withdrawal symptoms are strongest within the first 3 days of quitting smoking. Symptoms like cravings, restlessness, and insomnia can all make it hard to stay on track. Having a plan in place to help eliminate cravings and tackle relapses can help you quit smoking long-term.
Wimpole Clinic Services:
Hair Transplants, Beard Transplants & Eyebrow Transplants.
Talk to a specialist
With experience in all steps of the transplant process, including graft extraction, incisions, and graft placement, as well as proficiency with all incision methods – including sapphire blades – Dr. Correia (GMC 7426938) possesses an in-depth skill set at the disposal of his clients’ wishes.
His clientele has included celebrities, professional athletes, and social media influencers, all seeking discreet, high-quality care tailored to their public-facing lives.
Having undergone extensive training under the guidance of pioneering hair transplant surgeon Mr. Michael May at the esteemed Wimpole Clinic, he has developed a wealth of expertise in the field of hair restoration. His experience and mentorship under Mr. Michael May have equipped him with cutting-edge techniques and a profound understanding of the intricate art and science of hair transplantation. This comprehensive training has positioned him as a skilled and innovative practitioner in the realm of cosmetic surgery, ready to deliver exceptional results to his clients.
Having graduated from University College London with a Bachelor of Medicine and Surgery, along with a bachelor’s degree in Neuroscience, he continued with a 10-year career in the NHS in England, Scotland, and Northern Ireland, focusing on surgical specialties, including Emergency, Colorectal, Breast, and Transplant Surgery.
Dr. Correia enjoys combining his interest in the science of hair transplantation with his upbringing in an artistic family to create natural aesthetic designs that complement his clients’ unique features. He also understands how important the decision to undertake a hair transplant can be for his clients and prioritises collaboration throughout the process for optimal outcomes.
