Smoking before and after a hair transplant

By Prof. Dr. Soner Tatlidede 2019-08-21

When start smoking before and after a hair transplant is not a question of time, but of health and results. This is because smoking is not just bad for one’s overall health, but also for the results of a surgery, for example if you get a hair transplant using the method fue in Turkey.

A common question is: Can I smoke after a hair transplant? Well, doctors will warn you before your hair transplant to avoid smoking, both before and after the procedure; however, many habitual smokers may be tempted to smoke a few cigarettes. But, how does smoking affect the hair transplant? May the implanted grafts not survive? Does smoking hurt the transferred follicles? And if yes, to what extent does this occur? Let´s answer all this usual doubts.

Smoking and health risks

Hair transplant patients should consider the impact of smoking for their procedure results, but also their overall health as well as the well-being of people who are around them.

With time, smoking can cause damage to the respiratory system, making it harder to breathe. It can even lead to lung cancer. Heart disease is one of the major risks of smoking, too, together with many other health problems. In the United States, smoking accounts for almost 20% of all deaths from heart diseases in both men and women.

Smoking can also have a negative impact on non-smokers who are nearby. This is of particular concern when it comes to children. According to WebMD, exposure to tobacco smoke accounts for about 70,000 deaths each year from heart diseases.

Smoking and hair loss

According to a research conducted on identical twins with male pattern baldness genes, they will show different manifestations of their condition throughout their lives depending on their lifestyle habits. For example, siblings who smoke will display a greater extent of hair loss compared to those don´t smoking. Environmental factors can also affect how fast hair will fall out in those with genes of androgenetic alopecia.

When talking about a hair transplant, if a patient has abstained from smoking for the recommended time period following their procedure, but continues smoking cigarettes afterwards, he/she will still experience a rather high risk of losing more donor hair.

Due to the presence of sensitive protein receptors on graft structures, transplanted follicles can still be affected by Dihydrotestosterone (DHT), a main cause of male pattern hair loss linked to genetics. Besides, compromised blood circulation due to smoking will further deprive these structures of the oxygen and nutrients they need: therefore, thinning can occur much faster.

Therefore, patients may want to think about quitting cigarettes once and for all, rather than simply avoiding cigarettes during the recommended time frames before and after the hair transplant procedure.

FUE hair transplant and smoking    

How does smoking affect before and after a FUE hair transplant? What problems can experience patients if they don´t quit smoking? The following points are some of the main factors to consider, according to Clinicana’s doctors:

• Nicotine from cigarettes will cause the blood vessels to harden and constrict. In addition, carbon monoxide reduces the ability of the blood to carry oxygen.
• Poor circulation can undermine a patient’s wound healing and prolong the entire process. If the skin takes longer to heal, there is a much higher risk of infection since particles and microbes have a better opportunity to enter.
• If the skin has trouble in healing and closing the wounds, scabs and crusts may remain on the surface for longer periods of time: this will increase the likelihood of forming thicker scar tissue.
• Smoking also increases the risk of skin death (i.e. necrosis). This effect can be minor or larger in scale, depending on the number of cigarettes the patient had smoked in the past. It has been found that smokers who underwent surgeries requiring significant areas of skin excision (e.g. flap surgery and scalp reduction) face a much larger risk of skin necrosis following a hair transplant procedure.
• Furthermore, excessive oozing and bleeding may occur during the time of the surgery: this can extend the entire procedure and prolong the amount of time that the follicles are left outside the body. The limit time is around six hours.
• The survival of the hair transplant grafts can also be impaired due to the lowered availability of oxygen and nutrients. However, this would largely depend on the individual and whether or not they are chronic, long-term smokers.
• Patients who have smoked heavily for many years will have experienced drastic changes to their circulatory system that will more likely affect their wound healing capabilities and the survival of their grafts. But in those who are light or moderate smokers, smoking a few cigarettes after a procedure may not have much impact.
• There are many examples of smokers who have been able to experience successful hair restoration results. But at the same time, there is still the risk of lowered density for others who regularly smoke.

When can I start smoking after hair transplant?      

Many patients wonder: can we smoke after a hair transplant? Well, hair transplant surgeons usually recommend that patients abstain from smoking about one week before the surgery and two weeks after the hair transplant procedure.

However, it may be ideal to allocate a couple of months before and after the operation to help optimize the results. One cigarette after a hair transplant is not going to make any difference, but the fact is that usually regular smokers find hard to smoke just a single cigarette. So, despite the fact that even long-term smokers can obtain good results after a hair surgery, the medical recommendation is always to stop smoking before and after a hair transplant.