Association Between Smoking and Androgenetic Alopecia: A Cross-Sectional Analysis of Severity and Dose-Response Relationship in Adult Males

Background: Androgenetic alopecia is the most common form of hair loss in men, characterized by progressive thinning of scalp hair. Several factors have been implicated in its pathogenesis, including smoking, which induces oxidative stress that potentially affects the hair follicle health. The study aims to evaluate the association between smoking and the presence and severity of androgenetic alopecia in adult males. Methods: A cross-sectional study was conducted at the Combined Military Hospital, Rawalakot, for 6 months from July 2024 to December 2024. The inclusion criteria comprised adult males aged 18 to 50 years with a clinical diagnosis of androgenetic alopecia, who were willing to provide informed consent, including both smokers and non-smokers. Data were collected using a structured questionnaire. Smoking status was categorized as current, former, or non-smoker. Clinical assessment of AGA was performed by a dermatologist using the Hamilton-Norwood scale. Statistical analysis was done using SPSS 26, the chi-square test, with significance at p < 0.05. Results: Among the 120 participants, 84 (70%) had androgenetic alopecia. A significant association was observed between smoking status and the presence of AGA (p < 0.0001). Furthermore, the severity of AGA was significantly higher among current smokers compared to non-smokers (p = 0.017). Conclusion: There is a substantial correlation between smoking and the degree and presence of androgenetic alopecia. These results underline the significance of quitting smoking at an early age and suggest that smoking may be a modifiable risk factor in the development of AGA.