Does Alcohol Cause Hair Loss? | We Review The Science

Recent surveys tell us that over 80 percent of adults over 18 consume alcohol.

Drinking alcohol has become an extremely common pastime.

But, does alcohol cause hair loss? If so, how does it all happen? What are the negative effects of hair loss?

In this article, I’ll give insight into how alcohol impacts the body and hair loss. I’ll also bust some myths about drinking and help you figure out if you might be genetically predisposed to the negative effects of alcohol.

Just keep reading!

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What Is Alcohol?

Alcohol is a natural byproduct of fermentation.

The main constituent of alcohol is ethanol, a type of simple alcohol.

Alcohol drinkers can be classified into 3 categories: light, moderate, and heavy drinkers. Chronic heavy drinking may have some serious negative effects on health.

Key Takeaway: Alcohol contains ethanol that contributes to the negative effects of alcohol. Chronic heavy drinking may have some serious negative effects on health.

Does Alcohol Cause Hair Loss?

Some studies have demonstrated a connection between alcohol and hair loss.

According to one study of 92 twin males demonstrated that consumption of more than four alcoholic drinks per week was associated with hair loss (1).

Another study of 103 Androgenetic Alopecia (AGA) or pattern hair loss patients found 73 percent of patients with early-onset AGA had a history of alcohol consumption (2).

However, larger observational studies have also found no link (3).

Currently, no concrete studies have established a direct link to alcohol consumption and hair loss.

Nonetheless, there are some notable ways alcohol can influence bodily functions and possibly hair loss.

Nutrient Deficiencies

Alcohol is well known to lead to nutrient deficiencies (4). Specifically, niacin, folate, and zinc.

Folate is an essential nutrient needed for DNA synthesis, a process needed for cell functions in the whole body (5). It’s also responsible for detoxifying homocysteine, a toxic byproduct in the body.

Homocysteine is known to reduce microcirculation (6). This is important for scalp and hair health. The small vessels in and around the hair follicle provide the nutrients that hair needs to grow.

Homocysteine also downregulates Glutathione Peroxidase (GPx), an antioxidant enzyme in cells that neutralizes damaging free radicals (7). If homocysteine levels get too high and overwhelm GPx, it can lead to increased concentrations of free radicals in cells.

Cells before and after free radicals
Free radicals can cause damage throughout the body, including within the hair follicles.

In Dermal Papilla Cells (DPCs), the cells responsible for signaling hair growth, these free radicals can be especially damaging. Studies suggest that topical application of lipid peroxides, fatty substances that have been damaged by free radicals, arrest hair growth and lead to early shedding (8).

Low folate and high homocysteine levels are also connected to a form of autoimmune hair loss called alopecia areata (AA) (9).

So, reduced folate and the subsequent increased homocysteine, reduced microcirculation, and free radical damage could lead to hair loss.

Although, studies are contradictory. They suggest folate deficiencies don’t always lead to hair loss (4).

Another nutrient depleted by alcohol is niacin. Niacin deficiency manifests as a disease called pellagra.

In one pilot study, topical application of niacin resulted in significant increases in hair fullness among women in the study (10). However, whether dietary niacin has the same effect remains to be studied.

Additionally, there are no studies looking at how a niacin deficiency impacts hair growth and loss.

Alcohol’s depletion of zinc may also have implications in hair loss.

Zinc deficiency has been associated with various kinds of hair loss including AGA, female pattern hair loss, Alopecia Areata (AA), and Telogen Effluvium (TE; where many hair follicles transition from the anagen growing phase to the telogen resting phase at once) (4).

This is not surprising considering zinc is believed to play a key role in hair cycling (11). It is believed to inhibit DPC death and promote hair follicle recovery, promoting and maintaining hair growth.

Through these nutrient depletions, alcohol may lead to hair loss.

Key Takeaways:

  • Alcohol depletes niacin, folate, and zinc.
  • Folate detoxifies homocysteine which, at high levels, can reduce microcirculation and increase free radical damage.
  • Niacin promotes hair fullness when used topically, however, no studies have examined if there is a connection between niacin deficiency and hair loss.
  • Zinc deficiency is associated with various forms of hair loss. Zinc is believed to play a key role in hair cycling by inhibiting DPC death and promotiing hair follicle recovery.
  • Through these nutrient depletions, alcohol may lead to hair loss.

Increased Inflammation Via “Leaky Gut”

One of the adverse effects of alcohol is its effects on the gut lining.

According to human studies, even small doses of alcohol lead to increased permeability of the gut lining (12).

Under normal circumstances, the junctions between the gut lining cells are very tight. This allows nutrients and water to be absorbed from the diet into systemic circulation for use throughout the body.

However, when these tight junctions open up, as in increased permeability, it allows more than just nutrients out. A leaky gut lining allows inflammatory substances like bacteria and their endotoxins, as well as poorly digested foods, into systemic circulation.

As a result, these substances incite the immune system leading to inflammation. If the junctions of the gut lining aren’t returned to normal, this steady stream of foreign compounds can lead to chronic low-grade inflammation.

This constant release of inflammatory mediators like prostaglandins, leukotrienes, and thromboxanes further increases free radical production (13).

In turn, these free radicals trigger the activation of a transcription factor called NF-κB. When NF-κB makes its way to the nucleus, it influences gene expression to favor the production of pro-inflammatory signaling molecules and enzymes responsible for creating inflammatory mediators.

Put simply, inflammatory mediators stimulate oxidative stress and oxidative stress influences inflammatory gene expression.

Inflammation and oxidative stress are also closely linked to hair loss.

Inflammation at the hair follicles
Chronic inflammation of the hair follicle can lead to thinning and hair loss.

Both AA and AGA patients have elevated markers of oxidative stress (14, 15). Additionally, AA patients display higher levels of pro-inflammatory signaling molecules whereas AGA patients have localized scalp inflammation (16, 17).

Oxidative stress could also contribute to AGA in a novel way. Oxidative stress is a trigger for Hic-5/ARA55, a co-activator of androgen (male hormone) receptors.

Hic-5/ARA55 acts as a bridge to allow activated androgen receptors to effectively influence gene expression (18). One of the genes that androgens can influence through Hic-5/ARA55 is TGF-β.

TGF-β is the molecule responsible for the follicle miniaturization that is so characteristic of AGA.

So, through this increased intestinal permeability, it’s possible that alcohol can influence hair loss in this way. However, no studies have currently examined the effects of intestinal permeability on hair loss.

Key Takeaways:

  • Alcohol increases intestinal permeability.
  • Increased intestinal permeability allows foreign compounds into systemic circulation, causing low-grade inflammation.
  • If this doesn’t resolve, this chronic low-grade inflammation can become chronic.
  • Inflammation and oxidative stress are closely linked. Inflammation contributes to oxidative stress and oxidative stress stimulates the expression of inflammatory genes.
  • Oxidative stress markers are elevated in both AGA and AA patients. Inflammation is elevated in AA whereas inflammation is localized to the scalp in AGA.
  • Oxidative stress also enhances androgen-stimulates TGF-β expression through the translocation of Hic-5/ARA55. TGF-β is responsible for AGA follicle miniaturization.
  • It’s possible that increased intestinal permeability could influence hair loss in this way, but this hasn’t been examined in research.

Decreased Methylation: Increased Oxidative Stress and Possible Hair Loss Contributor

Alcohol is also detrimental to a critical function of the body: methylation (19).

Like mentioned earlier, alcohol depletes folate. Heavy drinking also inhibits an enzyme called methionine synthase.

Folate and methionine synthase play critical roles in a process called the methionine-folate cycle. Normally, folate is transformed into 5-MTHF by an enzyme called MTHFR.

5-MTHF is the cofactor for methionine synthase that creates methionine from homocysteine. Methionine is then turned into S-adenosylmethionine (SAM), which is the main methyl donor for the body.

Essentially, a methyl donor like SAM works with a family of enzymes called DNA methyltransferase (DNMT). Together, they interact with DNA to either “turn on” or “turn off” genes in a process called DNA methylation.

Because alcohol depletes folate and inhibits methionine synthase, it impairs SAM production and increases homocysteine levels. This leads to free radical damage and downregulated DNA methylation via DNMT.

This process could actually be very essential to hair growth and maintenance.

In one animal study, researchers manipulated mice genetics to knock-out the gene responsible for creating DNMT (20). As a result, a large percentage of hair follicles entered the telogen phase (similar to TE), sebaceous gland size increased (one factor in AGA), and increased DPC death.

They also observed that many hairs failed to re-enter the anagen phase, mimicking hair loss.

Human studies are needed to see exactly how this process translates to human hair growth.

Due to genetics, alcohol may influence DNA methylation in a very individual way.

For example, a folate deficiency along with alcohol consumption could result in dangerously low folate levels. As a result, this alone could negatively impair DNA methylation.

Another susceptible population could be populations with a single nucleotide polymorphism (SNP; genetic mutation) in their MTHFR gene, the gene responsible for creating the MTHFR enzyme. Certain polymorphisms can diminish the efficiency of this enzyme, decreasing folate to 5-MTHF conversion.

As a result, less homocysteine is converted into methionine.

Even worse, a combination of an MTHFR SNP and folate deficiency could make alcohol consumption detrimental, especially in the context of hair loss.

To avoid this, you can consume folate-rich foods like (21):

  • beef liver;
  • spinach;
  • asparagus;
  • brussel sprouts;
  • avocado;
  • and lettuce.

You can also supplement that contains folate or as opposed to folic acid.

You can find out if you have MTHFR SNPs through genetic testing services.

Key Takeaways:

  • Alcohol impairs DNA methylation.
  • Alcohol depletes folate and inhibits methionine synthase, which leads to elevated homocysteine levels and a decrease in SAM levels.
  • SAM is the co-factor needed for the DNMT enzyme responsible for DNA methylation. Essentially, DNMT turns on and turns off genes.
  • DNMT may play a key role in anagen re-entry, regulating sebaceous gland size, and preventing TE, according to mice studies. Human studies are needed to see exactly how this might work in humans.
  • Certain populations may also be susceptible to the negative effects of alcohol. MTHFR genetic mutations reduce the efficiency of this enzyme, leading to decreased 5-MTHF. This is problematic considering its the co-factor for methionine synthase.
  • Folate deficiency may also increase the detrimental effects of alcohol.
  • You can combat folate deficiency through consumption of folate-rich foods or supplementation with folate or 5-MTHF.
  • To identify if you have an MTHFR SNP, you need to use genetic testing services.

Is Alcohol-Induced Hair Loss Reversible?

Alcohol-related hair loss is likely reversible if it is the only factor contributing to hair loss.

If this is the case, reducing alcohol consumption and restoring the status of depleted nutrients could reverse hair loss.

In any sense, reducing alcohol consumption is beneficial for health even if other factors are contributing to your hair loss.

Key Takeaway: Alcohol-related hair loss is likely reversible if it is the only factor contributing to hair loss. Reducing alcohol consumption is beneficial for health and may reverse hair loss.

Wine and Hair Loss: Busting the Myth

Many tout red wine as “safe” alcohol.

While red wine does contain beneficial antioxidants, even small doses of alcohol are considered to disrupt the gut lining.

Because of this, even red wine may still contribute to inflammation and possibly hair loss.

This is especially true if you are part of the susceptible population that has a folate deficiency, MTHFR SNP, or both.

If you are struggling with hair loss, it may be beneficial to avoid alcohol altogether, including red wine.

Key Takeaway: Red wine contains beneficial antioxidant but still likely disrupts the gut lining. If you are struggling with hair loss or are part of the susceptible population, it may be beneficial to avoid alcohol altogether, including red wine.

Putting the Pieces Together: Are Alcohol and Hair Loss Connected?

So, does alcohol cause hair loss?

While the science isn’t definitive, there are some definite ways that alcohol could put a hamper on hair growth.

Additionally, some populations may be more susceptible than others to the negative effects of alcohol. In any sense, avoiding all forms of alcohol may be beneficial if you have hair loss.

Have you made a connection to times when you drink heavily and hair loss severity? Has cutting back on alcohol improved your hair loss? Leave a comment below.

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