When vaping - the use of electronic cigarettes - was first introduced in 2004, they were considered a breakthrough cessation aid and a valuable tool to help people give up smoking. Whilst this remains true to an extent, fourteen years later we are now starting to better understand some of the effects of vaping - not all of which are good.
Within a few years of vapes and e-cigarettes becoming available, anecdotal accounts linking their use to hair loss
started springing up on internet forums. Belgravia specialists also started receiving queries from people who claimed to notice that they started developing thinning hair soon after starting to use a vape for the first time.
As no specific studies into vaping and hair loss
have been carried out as yet, the answer remains unclear. However, as more research is carried out into the general health effects connected to these devices, it is increasingly clear that some of the findings may also have potential ramifications for hair health.
Toxic metals present
Vape devices typically involve the use of a metal coil to heat up 'e-liquids', generally containing nicotine, to create an aerosol. It is this aerosol that is then inhaled in a similar manner to how a smoker would inhale from a cigarette, providing a hit of nicotine without some of the well-established, detrimental health implications.
Johns Hopkins Bloomberg School of Public Health, a highly-respected medical institution in Baltimore, USA, published the results of its latest research into e-cigarettes in the Environmental Health Perspectives journal in February 2018. Its study involved a team of scientists lead by Ana M. Rule, PhD, MHS, and lead author Pablo Olmedo, PhD, investigating vape devices from a sample of 56 users who they recruited from vaping conventions and local Baltimore e-cigarette stores in 2015. This study builds on previous work that Rule had been involved with which discovered 'significant levels of toxic metals in e-liquids exposed to the e-cigarette heating coil'.
Each of the volunteers brought their e-cigarette devices to the Bloomberg School lab where the vapes were tested for the presence of 15 specific metals. Tests were conducted on the e-liquids contained both inside the coil-containing vape devices and in the participants' refills, as well as in the aerosols they generated when used.
These new findings showed a range of metals were present, including - most worryingly - quantities of lead, chromium, manganese and nickel which are toxic when inhaled. The median aerosol concentrations of each of these metals was said to have 'approached or exceeded safe limits', with that of lead in particular being found to be over 25 times more in the aerosol than it was in the refill dispensers. Almost half of the total aerosol samples taken were found to contain concentrations of lead that exceeded the limits defined as safe for health by the Environmental Protection Agency; 'significant levels' of arsenic were also found in 10 of the samples.
This report notes that 'Chronic inhalation of these metals has been linked to lung, liver, immune, cardiovascular and brain damage, and even cancers.'
It further states: 'Consistent with prior studies, they found minimal amounts of metals in the e-liquids within refilling dispensers, but much larger amounts of some metals in the e-liquids that had been exposed to the heating coils within e-cigarette tanks. The difference indicated that the metals almost certainly had come from the coils. Most importantly, the scientists showed that the metal contamination carried over to the aerosols produced by heating the e-liquids.'
What was particularly interesting about the metals discovered was that, whilst the presence of some - particularly nickel and chromium - could be easily explained given these materials are often used to manufacture the coil elements, scientists were at a loss when trying to pinpoint the source of the lead that was detected.
“We don’t know yet whether metals are chemically leaching from the coil or vaporizing when it’s heated,” Dr Rule explained, expanding upon a note in the research paper whereby the concentrations of metals were observed to be higher in devices where the coils were changed more often.
Support for this John Hopkins research project was provided by a number of organisations, including the Maryland State Cigarette Restitution Fund, the American Heart Association Tobacco Regulation and Addiction Center, and the National Institute of Environmental Health Sciences. Those involved concluded that further, wider-reaching investigations are needed in order to more fully understand the potential health implications for vapers, as well as to help the FDA establish a methodology for regulating the devices. As yet, the FDA
has not set out criteria which e-cigarette companies should ensure their products meet.
Hair loss and vaping
Anecdotal evidence relating to e-cigarettes and hairloss has so far largely revolved around smokers who switched to vaping reporting thinning hair
which they attribute to this change. Whilst there is compelling evidence linking regular cigarette smoking
to hair loss and premature greying, the associations between vaping and hair thinning were not immediately obvious.
Given the anti-smoking charity, ASH, stated in a 2015 report that 60 per cent of British vapers were still current smokers, it may be hard to tell specifically what is causing the increased shedding some users noticed. One issue that is known to cause thinning hair is when the body is placed under intense stress or strain - such as that caused by an underlying illness or new medication. This is known as telogen effluvium
and presents around three months after the initial trigger incident. It causes diffuse hair fall from the entire scalp, as opposed to genetic cases of male pattern baldness
or female pattern hair loss
where only the top of the head from hairline to crown is affected.
Whilst telogen effluvium treatment
is possible, the condition should clear up naturally within up to six months. However, for those with an existing genetic predisposition to hereditary hair loss, it may exacerbate active cases or accelerate the premature onset of male or female pattern baldness. It can also be the case that this temporary condition presents simultaneously alongside genetic hairloss, leading to shedding from all over the scalp that is more prevalent along the top of the head in the vertex and hairline areas. Should this happen, Belgravia
specialists can generally deal with both issues by tailoring a personalised hair loss treatment course
This latest link between toxic metals and vaping does give rise to the potential for another hair loss concern; that of sudden hair fall and baldness due to Alopecia Areata
. This is an autoimmune disorder, which - in its mildest scalp-only form - causes patchy hair loss, but - in the more severe phenotypes Alopecia Totalis and Alopecia Universalis
- can cause the whole head, and the head and body, respectively to become completely hair-free. Whilst the precise bio-mechanics behind these diseases are currently unknown, a range of triggers and contributing factors have been identified, with environmental pollution
believed to be one of them.
An association with these more extreme forms of baldness is perhaps the most worrying factor, given, whilst Alopecia Areata treatment
can be used in scalp-only cases, there are currently no viable options for Totalis or Universalis.