Abstract

A SYSTEMATIC REVIEW ON THE POTENTIAL ROLE OF SILDENAFIL AS A PRECURSOR FOR HAIR GROWTH: MECHANISMS, EFFICACY AND THERAPEUTIC IMPLICATIONS

Santhosh G.*, Sai Prasad K. K., Veerendra Vijay Murthi

Abstract

Aim and Objectives: This study systematically reviews the potential of sildenafil, a selective PDE5 inhibitor, as a therapeutic agent for hair growth. The objectives include evaluating its mechanisms of action, efficacy in preclinical and clinical studies, and its role in treating androgenetic alopecia (AGA). Methodology: A systematic review was conducted using PubMed to identify studies published between 2015 and 2023. Clinical trials, preclinical research, and in vitro studies were included, focusing on the effects of sildenafil on hair growth. Keywords such as "sildenafil," "hair growth," "PDE5 inhibitors," "vascular endothelial growth factor (VEGF)," and "androgenetic alopecia" guided the search. Results: Sildenafil enhances hair growth primarily by increasing cGMP levels, improving blood flow, and promoting angiogenesis through VEGF and PDGF upregulation. It also activates the ERK pathway, stimulating dermal papilla (DP) cell proliferation and prolonging the anagen phase. Preclinical studies showed increased follicle density and hair growth, while pilot clinical trials reported significant improvements in patients with AGA when sildenafil was applied topically or combined with minoxidil. Conclusion: Sildenafil demonstrates promising preclinical and clinical potential for hair restoration by improving follicular blood flow, promoting angiogenesis, and extending the anagen phase. However, larger randomized controlled trials are necessary to establish its efficacy, safety, and optimal dosing for clinical use.

Keywords: Sildenafil, PDE5 inhibitors, hair growth, VEGF, androgenetic alopecia, dermal papilla cells, anagen phase.