Does Viagra help to stop hair loss?

Did you hear about the use of sildenafil, which is better known by its trade name Viagra for the treatment of male pattern baldness?

Now, sildenafil is one of the most famous and prescribed medications in the entire world. It is heavily advertised and usually prescribed for the treatment of erectile dysfunction and is also sometimes prescribed to treat pulmonary arterial hypertension as it has been shown to have a blood pressure-lowering effect.

The drug has been on the market since 1998, so it is the oldest oral FDA-approved treatment for erectile dysfunction, but as it turns out interestingly enough the drug has recently been researched as a possible therapy for treating male pattern baldness.

Hair loss

We’ve decided to look into this and see if any of the research has led to many positive outcomes. We know what Viagra, also known as sildenafil, is used to treat, but what is it exactly? Well, it is part of a classification of drugs known as PDE5 inhibitors.

PDE5 inhibitors are otherwise known as phosphodiesterase type 5 inhibitors. Tadalafil and vardenafil, better known as Cialis and Levitra, are also a part of this class. They act by inhibiting the PD 5 enzyme and causing the smooth muscles to relax, which, in turn, improves blood flow to the corpus cavernous, which is the shaft of the penis.

The drug is also known to improve blood flow all over the body, which is why it’s sometimes prescribed for hypertension. Honestly, we were very skeptical of the blood flow theory of hair loss, but drugs like sildenafil have multiple effects, and it could be effective for many reasons, not just blood flow.

Impaired blood flow is not a direct cause of hair loss, and we know this because even bald men scalp will bleed as if you took a scalpel to answer to it. People with hypertension who have constricted blood vessels can still have full heads of hair, so we know it’s not just an issue of blood flow.

If blood flow were really impaired enough in an individual head and scalp that the hair follicles weren’t receiving a significant enough of blood supply to stay alive, then the individual would have a much more immediate problem to worry about such as stroke.

We found that a study published in 2018 examines the effect of sildenafil on hair growth. This is a very basic science study and very preliminary. It’s an in vitro study performed on human tissue. It also includes an in vivo study performed on mice.

During the in vitro portion of the study, scalp tissue samples were extracted from human subjects. None of them had any history of scalp disease, so there were no mitigating factors that could have adversely affected the study’s outcome.

The hair follicle cells and the dermal papillae are cells that are instrumental in hair growth were cultured in a petri dish. The researchers were able to measure the PDE5 levels and various growth factors in the cells, both with and without Viagra.

For those who don’t know what growth factors are – they are various hormones that stimulate cell growth and blood vessel growth, and they are active all over the human body.

One of the ways dihydrotestosterone (DHT) destroys the hair follicle is by inhibiting these growth factors as well as destroying the dermal papillae cells.

IGF-1 is the growth factor inhibited by DHT, and IGF-1 is known to regulate the growth cycle of the hair, so it is important to look at IGF-1 and other growth factors which these researchers did in the study.

In the in vivo rodent study, they applied two different topical solutions of Viagra. There was a 0.1% and 1% solution of Viagra, and they compared this to both a control group and a group using 2% minoxidil.

Getting to the results of these studies in the human hair cultures, it was found that the PDE5 enzyme is active in the human hair follicle.

Remember, PDE5 is the target enzyme for Viagra, so one would expect Viagra to have some effect on hair growth. In fact, after treatment with Viagra, it was found that the growth of the dermal papillae resells increased.

Now, the dermal papilla cells are the cells responsible for promoting hair growth, so the more of those you have, the better.

So far things are looking pretty promising with the study, they also found various growth factors in the dermal papillae cells increased as well. This includes IGF-1, which is the growth factor that is decreased by DHT.

What about the in vivo study with rodents? It is a mammal, and it has real hair just like us, so it would be a promising thing to see results as they relate to hair growth with Viagra in these rodents.

They found explicitly in the study in both the 0.1% of Viagra and 1% Viagra group that there was a transition from the telogen phase, which is the resting phase of the hair follicle to the growth phase.

This means that the growth phase of the hair follicle was prolonged, and the resting phase was shortened, resulting in more overall hair growth in rodents.

What was also notable is that the effectiveness of Viagra doesn’t seem to be very dose-dependent because both the 0.1% solution and 1% solution of Viagra promoted hair growth roughly on par with 2% minoxidil. And 2% minoxidil is a pretty strong hair growth stimulant, so that’s significant.

The final parameter they looked at was angiogenesis, which is the growth of new blood vessels in the skin’s skin around the hair follicles.

It is known as peripheral pair of follicular vessel formation. They didn’t include the minoxidil group in this one, but it was shown that both groups treated with both topical Viagra experienced significant angiogenesis compared to the control. In fact, the number of blood vessels doubled compared to control, which seems pretty impressive.

Summarizing the results, it was shown that Viagra promotes hair growth by what appears to be the angiogenesis mechanism caused by Viagra’s effect on stimulating growth factors.

Stimulating growth factors in the hair follicles and the dermal papillae cells would make it growth stimulants similar to something like minoxidil as opposed to an anti-androgen like finasteride.

Many people look at the results of the study, and they may come to the conclusion that improved blood flow is the reason why Viagra works and thus other measures that improve blood flow in the human organism such as cardiovascular training and supplementation or the use of other blood pressure medications may also improve hair growth.

Unfortunately, it’s not that simple. The reason why Viagra is beneficial for hair growth is not because of improved blood flow in general but rather because of its ability to create new blood vessels specifically in the scalp to counteract the destructive effect of DHT, which does the opposite by decreasing IGF-1 and thus destroying the scalp blood vessels.

IGF-1 itself has been used to treat hair loss and individuals who have something called Laron syndrome, which is a congenital birth defect where people do not produce enough IGF-1.

Those people use IGF-1 via injection to improve hair growth, but there is no evidence that IGF-1 used in healthy individuals promotes hair growth, and has even been shown that having elevated IGF-1 levels can, in fact, cause hair loss.

So it’s complicated, and it’s not recommended that people try to use IGF-1 to promote hair growth.

So it is true that decreased blood flow to the hair follicles will result in their destruction. But the effect is localized, it is not systemic. It is fully possible for an individual to have superlative cardiovascular health and still be bald because they’ve lost the blood vessels and their scalp due to DHT.

Improving your cardiac output isn’t going to do anything to improve blood flow to the hair follicles because the blood vessels specifically in that region aren’t there – they’ve been destroyed by the DHT.

You can kind of think of it like this – a firehose trying to put out a fire inside a burning building the water, in theory, would help stop the fire, but if the windows are closed, the water will never reach the fire no matter how strong the stream is.

So putting this into perspective, this is a basic science study, and more research is needed. Specifically, we need some more human studies to draw a conclusion, but what research we do have shows quite a bit of promise.

We know that minoxidil is the best hair growth stimulant on the market, but some people cannot use it due to allergies.

It also doesn’t work for everyone since certain individuals do not have sufficient amounts of the enzyme sulfurtransferase, which is what converts minoxidil into its active form and minoxidil sulfate.

For those people who don’t have enough of that enzyme putting minoxidil on their scalp would just be like putting water on their scalp, and it would do nothing. That’s probably why some people report that they use minoxidil – it doesn’t do anything for them.

Now, there are plenty of people who use Viagra who are bald or balding, but this study was done with topical Viagra, so perhaps if this could conveniently be compounded into a topical solution.

So this was a pretty recent study, but it does give us hope that there will be some follow-up studies done on humans in the future.

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