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Comparative Study between the Efficacy and Safety of Topical Sildenafil Citrate Solution and Topical Minoxidil 5% in the Treatment of Female Pattern Hair Loss

Heba Abdo Mostafa1*, Hassan Abou Khodair Mohammed2, Ibrahim Fouda2

Background: Female Pattern Hair Loss (FPHL) is a non-scarring progressive thinning of hair with gradual decrease in its number, especially in the frontal, central, and parietal scalp. The loss of terminal hairs in affected areas is usually incomplete and the frontal hairline is often spared. It is caused by follicular miniaturization, a process that gradually reduces the proportion of terminal to vellus hair.

Aim of the work: To evaluate the efficacy and safety of topical sildenafil citrate 1% solution in comparison with topical minoxidil 5% foam in the treatment of female pattern hair loss.

Patients and methods: This exploratory pilot study included 30 female patients suffering from female pattern hair loss. Included patients were divided into 2 groups;

Group 1: Received 1% topical sildenafil citrate solution.

Group 2: Received 5% topical minoxidil foam.

Assessment of treatment response was done using trichoscopy.

Results: In group 1 (treated with topical sildenafil 1%): There was a statistically significant increase in the vellus hair count in the frontal region, vertex and temporal side after treatment as compared to before treatment. Also, there was statistically significant increase in the terminal hair count in the frontal region and vertex region after treatment as compared to before treatment. There was no statistically significant difference in the hair thickness in all the regions after treatment, group 2 (treated with topical minoxidil 5%) there was a statistically significant increase in the terminal hair count and hair thickness in the frontal region, vertex and temporal side after treatment as compared to before treatment. Also, there was statistically significant decrease in the vellus hair count, but it was detected only in the frontal region.

Conclusion: Topical sildinafil 1% treatment proves to be a good alternative in the treatment of FPHL, although topical minoxidil 5% is still the first choice in FPHL treatment.