Sildenafil (Generic) Hair and Skin Changes: What Patients and Clinicians Need to Know

What skin effects does sildenafil cause?

Flushing is the most common skin-related adverse reaction. In the fixed-dose trials of Viagra for erectile dysfunction, flushing occurred in 10% of patients taking 25 mg, 19% taking 50 mg, and 18% taking 100 mg, compared with 2% on placebo [1]. In flexible-dose trials that reflect typical as-needed use, flushing was reported in 10% of patients versus 1% on placebo [1].

Rash is less common. The same Viagra fixed-dose trials reported rash in 1% of patients on 25 mg, 2% on 50 mg, and 3% on 100 mg, versus 1% on placebo [1]. In flexible-dose trials, rash occurred in 2% versus 1% on placebo [1]. The Viagra label notes that hypersensitivity reactions, including rash and urticaria, have been reported, and it lists known hypersensitivity to sildenafil as a contraindication [1].

The label also lists photosensitivity reaction among events occurring in less than 2% of patients in controlled trials, with a causal relationship to Viagra uncertain [1].

Does sildenafil cause hair loss or hair growth?

Alopecia does not appear among the adverse reactions listed from the Viagra clinical trials [1]. The label's only indication is erectile dysfunction, so hair growth is not a labeled use [1].

What did the first major trial report?

The 1998 Goldstein trial, which established sildenafil's efficacy in erectile dysfunction, reported headache, flushing, and dyspepsia as the most common side effects, occurring in 6% to 18% of patients [3]. The trial included 532 men in a 24-week dose-response study and 329 men in a 12-week flexible-dose study [3].