Many people exploring treatments for hair loss wonder whether tadalafil, a medication commonly prescribed for erectile dysfunction, might offer benefits for hair regrowth. Tadalafil works by improving blood flow through vasodilation, leading some to speculate about potential effects on scalp circulation and hair follicles. However, it is important to understand that tadalafil is not licensed or recommended for hair loss in the UK, and there is no robust clinical evidence supporting its use for this purpose. This article examines the science behind tadalafil, clarifies its role (or lack thereof) in hair loss treatment, and outlines proven, evidence-based options available through the NHS.

What Is Tadalafil and How Does It Work?

Tadalafil is a prescription medicine primarily licensed for adult men with erectile dysfunction (ED), benign prostatic hyperplasia (BPH), and also for pulmonary arterial hypertension (PAH, under the brand name Adcirca). It belongs to a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors, which also includes sildenafil and vardenafil. In the UK, tadalafil is available under brand names such as Cialis, as well as generic formulations approved by the Medicines and Healthcare products Regulatory Agency (MHRA).

The mechanism of action centres on the inhibition of the PDE5 enzyme, which is found in the corpora cavernosa of the penis and in vascular smooth muscle. When sexual stimulation occurs, nitric oxide is released in the penile tissue, triggering a cascade that increases levels of cyclic guanosine monophosphate (cGMP). This molecule relaxes smooth muscle and dilates blood vessels, facilitating increased blood flow. Tadalafil prolongs the action of cGMP by preventing its breakdown, thereby enhancing erectile function. The same vasodilatory effect also benefits men with lower urinary tract symptoms related to BPH by relaxing smooth muscle in the prostate and bladder neck.

Tadalafil is typically taken as a 10 mg tablet initially (up to 20 mg if needed) on an as-needed basis for ED, not more than once daily, or as a lower daily dose (2.5 mg or 5 mg) for continuous treatment. Its long half-life—approximately 17.5 hours—means effects can last up to 36 hours. Common side effects include headache, indigestion, back pain, muscle aches, flushing, and nasal congestion. Serious adverse effects are rare but can include sudden vision or hearing loss (requiring immediate medical attention), and priapism (a prolonged, painful erection lasting more than 4 hours requiring emergency treatment).

Tadalafil is contraindicated with nitrates and riociguat due to the risk of severe hypotension. Caution is needed with alpha-blockers, and dose adjustments may be required with strong CYP3A4 inhibitors or inducers and in patients with hepatic or renal impairment. If you experience any side effects, report them through the MHRA Yellow Card Scheme.

Does Tadalafil Help with Hair Loss?

There is no official link between tadalafil and hair regrowth, and it is not licensed or recommended for the treatment of hair loss in the UK. While tadalafil improves blood flow by dilating blood vessels, the pathophysiology of androgenetic alopecia (male or female pattern hair loss) is driven primarily by hormonal factors—specifically the action of dihydrotestosterone (DHT) on genetically susceptible hair follicles—rather than by inadequate blood supply to the scalp.

Some online discussions and anecdotal reports have speculated that improved circulation might theoretically benefit hair follicles. However, no high-quality human evidence supports the use of tadalafil for hair loss. The MHRA and the European Medicines Agency (EMA) have not approved tadalafil for this indication, and it does not appear in UK clinical guidance such as NICE Clinical Knowledge Summaries or British Association of Dermatologists resources on alopecia management. Using tadalafil off-licence for hair loss would be considered experimental and is not supported by current evidence-based practice.

Furthermore, taking tadalafil without a legitimate medical need exposes patients to unnecessary risks, including the side effects mentioned earlier, potential drug interactions, and cardiovascular complications—particularly in individuals with underlying heart conditions. If you are experiencing hair loss, it is important to consult a GP or dermatologist to identify the underlying cause and discuss evidence-based treatments that are proven to be effective and safe. Self-medicating with tadalafil for hair loss is not advisable, should not be attempted outside clinical trials, and may delay appropriate diagnosis and management.

Treatments That Are Proven to Help Hair Loss

For individuals experiencing hair loss, several evidence-based treatments are available, depending on the type and cause of alopecia. The most common form is androgenetic alopecia, which affects both men and women and is characterised by gradual thinning and a predictable pattern of hair loss.

Minoxidil is a topical treatment available over the counter in the UK, typically as a 5% solution or foam for men and 2% for women (though 5% is sometimes used off-label in women). Its mechanism is not fully understood but is thought to prolong the growth phase of hair follicles and may increase blood flow to the scalp. Regular application is required, and it may take 3-6 months to see results. Benefits are lost when treatment stops. Initial shedding may occur in the first few weeks of treatment. Side effects are generally mild and include scalp irritation and unwanted facial hair growth in some women. Minoxidil should be avoided during pregnancy and breastfeeding.

Finasteride is an oral prescription medication licensed for men with male pattern baldness. It works by inhibiting the enzyme 5-alpha reductase, which converts testosterone to DHT, the hormone responsible for shrinking hair follicles in androgenetic alopecia. Clinical trials have demonstrated that finasteride can slow hair loss and promote regrowth in a significant proportion of men. It is not licensed for use in women and is contraindicated in pregnancy due to the risk of birth defects; women should not handle crushed or broken tablets. Common side effects include reduced libido and, rarely, erectile dysfunction. The MHRA has issued safety warnings about the risk of psychiatric adverse effects (including depression and suicidal thoughts) and sexual dysfunction, which may persist after stopping treatment. A patient alert card is now provided with finasteride in the UK.

Low-level laser therapy (LLLT) has limited evidence for efficacy, and platelet-rich plasma (PRP) injections have mixed evidence. Neither is routinely available on the NHS. For scarring alopecias or autoimmune conditions like alopecia areata, treatments may include topical or intralesional corticosteroids, immunotherapy, or systemic medications. UK clinical guidance emphasises the importance of accurate diagnosis and tailored management, often requiring referral to a dermatologist.

When to See a GP About Hair Loss

While some degree of hair shedding is normal—most people lose 50 to 100 hairs per day—certain patterns or features warrant medical evaluation. You should contact your GP if you notice sudden or patchy hair loss, significant thinning, hair loss accompanied by other symptoms (such as fatigue, weight changes, or skin changes), or if hair loss is causing significant psychological distress.

Key triggers for seeking medical advice include:

• Rapid or extensive hair loss over a short period

• Bald patches or unusual patterns of hair loss (e.g., alopecia areata)

• Hair loss associated with scalp symptoms such as redness, scaling, pain, or itching

• Signs of scarring alopecia (pain, tenderness, pustules) requiring urgent dermatology referral

• Suspected fungal infection of the scalp (tinea capitis), particularly in children

• Hair loss in children or adolescents

• Hair loss following a new medication, illness, or stressful life event

• Family history of autoimmune or endocrine disorders

Your GP will take a detailed history, including any medications, recent illnesses, dietary habits, and family history. A physical examination of the scalp and hair pattern will help identify the type of alopecia. In some cases, investigations may be arranged, such as blood tests to check for thyroid dysfunction (TSH), iron deficiency (full blood count, ferritin), or other nutritional deficiencies. In women with signs of hyperandrogenism, hormone tests may be considered. A skin biopsy or trichoscopy (a specialised form of dermatoscopy) may be required if the diagnosis is uncertain.

Early consultation is important because some forms of hair loss, particularly scarring alopecias, can lead to permanent follicle damage if left untreated. Additionally, hair loss can significantly impact self-esteem and mental health, and your GP can provide support or refer you to appropriate services, including dermatology or counselling. If an underlying medical condition is identified—such as hypothyroidism or polycystic ovary syndrome—treating the root cause may improve or resolve the hair loss. Remember, effective and safe treatments are available, and professional guidance ensures you receive the most appropriate care for your individual circumstances.

Frequently Asked Questions