Topical eflornithine enhances the efficacy of laser hair removal in women with unwanted facial hair, according to study findings published in a recent issue of the Journal of the American Academy of Dermatology. Dr. Hamzavi I and team from the Henry Ford Hospital, Detroit, Michigan, conducted a study comparing eflornithine cream combined with laser treatment versus laser alone for removing unwanted hair on the upper lip of women.
Participants underwent laser (long pulse Alexandrite laser) therapy for the entire upper lip every 4 weeks for up to 6 sessions, and also applied either topical eflornithine or placebo cream twice daily. Safety was assessed by recording adverse events, and efficacy was evaluated using investigator global scoring, patient self assessment, and hair count analysis. Eflornithine plus laser treatment was found to be superior to laser treatment alone for all outcome measures. Of the 31 patients evaluated, complete or almost-complete hair removal was achieved in a higher proportion of subjects in the eflornithine-laser–treated group compared to those in the placebo cream-laser–treated group (93.5% versus 67.9%; P = 0.021). Blinded patient grading (P = 0.029) and hair count analysis (P < 0.01) also demonstrated statistically significant benefits in favor of eflornithine at the final assessment.
Eflornithine HCl 13.9% cream is the first topical prescription treatment to be approved by the US FDA (August, 2000) for the reduction of unwanted facial hair in women. It is an irreversible inhibitor of ornithine decarboxylase, an enzyme that catalyzes the rate-limiting step for follicular polyamine synthesis, essential for hair growth. This enzyme reduces the rate of hair growth by prolongation of the anagen or growth phase of the hair. Regardless of the etiology of unwanted facial hair (hereditary or androgen excess disorder as in polycystic ovarian syndrome), eflornithine proved to be effective. It complements other hair removal methods currently available by slowing the rate of hair regrowth. In eflornithine-laser treatment, eflornithine reduces follicular cell growth rate, while laser photoepilation heats hair and adjacent tissues to suspend growth. The cream is also useful in treating hair that is unresponsive to laser therapy (white or vellus hairs).
An earlier study conducted by Smith SR et al (Dermatologic Surgery, 2006), consistent with the findings of the study by Hamzavi, concluded that eflornithine when combined with laser hair removal treatment is safe and promotes more rapid hair removal. Also, patient preference was evidently in favor of eflornithine with laser treatment.
References
1. Hamzavi I, Tan E, Shapiro J, et al. A randomized bilateral vehicle-controlled study of eflornithine cream combined with laser treatment versus laser treatment alone for facial hirsutism in women. Journal of the American Academy of Dermatology. 2007 Jul;57(1):54-9. Epub 2007 Jan 30.
2. Smith SR, Piacquadio DJ, Beger B, et al. Eflornithine cream combined with laser therapy in the management of unwanted facial hair growth in women: a randomized trial. Dermatologic Surgery. 2006 Oct;32(10):1237-43.
3. Shapiro J, Lui H. Treatments for unwanted facial hair. Skin Therapy Letter, 2005 Dec-2006 Jan;10(10):1-4.
4. Shapiro J, Lui H. Vaniqa–eflornithine 13.9% cream. Skin Therapy Letter. 2001 Apr;6(7):1-3, 5.
