he stigma associated with Hirsutism is often the chief reason for psychological complications associated with it. Defined as the presence of coarse terminal hair in females with male-like distribution, Hirsutism has a 5-10% incidence and at present no permanent method of treatment. The nature of the problem makes it a common presenting complaint among dermatology and cosmetic clinics dealing with the situation. Treatment options range from diet changes to laser ablations depending on the extent of hirsutism.
Of all the available options, topical options for unwanted hair on the face are the most popular all because of faster results, associated patient comfort, and ease of application. Vaniqa cream Australia is one such topical option.
What is Vaniqa?
Vaniqa is the trade name of Eflornithine belonging to the 5-alpha reductase inhibitors group of medications. Eflornithine was initially developed in the 1970s for use as an anticancer medication before being approved in the 1980s as a hair removal cream. The WHO has listed it as an Essential medication because of its effectiveness in the treatment of sleeping sickness conditions. Vaniqa is so far the only topical prescription treatment used for slowing down the growth of facial hair.
Apart from physically reducing the facial hair in hirsutism cases, it even works in lessening the psychological burden associated with the condition. It can be used on its own or in combination with other hair removal methods for improved results among users.
It is important to understand briefly the pathophysiology of Hirsutism to better understand Vaniqa’s mechanism of action.
How does it work?
5-alpha reductase or 3-oxo-5 alpha steroid 4 dehydrogenase enzymes are enzymes involved in steroid metabolism that use the method of androgen biosynthesis to achieve their functions. Hyperactivity of the 5-alpha reductase enzyme due to medical, idiopathic, or other reasons is considered the chief cause of hair growth in women with hirsutism conditions.
Vaniqa acts as an inhibitor of this 5-alpha reductase enzyme to prevent the over secretion of androgen from ovaries and adrenal glands. This enables it to control further hair growth. Further, Eflornithine, the active ingredient in Vaniqa, irreversibly inhibits ornithine decarboxylase (enzyme) that is involved in the production of hair shafts in the hair follicle. By blocking the enzyme, hair growth is slowed down. The anagen phase of hair growth is slowed down and the telogen phase of hair growth is activated to help in hair loss and slower hair growth.
Why choose Vaniqa to treat female facial hair?
Of the various clinical studies conducted on evaluating the safety and efficacy of Vaniqa in hirsutism patients, all of them have been unanimous on one ground; Vaniqa does not cause contact sensitization, phototoxic, or photosensitization during its use unless you are allergic to its ingredients or have overused the medication beyond its designated time of use.
In a bid to further demonstrate the efficiency of Vaniqa, 2 randomized trial studies were conducted on 594 female patients. The study included women diagnosed with hirsutism who had a frequency of removing facial hair twice or thrice a week. Of the total subjects enrolled for the study, 393 were treated with Vaniqa, and 201 subjects were treated with vehicle medication. Subjects with severe inflammatory acne or confirmed pregnancy status were excluded from the study. Improvement in facial hair reduction was noticed consistently within 8 weeks of treatment. This improvement continued throughout the 24 months of the treatment period.
In these studies, the Physician’s Global Assessment Method; a well-accepted scale measuring the overall response to treatment as assessed by a physician was used. In total, 32% of patients showed improvement with Vaniqa after 24 weeks of treatment. In comparison, the vehicle or placebo medication showed merely 8% improvement. Similarly, the incidence of patients not responding to the medication was much less in Vaniqa than in-vehicle medication.
PGA OUTCOME combined after 24 weeks of 2 studies | VANIQA | VEHICLE |
| Clear/ Almost clear | 5% | 0% |
| Marked Improvement | 27% | 8% |
| Improvement | 26% | 26% |
| No improvement/worse/missing | 42% | 66% |
Subgroup analysis showed slighter benefits for White Women in comparison to Non-White Women. But in comparison to vehicle ointment, non-white women (mostly Black) showed significant improvement. Additionally, significant improvement was observed in post-menopausal women that were a part of the study.
The results proved that Vaniqa could be used successfully in women of all ethnicities and age groups and be used to yield successful results after treatment. This was important as laser treatment for Vaniqa is not suitable for dark-skinned patients. The study even proved that Vaniqa reduced the social anxiety the patients felt with their condition along with the time spent hiding their condition.
Hair regrowth did not occur even until 8 weeks (2 months) of discontinuing the medication. Throughout the study, treatment-related adverse reactions occurred in less than 1% of the subjects. This was resolved on its own without medical treatment or discontinuation of the medication.
The study proved that Vaniqa was the ideal medication for hirsutism subjects requiring a cost-effective, efficient, and less time-consuming method of dealing with their condition.
Other Vaniqa-related trials
In an effort to evaluate the success rate of the outcome of combining Vaniqa with other treatment methods of Hirsutism, a combination mode of the treatment regimen was included in a few studies. It was observed that a combination of Eflornithine cream and laser hair removal treatment in patients with hirsutism yielded significantly better results than treatment with the laser method only. The combination therapy yielded successful results when used for up to a treatment period of 6 months.
Similarly, in another study conducted to evaluate combination treatment with Eflornithine, it was observed that pretreatment of skin with micro needles before topical application of Eflornithine further augmented the medication’s ability to inhibit hair growth. Researchers postulated that the micro needles breached the stratum of the corneum barrier and thus enabled better diffusion of Vaniqa into the skin surface. These studies proved that Vaniqa, whether used on its own or in combination with other medications, has the ability to significantly reduce facial hair growth in females with the condition.
To sum it up, Vaniqa is preferable to other medications for the treatment of facial hirsutism because
– It is the only topical cream available for Hirsutism.
– It works well for the condition whether used on its own or in combination with other treatment measures.
– It can be used in darker-skinned people with facial hair who don’t obtain satisfactory results with laser treatment.
– The incidence of side effects is very less in Vaniqa when used judiciously.
– It has actually been recommended by centers like NICE and by the British Association of Dermatologists for being used for Hirsutism conditions.
But side-effects do exist and it is important to use the medication within the recommended time limit to avoid problems associated with overuse of the medication.
What are the side effects of Vaniqa?
Acne is one of the most common adverse reactions noticed in Hirsutism patients using Vaniqa cream. In studies evaluating Vaniqa cream in comparison to vehicle ointment, those with pre-existing acne after use of Vaniqa reported worsening of the symptoms. In those without acne at the beginning of the study, post-treatment period, acne breakouts were noticed in the subjects.
Apart from acne, some of the other side effects observed with the use of Vaniqa are- skin irritation, stinging and burning sensation, dry skin, skin rashes, and folliculitis.
Occasionally reactions like an ingrown hair, papular rash, hypopigmentation, flushing of the skin, lip numbness, and facial edema can occur. This can be especially so if you are allergic to the medication or its ingredients.
Rarely, phenomena like rosacea, seborrheic dermatitis, maculopapular rash, and skin neoplasms are associated with the use of Vaniqa. It is advisable in these conditions to stop using the medication immediately and get immediate help for your condition or opt for other forms of treatment options.
CLINICAL TRIALS
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Are there any other options for treating Hirsutism?
There are other treatment options available instead of Vaniqa if you are diagnosed allergic to the medication or are considered ineligible for its use. Some of these methods are:
Bleaching – Done with the intention of making dark hair lighter. Not suitable for dark skin.
Shaving – Effective but time taking method of hair removal. Needs to be conducted on a regular basis for maintaining the results.
Waxing – Uses hot wax method to remove facial hair. Painful and not suitable for acne-prone skin.
Laser – Targets the hair follicles for hair reduction. Works best on pale skin with dark hairs.
Other drug treatments – Contraceptive pills, and anti-androgen pills are some other medications used for reducing excess androgen levels.
None of these methods are as effective as Eflornithine or yield quality results in the stipulated time period. That said, Vaniqa has its own sets of pros and cons and should be used with precaution for all users.
Precautions while using Vaniqa
1) Wash hands before using the cream as unclean hands can result in bacterial-induced breakouts throughout the face.
2) Perform any hair removal application at least 10-15 minutes prior to application of the cream and not immediately before or after using it.
3) Do not wash the face or apply makeup for at least 4 hours after application of the cream.
4) Do not use Vaniqa if you are pregnant/ breastfeeding.
Where can I obtain Vaniqa?
Vaniqa is a prescription medication and can be obtained from either of the below-mentioned options
– Registered pharmacy
You can obtain the cream from registered pharmacies dealing with the medication by providing them with a prescription.
– Dermatologist clinics
You can avail a Dermatologist’s opinion through NHS or through a private appointment NHS will enable you to get the cream at a reduced price for your condition.
– Online hubs
Online portals enable you to get the medication quickly and in a cost-effective manner. Ensure that you obtain from a portal dispensing genuine products to obtain a valid product / go for an online pharmacy with good customer service to provide you the required help for your queries or required information.
References
- https://en.wikipedia.org/wiki/Eflornithine
- https://pubmed.ncbi.nlm.nih.gov/7962284/#:~:text=Hyperactivity%20of%205%20alpha%2Dreductase,serum%20androgens%20(idiopathic%20hirsutism).
- https://emc-prod-ukwest-wa.azurewebsites.net/emc/product/6398/smpc#gref
- https://scholar.google.com/scholar_lookup?journal=J+Am+Acad+Dermatol&title=A+randomized+bilateral+vehicle-controlled+study+of+eflornithine+cream+combined+with+laser+treatment+versus+laser+treatment+alone+for+facial+hirsutism+in+women&author=I+Hamzavi&author=E+Tan&author=J+Shapiro&author=H+Lui&volume=57&issue=1&publication_year=2007&pages=54-59&pmid=17270315&
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4348346/
- https://emc-prod-wa.azurewebsites.net/emc/product/6398/smpc#UNDESIRABLE_EFFECTS
