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Evidence summaries

Eflornithine Treatment in Women with Facial Hirsutism

Eflornithine combined to laser hair removal may be effective for facial hirsutism in women. Level of evidence: "C"

Comment: The quality of evidence is downgraded by imprecise results (few patients) and by suspected publication bias (only small and mostly commercially funded studies).

Summary

A randomized, double-blind, placebo-controlled, right-left comparison study 1 evaluated eflornithine cream combined with laser treatment versus laser alone for treating unwanted hair on the upper lip in women. All subjects (n=31) underwent treatment to the entire upper lip with a long pulse alexandrite laser every 4 weeks for up to 6 sessions. Each patient also applied either eflornithine or placebo cream twice daily to each side of the upper lip in a double-blinded manner.Both treatment modalities were well tolerated. At the end of the study, complete or almost complete hair removal was achieved in 29 of 31 (93.5%) of the eflornithine-laser-treated sites versus 21 of 31 (67.9%) for the placebo cream-laser-treated sites. Statistically significant differences in favor of eflornithine were demonstrated at the final assessment through blinded patient grading (13/31 =41.9%) and hair count analysis.

A randomized, split-face, single-blinded controlled trial 2 assessed topical eflornithine vs. no eflornithine treatment after 5-6 photoepilation treatments (intense pulsed light, IPL) in 22 women with facial hirsutism. Application of eflornithine was initiated after the final IPL-treatment (baseline) and used twice daily for 6 months to half of the face. Patients were assessed at baseline and 1, 3 and 6 months after the final IPL-treatment. A total of 18/22 patients completed the study protocol. At 1 month, eflornithine reduced hair regrowth by 14% (P = 0.007, n = 20 patients), at 3 months by 9% (P = 0.107, n = 19) and at 6 months by 17% (P = 0.048, n = 18) compared to no treatment. Patient-evaluated efficacy supported blinded hair counts.

Clinical comments

Note

Date of latest search: 2017_11_01

References

  • 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. J Am Acad Dermatol 2007;57(1):54-9. [PubMed]
  • Vissing AC, Taudorf EH, Haak CS et al. Adjuvant eflornithine to maintain IPL-induced hair reduction in women with facial hirsutism: a randomized controlled trial. J Eur Acad Dermatol Venereol 2016;30(2):314-9. [PubMed]

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