Can you tell me about hair removal creams, like Vaniqa? If you stop using it, will the hair grow back thicker and faster? Also, do the home electrolysis machines work just as well as the ones professionals use?
Vaniqa is a cream containing a drug called eflornithine which is being heavily promoted for the removal of unwanted hair. It is the first topical cream approved for this purpose by the FDA that actually reduces the growth of hair, as opposed to removing the hair that has grown out of the hair follicle. Eflornithine was originally developed as a drug given intravenously for the treatment of a tropical parasitic disease, African Sleeping Sickness.
According to the Medical Letter (2000;42:93), a nonprofit journal that reports on recently approved medications and procedures, there have been no published studies on eflornithine cream. The FDA approval was apparently based on the summaries of two studies sponsored by the manufacturer of the drug. These studies were conducted with controls, and I presume that they were double blinded, meaning that neither the people in the study nor the physicians conducting the study were aware of who was taking the active medicine, and who the placebo. Such randomized double blind studies are considered the best way of evaluating the effectiveness of new drugs and procedures. In the absence of publication in a peer-reviewed journal, however, it is difficult to say whether the studies were truly significant or not.
Nonetheless, the Medical Letter report states that in one of the studies, about 20 percent of the people receiving the active drug noticed marked improvement, and in the other study, 40 percent had marked improvement. About 10 percent of the people receiving the placebo also had marked improvement.
It took about eight weeks for a difference to appear between the women taking the active drug and those taking the placebo. After stopping the cream, hair growth resumed in those who had been taking the active drug, and after eight weeks off the drug, there was no difference between those who had been on the drug and those who had received the placebo. In answer to our first writer, I would interpret this to mean that the cream must be used indefinitely, or hair will grow back. I would not expect the regrown hair to be thicker or grow faster than the original hair, but the report did not comment on that question.
The studies reported that less than one percent of the applied eflornithine was absorbed into the body. Side effects noted were minimal, mostly burning when the cream was applied to sensitive or irritated skin. Animal studies of the drug have not demonstrated any tendency to cause cancer or birth defects.
Despite this, of 19 women who became pregnant during the studies, five chose to have abortions, four had miscarriages, and of the remaining ten live births, one, to a 35-year-old woman, had Down’s syndrome. Four miscarriages and one birth defect out of 14 pregnancies does not sound like a totally harmless drug to me.
The cost of the cream to the pharmacist is around $42.00. Pharmacy markups are commonly 100 percent, so the cost to the consumer may well be around $80.00. I would doubt that insurance will cover this cream, since they can claim it’s for cosmetic use. It is available by prescription only, so the cost of the doctor visit will also have to be factored into a person’s decision to try it.
Our two writers will have to decide if they want to pay this much for a cream that is effective less than 50 percent of the time. They might want to consider other possibilities, including bleaching, which of course does not prevent hair growth but renders the hair almost invisible. I’m afraid I can’t comment on the home electrolysis units, since I have had no experience treating someone who used this method of hair removal.