Facial hirsutism: Treatment approach

Before an adequate treatment decision can be taken, the cause of hirsutism or unwanted facial hair must be determined or excluded. No matter what treatment route is chosen, the objectives of treating facial hirsutism should always aim to:

	Reduce the appearance of facial hair
	Reduce the psychological impact of facial hair
	Allow flexibility of co-prescribing without systemic effects
	Be well-tolerated

Facial hirsutism: Management and treatment options

The following is an overview of the most common management and treatment options, along with an objective assessment of their respective benefits and disadvantages. Consider that a combination of regular hair removal techniques complimented by medical treatment may often be more effective than managing with one.

Facial hirsutism: Treatment options

Technique	Body Area	Advantages	Disadvantages
Plucking	• Face • Eyebrows • Bikini area	• Inexpensive • Regrowth can take weeks	• Painful • Slow
Waxing	• Face • Eyebrows • Groin • Trunk • Extremities	• Regrowth can take weeks	• Painful • Slow • Risk of folliculitis
Depilatories	• Extremities • Groin • Face	• Quick	• Can be irritating • Regrowth in days
Shaving	• All areas	• Easy • Inexpensive	• Quick regrowth • Risk of folliculitis • Time consuming
Electrolysis	• All areas, but usually the   face	• May provide permanent   removal	• Painful • Repeat treatments    needed • Very time consuming • Expensive • Risk of scarring and   skin pigment changes
Laser and Intense Pulsed Light (IPL)	• All areas	• May provide permanent   hair reduction • Efficient	• Painful • Repeat treatments   needed • Dark hair required • Expensive • Risk of scarring and skin   pigment changes • Rare reports of   paradoxical   hypertrichosis.
Eflornithine cream	• Face • Neck	• On stopping, regrowth   can take 2 months • Minimal adverse effects • Can be used in   conjunction with other   treatments	• Must be continued   indefinitely to prevent   regrowth
Antiandrogens and oral contraceptives	• Inhibits androgen-   driven hairs in all areas		• Takes months to show   benefit • Some adverse effects • Long-term treatment   required

(Shapiro 2006)

Beside the various treatment options, clinicians commonly advise lifestyle modification, including physical activity, diet and weight reduction, as well as psychological support in their effort to reduce unwanted facial hair and its symptoms.

Facial hirsutism: Supportive therapy

Beside the various treatment options, physical activity, reduction of weight and psychological support may contribute significantly to relieve the symptoms of unwanted facial hair.

Vaniqa: The non-hormonal prescription treatment option for facial hirsutism

Vaniqa (eflornithine 11.5% cream) is a topical treatment for facial hirsutism in women. In fact, it is the only non-hormonal, topical prescription cream proven to slow the growth of facial hair in women. Applied twice daily, 81% of women who use Vaniqa show clinical improvement after one year of treatment (Schrode 2000b).

Vaniqa: Uniquely suited for combination therapy

Due to its unique mechanism of action, Vaniqa can be used as monotherapy, as well as in combination with all other hair removal methods or treatment options, such as electrolysis or laser therapy (Shapiro 2005). Vaniqa can also be used with anti-androgens, such as oral contraceptives. Vaniqa can slow hair growth and may reduce the frequency of the need for hair removal by other means (Shapiro 2005). When combined with laser treatment, for example, Vaniqa provides significant hair reduction faster than laser alone (Hamzavi 2007).