Eflornithine is a prescription approved by the Food and Drug Administration (FDA). This is used for the treatment of facial hirsutism or excessive hair growth on the face. This medicine helps block certain natural substances that are needed for hair growth in the skin. The effect slows the growth of the hair and also makes the hair finer and lighter.

Facial hirsutism is a condition in women that results in excessive growth of dark or coarse hair in a male-like pattern. With hirsutism, extra hair growth often arises from excess male hormones primarily testosterone. These hormones are called androgens. Hirsutism is stiff or dark body hair that appears on the body where women don’t commonly have hair. It is primarily the face, inner thighs, lower abdomen, back, and chest. People have widely varying opinions on what’s considered excessive. When high androgen levels cause hirsutism, other signs might develop over time. The process is called virilization. Signs of virilization might include:

• Balding
• Deepening voice
• Acne
• Increased muscle mass
• Decreased breast size
• Enlargement of the clitoris

Hirsutism can be emotionally distressing. Some women feel self-conscious about having unwanted hair. Some develop depression. Also, although hirsutism doesn’t cause physical complications, the underlying cause of a hormonal imbalance can. If you have hirsutism and irregular periods, you might have polycystic ovary syndrome, which can inhibit fertility. Women who take certain medications to treat hirsutism should avoid pregnancy because of the risk of birth defects. Several factors that can influence your likelihood of developing hirsutism may include:

• Obesity. Being obese causes increased androgen production which can worsen hirsutism.
• Ancestry. Women of Mediterranean, Middle Eastern, and South Asian ancestry are more likely to have more body hair with no identifiable cause than are other women.
• Family history. Several conditions that cause hirsutism including polycystic ovary syndrome and congenital adrenal hyperplasia, run in families.

How does the medicine work?

The unwanted hair usually grows around the lips or under the chin. It may be associated with hormonal conditions or with treatment with certain medicines. Eflornithine works by blocking the action of an enzyme called ornithine decarboxylase. This is an enzyme found in hair follicles and is needed for hair to grow. By blocking this enzyme, this drug slows down hair. The cream is applied to the affected areas of the skin to reduce the growth of unwanted hair.
Eflornithine only slows down the growth of unwanted hair. It does not actually remove hair, so another method for hair removals such as plucking or shaving may need to be continued while using the cream. The benefit of using this cream may be seen within two months after starting the treatment.

How to use this medicine?

This medication is for use on the skin only. Apply a thin layer of this medication only to the affected areas of the face and chin. Rub in well. It is usually applied twice daily at least 8 hours apart or as directed by your doctor. Do not apply for at least 5 minutes after hair removal. Do not wash the treated area for at least 4 hours. Wash hands right away after using this product. Avoid getting the product in your eyes, nose, or mouth. If the medication gets in these areas, rinse right away with clean water. Wait until the medication has dried completely before applying moisturizers, cosmetics, or sunscreens over the treated areas.

This product is not a hair removal product. Continue to use hair removal techniques while using this medication. If you stop using this product, hair growth will return. You should see some improvement in 4 to 8 weeks. Use exactly as directed because this medication works slowly.

Do not use more of this product or use it more often. Your condition will not improve faster and the risk of side effects will increase. Tell your doctor if your skin becomes red or irritated. Your doctor may direct you to apply the medication only once a day or stop the medication. Tell your doctor if your condition persists or worsens.

What are the possible side effects of the medicine?

Common side effects:

• Headache
• Skin dryness
• Temporary rash, redness, stinging, burning, tingling, or itching
• Acne or red bumps on the skin

Stop using Eflornithine and call your doctor at once if you have:

• Severe irritation of treated skin
• Redness or crusting around your hair follicles
• Acne “hair bumps” or folliculitis

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Get emergency medical help if you have signs of an allergic reaction:

• Hives
• Difficult breathing
• Swelling of your face, lips, tongue, or throat.

Warnings and Precautions

• Tell your doctor if you have any other medications including vitamins or food/herbal supplements.
• Do not give this prescription to others with the same condition as yours.
• Certain medications should not be used during breastfeeding or pregnancy. However, other drugs may be safely used in breastfeeding or pregnancy providing benefits to the mother. Always inform your doctor if you are pregnant or planning a pregnancy before using any medications.
• This should not be used if you are allergic to any of its ingredients. Inform your doctor if you previously experienced such an allergy. If you feel experienced an allergic reaction, stop using the medicine and let your doctor know right away.
• The medication should be used with caution in women with decreased liver or kidney function.
• In girls aged 18 years old, this cream is not recommended for use. As well as in male or breastfeeding women, this product should not be used.
• You may apply cosmetics to the areas of skin treated with this cream. But, don’t apply them any sooner than 5 minutes after applying the cream.
• Before using, inform your doctor if you have any medical history such as infections, cuts, or sores on the face.