eflornithine is a specific, irreversible inhibitor of the enzyme ornithine decarboxylase present in hair follicles
ornithine decarboxylase enzyme is responsible for a key step in the biosynthesis of polyamines such as spermidine and putrescine
it is believed that these polyamines have important roles in cell proliferation, and blocking them in hair follicles slows the growth of the hair
there is a continual regeneration of ornithine decarboxylase. Therefore when inhibition of this enzyme ceases, the functional activity of ornithine decarboxylase increases (i.e. hair growth resumes)
topical eflornithine is applied twice daily to affected areas of the face
topical eflornithine was evaluated in 596 adult women in two multicenter, randomized, double-blind, placebo-controlled therapeutic trials (1)
the women recruited in the trial had five or more terminal hairs per square centimeter in four discrete facial areas 48 hours after shaving, as determined by video image analysis
all the women habitually removed facial hairs at least twice a week
eflornithine cream was applied twice daily for 24 weeks, followed by an 8-week no treatment period
after 24 weeks, 32% of patients treated with topical eflornithine were judged "clinical successes" vs. 8% of the placebo group
when "clinical success" and "improved" were taken together, the percentage of patients with a positive response to eflornithine at 24 weeks jumped to 58% versus 34% in the placebo group
self-assessment by patient questionnaire showed eflornithine to reduce overall discomfort and bother by 33% in the treated group vs. 15% in the placebo group
benefit of eflornithine to be lost after the 8-week no-treatment phase, when hair growth returned to its pretreatment rate
adverse effects
most common reported side effect was acne (approximately 20%); however, the rate of acne reported in the placebo group was virtually the same
about 15% of eflornithine group reported symptoms of burning/stinging/tingling and in only 5% of the placebo group, making this the most common side effect specific to eflornithine vs. the placebo
the adverse effects of eflornithine were generally mild in nature and no serious treatment-related events occurred
in the UK topical eflornithine is being marketed as a treatment to reduce the frequency of a woman's usual method of hair removal and not as a replacement for the current method
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