Vaniqa
Vaniqa (pronounced “VAN-i-ka”) is a prescription cream applied to the skin for the reduction of unwanted facial hair in women ages 12 and older. For unknown reasons, Vaniqa does not work for everyone.
You'll have to get a prescription from your doctor. Some insurance policies do not cover Vaniqa.
Effectiveness: About 58% of women who tried Vaniqa in clinical trials had improvement. The other 42% had no improvement.
This medication is not a depilatory, but rather appears to retard hair growth to improve the condition and the appearance of some consumers. You will likely need to continue using a hair removal method (e.g., shaving, plucking) in conjunction with Vaniqa. It will usually take 2 months of treatment before you see if it works or not. If you stop taking Vaniqa, your hair may come back to previous levels within 2 months after stopping.
The active ingredient in Vaniqa is eflornithine hydrochloride. It inhibits an enzyme that affects hair growth, called ornithine decarboxylase (ODC). Clinical data indicates that taking an oral version of the drug can affect hair growth.
Vaniqa should not be used:
- By men. It has not been tested on males.
- By women who are pregnant or nursing, because Vaniqa has not been tested to see if it causes birth defects and miscarriages in humans
- By females under age 12.
- Anywhere except on the face and chin.
- In the eyes, nose, mouth, or vagina.
- If you have severe acne or broken skin.
Background
Hair growth cells and cancer cells share some interesting characteristics: rapidly dividing with multiple potentials for differentiation. This is part of the reason chemotherapy and radiation can result in hair loss: they disrupt the same kinds of cellular activity. It has been theorized that some cancer drugs may be used to induce a controlled amount of hair loss or reduction. Vaniqa's active ingredient, eflornithine hydrochloride, has been observed to result in antitumor activity. It is the first commercially-available topical preparation to come out of this sort of research.
Vaniqa became available on July 31, 2000. Originally made by Bristol-Myers Squibb in a partnership with Gillette, it is now a separate company under the name Women First Healthcare.
Vaniqa website
Clinical data
Eflornithine hydrochloride inhibits an enzyme which has been observed to affect hair growth in rats. Regulation of this enzyme, called ornithine decarboxylase (ODC), was later shown to reduce hair growth in mice and sheep. Recent studies suggest observations in certain types of mice may have parallels in humans.
This drug has been found to be an astonishingly effective cure for some types of African "sleeping sickness," even able to cause a rapid and complete recovery in comatose patients. Clinical reports show that taking it orally to treat sleeping sickness can induce hair loss as a side effect.
One large published study on safety found the product rarely caused significant side effects such as acne, follicle irritation, itching or dryness. This corroborates unpublished data submitted to FDA showing about 2% of subjects discontinued use due to adverse reactions.
Unpublished efficacy data submitted to FDA observed about 58% of women using it on facial hair had improvement. This study suggests it may be particularly effective in postmenopausal women.
See my Vaniqa clinical data pages for more on effectiveness and side effects.
Proof of how hard it is to judge effectiveness
Perhaps the most striking result was how many women in the control group (who used cream with no active ingredient) were observed to have less hair. Of 201 patients, over one-third who used a placebo were assessed by physicians as either “improved” or “marked improvement.”
This huge number of “false positives” means two things for consumers seeking hair removal:
It's really hard to tell if a new hair removal product is effective or not, especially based on the personal experiences of just a few people.
It's really easy for quacks to exploit this difficulty and make overblown claims about products they promote.
That's why you should rely on large-scale controlled studies to determine if a hair removal product is effective.
A note on internet marketing of Vaniqa
Consumers should be cautious when looking to purchase Vaniqa online. Many websites offer come-ons like this:
Free Online Medical Consultation!
No Prior Prescription Needed!
Because it is a prescription drug, and because it's not right for everyone, you should visit a doctor in person before getting a prescription. In fact, it is illegal to sell Vaniqa without a prescription, so many online companies are breaking the law or bending it with a "rent-a-doctor" who rubber-stamps all purchases. This is unsafe and probably against the law. Some consumers ordering prescriptions online have their orders confiscated by postal inspectors or simply never sent, so you run a risk by ordering through fly-by-night companies online.
Vaniqa (pronounced “VAN-i-ka”) is a prescription cream applied to the skin for the reduction of unwanted facial hair in women ages 12 and older.
For unknown reasons, Vaniqa does not work for everyone.
You'll need a prescription from your doctor. Most insurance policies do not cover Vaniqa.
Vaniqa became available on July 31, 2000, and is made by Bristol-Myers Squibb in a partnership with Gillette.
Effectiveness: About 58% of women who tried Vaniqa in clinical trials had improvement. The other 42% had no improvement. There have been no studies done on TS women.
A TS consumer's experience
Please note that with hair removal, one person's experience can be a very useful thing to read, but it is no indication of the results you might expect. As I stated, Vaniqa does not work for many consumers, and they don't know why. In fact, they aren't completely sure why it works in the first place.
Preface:
The tried-and-true approach to getting rid of facial hair is electrolysis. It’s a sure thing. If you want to be rid of facial hair forever, do the electrolysis thing. I leave debate over effectiveness of lasers, whose proponents assert that the tiny lights also permanently remove facial-hair, to those more knowledgeable.
Beyond permanent solutions there exist ways to “manage” facial hair, from plain ol’ shaving to epilation by various means. Those work too... until the hair reappears. Then you’re back at square one.
At the very bottom of the heap are elixirs sold by unscrupulous con men who promise eternal facial smoothness for a modest investment, and “urban legend” cures (like Bacitracin, really!). Beware.
In the late summer of 2000, the FDA approved a product called Vaniqa (note absence of letter U), developed by Bristol-Myers for prescription use. Vaniqa’s active ingredient is the chemical eflornithine in 13.9% solution. Vaniqa is, according to Bristol-Myers, “the first prescription therapy approved by the FDA to eliminate unwanted facial hair growth in women.” Vaniqa is marketed by Gillette under license from Bristol-Myers.
The following is one gal’s experience with Vaniqa. Before we go any further, I’ll say what most of you probably already know. However, hope — too often unfounded — often clouds the vision of even the most learned among us, so I’ll repeat it. What works well for one of us may fail miserably for another. Too (with the possible exception of estrogen ), magic is equally rare in bullets and pills. Vaniqa is definitely a YMMV kinda thing.
My account is anecdotal. My discipline is not in chemistry or biology. I seriously doubt that there exist any double blind, controlled studies of Vaniqa’s effectiveness (or persistence) in transsexual populations. So I offer this to you for what it’s worth. Only by trying Vaniqa will you know how well or whether it works for you.
Vaniqa has exceeded my expectations and met most, if not all, of my early hopes. I am still using it (some hairs persist), so the story is not yet over. The thrilling climax will come when Vickie summons the courage to stop using the stuff and waits for like six months to see whether the nasty little black things return with a vengeance. I don’t want to think about that right now.
Hopes & Expectations:
My early hope was that Vaniqa would reduce my facial hair to the kind “peach fuzz” possessed by most pre-menopausal genetic females. I also hoped that it would result in my never having to shave (ugh, ook, gak) again in my life... ever. Finally, I hoped that its effects ultimately would be permanent. In other words, I hoped that after some amount of treatment I could stop and its effects would persist (see previous paragraph).
Those familiar with Vaniqa enclosures or ads know that it purports to be a temporary solution, effective for only so long as it is used. Such remedies abound and seem to work out very well for pharmaceutical companies’ bottom lines (not to imply that they would ever design it so).
Vaniqa is intended for women with some ongoing cause of terminal facial hair. But for those of us taking female hormones and/or androgen suppressants, the cause of facial hair is precipitant but perhaps not persistent. So, I reasoned happily, my follicles once in a comatose state might agreeably remain there without further treatment. Still, the cynic in me doubts that.
In any case, that was my hope. My expectation however — heavily laced with a skepticism born of disappointment — was more modest. In fact, I fully expected that after six months or so I’d abandon yet another magic fix and turn my eyes at last to the grim and costly alternative.
Electrolysis: As long as I brought it up, I may as well explain why I didn’t just go for the hot needle. Let me count the ways:
Pain — I had a fifteen-minute, freebie electro session with a gentle, Santa Cruz electrologist. My take-away from the session was that it wasn’t all that bad. However, I’ve read enough of others’ experiences not to place much faith in that single short experience.
Inconvenience — I’m a fulltime student. School has become what life I possess. I don’t have time for 200 one-hour appointments.
Cost — I’ve read that having one’s face cleared of the hideous bristles can cost from $15k to $20k, plenty sous by any standard. Vaniqa, on the other hand, runs $53 per tube; a tube lasts (me) about two months. That works out to $300 and change per year. At that rate and assuming the worst (i.e., that the price of Vaniqa doesn’t drop, that a more cost-effective alternative doesn’t appear, and that I have to use it forever), I break even between 50 and 65 years.
Possible damage to underlying collagen tissue — Just what I’ve read. I don’t know how much truth there is to this, but nuking follicles and the tissue that surrounds them is probably not a happy thing for one’s skin. Still, our bodies have amazing remedial powers so I wouldn’t worry too much about that issue.
Procedure:
Equipment: If you’re still game, here’s what you’ll need:
Your first tube of Vainqa (for which you’ll need a prescription. BTW, I hear it’s difficult or impossible to lay hands on Vainqa most places outside the U.S.);
Either a good tweezers — stainless — not junk, an epilator or a good razor;
A magnifying mirror (I use a small one, suit self);
Two spray bottles (I use empty and well-rinsed Minoxidil bottles): One spray bottle should contain water; the other, Witch Hazel (personal choice).
The goal is to apply Vaniqa to areas of hair growth roughly in proportion to hair density. As Vaniqa begins taking effect (assuming it does) you’ll alter your application accordingly. To begin, mentally divide your face & neck into areas. I use six: sideburns to bottom inch of neck; cheeks to bottom inch of neck; central area from upper lip to bottom inch of neck; finally, the bottom frontal inch of neck, each side. Areas are a function of hair density and real estate. For example, although my cheeks account for almost half the total treatment area, they now receive no Vaniqa because the growth there is vellus and quiescent. For some reason (perhaps because I only began treating that area during these past four months), the bottom ? inch of my neck is the source of most of the persistent terminal hair (right-hand side, go figure).
Reading the last paragraph over, I think I’m making this look like rocket science. It isn’t. You just want to get complete coverage without using so much it breaks you financially. The routine is really easy. Once you’re used to it, it takes about a minute for each of the two daily applications. Piece of cake, guys.
Shaving: Unless your facial hair is very light, I recommend shaving at first, both morning and evening. You can graduate from shaving to epilation when shaving becomes silly, i.e., the razor is just gliding over smooth skin. You’ll recognize the sensation.
Epilating: By the time you reach this stage, it will be a minor task. For example, I devote about ten to fifteen minutes a day to plucking. An obsessive person, I find myself disappointed when there’s nothing to pluck. Yesterday, for example, I used every skill I possess to locate the smallest hair to root out. BTW, we’re looking for typical terminal hairs here, not vellus Girls have vellus hair. It’s peach fuzz, something you won’t have if you use electrolysis. I’m fine with vellus hair (NPI). It doesn’t grow out or become dark and is almost invisible unless looked at in strong light. I locate the terminal hairs mainly by touch and get ‘em when they barely begin to surface. Once the treatment was underway, I noticed that even terminal hairs became very slow to extend.
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