Eflornithine

How it works

It irreversibly inhibits ornithine decarboxylase in the hair follicle, slowing the rate of hair growth rather than removing existing hair.

Prescribing in practice

• It controls rather than cures hirsutism; growth returns towards baseline after stopping, and treatment should be discontinued if no improvement is seen after a reasonable trial.
• It is for facial application only and existing hair-removal methods may need to be continued alongside it.
• Transient stinging, burning or acne-like eruptions at the application site are common and usually mild.

Monitoring

No laboratory monitoring is needed; review for clinical benefit after several weeks and for tolerability of local effects.

Counselling the patient

• Effect is gradual and may take several weeks to become apparent.
• Continue your usual hair-removal routine as the cream slows but does not remove hair.
• Avoid getting the cream in the eyes or on broken skin and wash hands after applying.

Evidence & guidelines

Topical eflornithine is an established adjunct for facial hirsutism, supported by randomised controlled trial data demonstrating reduced hair growth versus vehicle.