Eflornithine is an irreversible inhibitor of ornithine decarboxylase. This enzyme catalyzes the conversion of ornithine to polyamines, which are involved in the regulation of cell growth and differentiation in several tissues. The enzyme is modulated by androgens and takes part in the physiology of hair growth, regulating the proliferation of matrix cells in the hair follicle. Studies have indicated that blockade of this enzyme activity in hair follicles slows hair growth, and the drug has recently been licensed for topical treatment of facial hirsutism. Percutaneous absorption of the drug is negligible. In short-term clinical studies, eflornithine 11.5-15% cream was better than placebo in reducing hair growth in women with unwanted facial hair, as demonstrated by objective and subjective methods (11). However, hair growth returned to pretreatment rates within a few weeks after stopping treatment. Mild irritation and folliculitis may affect the skin with treatment. Anecdotal evidence also suggests that eflornithine may also be used in reducing unwanted hair in other body sites. Currently there are no controlled studies comparing this drug with the systemic pharmacological tools used for hirsutism. However, it appears reasonable to suggest eflornithine as single-drug therapy in mild hir-sutism to reduce the frequency for the need for hair removal, although other pharmacological strategies should be considered in more severe hirsutism.
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