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How does Vaniqa work?

Vaniqa is not a hair remover, but works by reducing new hair growth and regrowth. Vaniqa works at the level of hair follicles by reducing the activity of an enzyme (ornithine decarboxylase) involved in hair growth.

What causes female facial hair?

All women have some male hormone (androgen) as well as female hormone (oestrogen) in their system. Female facial hair or hirsutism in women is caused by an androgen effect on hair follicles either by too much circulating male hormone or by an increased hormone sensitivity in the hair follicles themselves. Hirsutism may be a family trait. It is more often found in women of South Asian and Southern European ethnicity.

It can also be caused by medical conditions, most commonly Polycystic ovary syndrome (PCOS), but also other rare hormone conditions or tumours. Increased facial hair can be a result of hormone changes at the menopause. It can also be a rare side effect of some prescription medicines.

It is important that women who are considering using Vaniqa for facial hair have first consulted with their own GP who may choose to arrange blood tests to check for medical causes. An underlying medical condition is more likely in the following cases:

• Hirsutism has developed quickly over the previous few months or years,
• Associated menstrual problems as well,
• Other male hormone effects such as thinning hair over the scalp, balding, or deepening of the voice,
• Associated obesity or diabetes.

Prescription medicines associated with hirsutism include cyclosporin, minoxidil, steroids, and carbamazepine.

For further information please see British Association of Dermatologists - Hirsutism and - Excessive hair growth (hirsutism).

Who will benefit from Vaniqa?

Vaniqa can be used by all women over 18 who are troubled by excessive facial hair growth. It does not work for hair in other parts of the body.

In the drug trials 70% of women saw improvement after 24 weeks use.

Who is not suitable to use Vaniqa

The Dr Fox online consultation carries out checks for suitability. If you have severe kidney or liver disease, the manufacturers recommend that you discuss with your doctor before using Vaniqa, although there are no documented problems.

Skin preparations which may irritate the skin, like some acne treatments, should not usually be used at the same time as Vaniqa - discuss with your GP.

How to use Vaniqa

• For use on the face and chin only.
• Wait at least 5 minutes after removing hair (e.g. shaving, plucking, waxing), before applying Vaniqa.
• Vaniqa cream can cause burning or stinging if applied to cut or irritated skin.
• Apply a small pea-sized amount of cream twice daily to clean, dry skin and rub it in until no longer visible.
• Use only on affected area, usually the chin and upper lip.
• Avoid contact with the mouth, inner nose, and eyes.
• Wash hands after applying the cream.
• Leave at least 8 hours between applications. If irritation occurs, reduce application to once daily. Consult a doctor if irritation persists.
• Wait at least 5 mins for Vaniqa to dry, before applying makeup and other skin applications.
• Leave the cream on for at least 4 hours.

If a substantial amount of Vaniqa is accidentally swallowed, consult a doctor or use the NHS 111 service.

How effective is Vaniqa?

Vaniqa does not remove existing hair. It slows down new growth and regrowth. Hair removal, for example by plucking or shaving, should be continued.

It can take up to 8 weeks for results. If after 4 months there is no improvement, Vaniqa should be stopped and a doctor consulted.

Vaniqa's effects wear off after 8 weeks of stopping treatment. To maintain the effect, Vaniqa must be used continuously.

Side effects of Vaniqa

Side effects, if they occur, usually only affect the skin at the site where the cream is applied, and usually settle once treatment is discontinued.

The most common side effect, in up to 1 in 10 women, is acne. Also common, in up to 1 in 100 are: dry skin, hair loss, inflammation, itching, rash, redness, and stinging and tingling. Other side effects are less common.

A full list can be found in the manufacturer's Patient Information Leaflet.

Do any drugs/medicines interfere with Vaniqa?

No drug interaction studies have been undertaken, so this is unknown. However as Vaniqa is a local treatment and only small amounts are absorbed into the body, drug interactions are very unlikely. Vaniqa will not affect your contraception.

Pregnancy and breastfeeding

Do not use Vaniqa if you are pregnant or breastfeeding. Alternative treatments should be used.

Other treatments for unwanted female facial hair

Vaniqa is the only cream with a direct action that reduces growth of unwanted female facial hair. It is only manufactured by Almirall and there is no cheaper generic alternative available.

As female facial hair is usually linked with excess male hormone (androgen), most other treatments work by reducing the amount of androgen activity in the body.

The simplest way to do this, is to take the combined contraceptive pill and, before the menopause, that is often a good choice which can also be used alongside Vaniqa. Two specific anti-androgen, combined contraceptive pills - Dianette containing cyproterone acetate or Yasmin containing drospirinone - can be used, but they have a greater risk of thrombosis (blood clots) than other combined hormonal contraceptives. In extreme cases, endocrinologists may prescribe androgen blockers.

In obese women, significant weight loss will reduce the levels of androgens and can therefore help to reduce unwanted facial hair.

How else to manage facial hair

• Shaving.
• Waxing.
• Depilatory cream which dissolves the hair shaft.
• Bleaching, but risks also bleaching underlying skin.

Permanent hair removal

Electrolysis, Laser, and Intense pulsed light (IPL) are all methods of permanently destroying the hair follicle and stopping hair growth. They are not usually provided on the NHS. It is important to use a fully registered practitioner. Potential side effects can include scarring.

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