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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 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

editor's note: I received the excellent account below from Vickie in April 2002

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:

  1. 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.
  2. Inconvenience — I’m a fulltime student. School has become what life I possess. I don’t have time for 200 one-hour appointments.
  3. 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.
  4. 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.

About Me:

I’m an MtF transsexual. Been on a moderate ERT regimen since August of 1990. I began with a fairly heavy, 5mg dose of Premarin, but switched to 6mg Estrace within six months or so. Being a minimalist by nature, it wasn’t long before I cut my dose to 4mg. I stayed between 4mg and 2mg sublingual from then on. I was on spironolactone for six weeks ending shortly after Christmas 1991 when I discovered what turned out to be a benign cyst beneath my right nipple. Scared heck out of me and led to an embarrassing-but-funny-in-retrospect and certainly out of scope session with the surgeon who aspirated it. Also out of scope and based upon a second adventure is my conviction that spironolactone offers no benefit to me whatsoever. I had an orchiectomy in June. My pre-op testosterone was flying below radar at "< 10ng/dl," so I didn’t have the operation to reduce testosterone levels. I did it to be rid of superfluous equipment and to feel more comfortable in a bikini. It’ll be a while before I have time for SRS.

Although before HRT I had moderate body hair, that all went bye-bye on my modest estrogen regimen alone. I had Tanner-4, B-cup breasts before the end of five years. My facial hair was probably average male density and vigor. Estrogen seemed to discourage it to a degree, but I still had to shave daily to feel human.

Not for Everyone: Some don’t take the road less traveled, but understandably prefer the tried and true (e.g., electrolysis). Notwithstanding what I said above, I fully understand and relate to that point of view. The decision one makes may have as much to do with personality as with obligations and financial circumstances.

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.

Application: I apply Vaniqa twice per day, morning and evening to coincide with face washing. Be sure your face is freshly washed and either shaved or plucked. Once that’s out of the way, do the following:

  1. Lightly spray area to be treated with water to help distribute the very light Vaniqa application. You don’t want it dripping wet, just moist.
  2. Spread the water with clean index finger to get a fairly even coating.
  3. Squeeze small (BB-sized) amount of Vaniqa from tube onto index finger and spread on first of six areas of face & neck. (See admonition, below.)
  4. Repeat step 3 for the remaining five face & neck areas;
  5. When skin is good and dry, the application has been absorbed. This typically takes less than five minutes. I suppose it varies depending on whether you live in New Orleans (humid) to Monterey (not). There should be a little visible white residue. Re-dilute the residue for a second absorption by applying a light spray of Witch Hazel to the treatment area and distributing lightly and evenly with (ideally, the same) index finger. Don’t ask me why Witch Hazel. No scientific reason. It brings back nice childhood memories for me.

Admonition: You now have on your index finger a chemical very effective at discouraging (if not eliminating) terminal hair. Be sure to wash your hands and especially that finger thoroughly right after application. You sure as heck don’t want to be rubbing Vaniqa into your scalp, say, with your Minoxidil treatment right? Gives me the shivers just to think about it.

General Notes:

I am both test and control group and so have no idea whether my experience with Vaniqa is typical. For example, I needed little estrogen (2mg to 4mg estradiol, sublingual) to achieve complete diminution of body hair to vellus and all the other attributes we seek. No andro-agonists. There’s no way to know in advance whether your experience will be like mine. You just have to try it on your own. YMMV.

Use enough, but resist the urge to over apply. Excess application is, I think, ineffective. At the outset, you’ll probably use too much as I did. That may be a good thing if it kick starts the program.

Vaniqa tubes come with two kinds of orifice: big and small. That’s unfortunate because you can easily push too much out if you’re used to the smaller opening and your next tube has the big mouth. Watch out for this.

Vaniqa’s relatively expensive at $53 / tube. When you’ve squeezed the “last” out of a tube, there’s more inside — maybe three days’ worth or more. Sooo when it looks like the tube is dry, cut the tube about one inch from the top (sealed end) and stick your index finger (yah, the same one) in there to extract the precious stuff. Do the same with the middle and bottom (orifice) ends. When you’re down to the small amount at the opening end, you can blow gently into the cut end, holding your finger outside the orifice to get the last little bit.

After sixteen months of religious use, my face is smoother than those of my GG grrrlfriends, most of whom are in their late twenties to mid-thirties. My cheeks and sideburns are vellus. I still get a few terminal (although not well-rooted) hairs on the end of the jaw by the earlobe, and my lower neck. If/when I cannot find any hairs to pluck for about a month, I think I’ll take a deep breath and go off Vaniqa altogether.

[ed. note: the manufacturer recommends continuation of use to maintain effect, like Rogaine. There is a possibility that discontinuation will cause hair to return.]

If you try Vaniqa I’d love to hear your experience, good or bad. You may also feel free to email me with questions, but please excuse brevity and slowness in responding. I do a lot of school stuff these days.

Here’s a log I have kept to the date of this writing. Good luck, whatever you do. Vickie Jo —seahorsemoi@excite.com

Vaniqa record

Date Day days tube lasted Comments
2000
25 October 298:   Began Vaniqa today on chin (added upper lip a week later) only.

7 November
    Began using on rest of face. Results already on chin and upper lip!
23 November 327 [30] Exhausted first tube. Facial hair is definitely slowing.
16 December 350 [24] Exhausted second tube. There’s still some slight growth in sideburn area, neck and chin. Around the mouth is smooth.
2001      

13 January
13 [29] Exhausted third tube. Seems to be getting smoother.

7 February
38 [26] Exhausted fourth tube. Face is perfectly smooth except for the jaw line and upper sideburns, which are only somewhat rough at day’s end.
3 March 62 [25] Exhausted fifth tube. Smoothness continues!
27 March 86 [25] Exhausted sixth tube. Close, but still no cigar.
22 April 112 [27] Exhausted seventh tube.
20 May 140 [29] Exhausted eighth tube. Shaving is becoming silly. All I feel is a slight roughness at the jaw line and mid-point & just below the side burns.
16 June 167 [28] Exhausted ninth tube. Dr. Garner (dermatologist) asked me yesterday how I got my face so smooth.
23 July 204 [38] Exhausted tenth tube. Using less with same results. I still feel some roughness below the jaw and mid-sideburn, especially at day's end.

15 September
258 [55] Exhausted eleventh tube. Stopped shaving. Pulled several tiny hairs. It's working like gangbusters! I'm just happy as heck. Wow.
8 November 312 [54] Exhausted twelfth tube. I must now hunt for hairs to pull. There are probably 100 or so of them of any coarseness at all. I locate them now only in ones & twos. I have to wait patently for days for them to become long enough to grip with he tweezers.
19 December     I pull about 20 to 40 hairs per day now. Most are just due to obsessiveness they are so light. Perversely, some of the persistent (i.e., rooted) ones are on my chin and upper lip. There is also a little persistence at the place where my left jawbone meets my ear lobe. More understandable are the rooted hairs on my lower right neck, perhaps an inch from the base, an area I neglected to medicate until the last sixty days or so.
2002      
19 January 19 [72] Wow! And I thought I had increased the amount of Vaniqa I was using! This is too awesome. I’m getting almost 2.5 months (75 days) to a tube. I spend maybe fifteen minutes a day searching for teeny-tiny hairs. I’m pulling fewer hairs now, possibly a dozen to sixteen serious ones per day. My upper lip and jawbone at chin and margin (ears) are still the locus of most of them.
4 March 63 [44] Quel regression! This so totally reflects my state of emotions and stress over being in school. Must have been compensating or something. Obviously using ‘way too much this time. Anyhow, face is very smooth. I pull maybe ten or so hairs a day now. Most of the time is spent finding the little devils.