Combination of Intense Pulsed Light and Topical Eflornithine Therapy Versus Intense Pulsed Light Alone in the Treatment of Idiopathic Facial Hirsutism: A Randomized Controlled Trial.

BACKGROUND

Idiopathic facial hirsutism (IFH) exerts a measurable negative impact on psychosocial well-being, even in the absence of identifiable endocrine dysfunction. Although light-based epilation technologies offer durable hair reduction, treatment-resistant regrowth remains a clinical challenge. Adjunctive topical therapies that modulate follicular activity are under investigation to potentially enhance and prolong the efficacy of such interventions.

OBJECTIVE

The objective of this study is to compare the efficacy and tolerability of six-month sessions of intense pulsed light (IPL) combined with a topical agent versus the same IPL protocol alone in Pakistani women with IFH.

METHODS

In this open-label randomised controlled trial, 152 women aged 18-70 years were randomised 1:1 to combination therapy (n = 76) or IPL alone (n = 76). The primary outcome was the proportion of participants achieving ≥ 1‑grade reduction on the modified Ferriman-Gallwey (mFG) scale at week 24. Secondary outcomes included mean percentage terminal-hair reduction and patient satisfaction.

RESULTS

Baseline characteristics were comparable. At week 24, 89.5 % of the combination group met the primary endpoint compared with 69.7 % receiving IPL alone (absolute risk difference 19.8 %, p = 0.003). Mean terminal-hair reduction was 90 % versus 59 % (p < 0.001). Treatment-related adverse events were limited to transient erythema and xerosis without between-group differences.

CONCLUSION

Adding a topical agent to IPL significantly improves clinical and patient-reported outcomes in IFH without increasing toxicity. The regimen may offer a practical, hormone-free first-line strategy for South-Asian women seeking rapid, durable cosmetic benefits.