La crème Vaniqa est un médicament sur prescription médicale. Le libellé de son autorisation de mise sur le marché (AMM) ne fait référence qu'au traitement de l'hyperpilosité du visage où elle agit en frein à la repousse. Des études récentes ont montré une très bonne synergie du couple Vaniqa - Laser alexandrite.  Sur le plan purement médico-légal cette crême a été validée pour le visage uniquement où elle a démontré une efficacité.

Elle n'est pas indiquée comme traitement pour le reste du corps. Sa prescription hors AMM est de la responsabilité du médecin. Sur le plan de la réflexion, il paraît assez logique de penser que cette crème devrait présenter une efficacité sur le sein, mais des études doivent le démontrer. Il convient aussi de vérifier par étude que la Vaniqa ne présente pas de caractère irritant pour la zone du mammelon. Enfin, il faudrait probablement limiter son usage aux femmes qui n'allaitent pas pour des raisons de toxicité.

Donc il ne semble pas illogique que la crême Vaniqa fonctionne sur la pilosité du sein en freinant la repousse, mais sa prescription est de la reponsabilité personnelle du médecin, en l'absence d'AMM clairement informative.

Le crème VANIQA n'est pas remboursée par la sécurité sociale. Elle n'est délivrée que sur ordonnance cependant.

Pour info: La société Américaine pour les lasers en médecine et chirurgie a démontré en 2003 que les traitements combinés Laser Alexandrite et Vaniqa sont meilleurs que le laser seul.

# Reported at American society of Laser Medicine and Surgery Abstracts 2003 105:32. Hair removal with combined Alexandrite laser and Vaniqa was superior to removal of unwanted facial hair with laser alone

Cete étude a été confirmée la même année par l'académie de dermatologie de San francisco.
# Reported at 61st annual Meeting of the Academy of Dermatology San Francisco 2003(Poster 649)

A randomized bilateral vehicle-controlled study of eflornithine cream combined with laser treatment versus laser treatment alone for facial hirsutism in women.

Hamzavi I, Tan E, Shapiro J, Lui H.
J Am Acad Dermatol. 2007 Jul;57(1):54-9. Epub 2007 Jan 30.
PMID: 17270315 [PubMed - indexed for MEDLINE]

A randomized bilateral vehicle-controlled study of eflornithine cream combined with laser treatment versus laser treatment alone for facial hirsutism in women.Hamzavi I, Tan E, Shapiro J, Lui H.
Department of Dermatology and Skin Science, University of British Columbia and the Vancouver Coastal Health Research Institute, British Columbia, Canada.

BACKGROUND AND OBJECTIVE: Although there are a multitude of therapeutic modalities for removing unwanted facial hair in women, there is very little information on using the newer medical treatment approaches in combination. This study was designed to determine whether topical eflornithine can enhance the efficacy of laser hair removal. DESIGN: This was a randomized, double-blind, placebo-controlled, right-left comparison study of eflornithine cream combined with laser treatment versus laser alone for treating unwanted hair on the upper lip in women. All subjects underwent treatment to the entire upper lip with a long pulse alexandrite laser (10-40 ms pulse duration) at fluences of 7 to 40 J/cm(2). Laser treatments were performed every 4 weeks for up to 6 sessions. Each patient also applied either eflornithine or placebo cream twice daily to each side of the upper lip in a double-blinded manner. Subjects were evaluated for safety by recording adverse events and for efficacy via (1) investigator global scoring, (2) patient self assessment, and (3) hair count analysis. RESULTS: Both treatment modalities were well tolerated by the 31 evaluable patients. All 3 outcome measures showed significantly better results in favor of eflornithine plus laser versus laser treatment alone. At the end of the study, complete or almost complete hair removal was achieved in 29 of 31 (93.5%) of the eflornithine-laser-treated sites versus 21 of 31 (67.9%) for the placebo cream-laser-treated sites (P = .021, McNemar test). Statistically significant differences in favor of eflornithine were likewise demonstrated at the final assessment through blinded patient grading (13/31 patients [41.9%] thought that the eflornithine was superior to placebo, P = .029, Poisson regression) and hair count analysis (P < .01, paired t test). LIMITATIONS: This is a single-center study that did not determine whether the differences noted above last beyond 6 months. CONCLUSIONS: On the basis of both investigator and patient assessments and hair count analysis, we have demonstrated that the addition of eflornithine to laser hair removal results in a more rapid and complete reduction of unwanted facial hair in women when the combination is used for up to 6 months.

PMID: 17270315 [PubMed - indexed for MEDLINE]

Eflornithine cream combined with laser therapy in the management of unwanted facial hair growth in women: a randomized trial.

Smith SR, Piacquadio DJ, Beger B, Littler C.
Dermatol Surg. 2006 Oct;32(10):1237-43.
PMID: 17034372 [PubMed - indexed for MEDLINE]

Eflornithine cream combined with laser therapy in the management of unwanted facial hair growth in women: a randomized trial.Smith SR, Piacquadio DJ, Beger B, Littler C.
Therapeutics, Inc., San Diego, California, USA.

BACKGROUND: Eflornithine cream is approved for the reduction of unwanted facial hair in women. The mechanism of action for eflornithine is reduction in follicular cell growth rate, while laser photoepilation heats hair and adjacent tissues to suspend growth. OBJECTIVE: The objective was to assess the efficacy and safety of eflornithine or vehicle with laser therapy in the treatment of unwanted facial hair in women. METHODS: Subjects were randomized to treatment with eflornithine on one side of the face and vehicle on the contralateral side for 34 weeks. Subjects received Nd:YAG or alexandrite laser therapy to both sides of the face at Weeks 2 and 10. Blinded evaluations included left to right comparisons and appearance relative to baseline. RESULTS: Fifty-four women completed the trial. From Weeks 6 through 22, eflornithine-treated sides showed significant reduction in hair growth. By Week 34, no significant differences were seen. Subject grading showed significant and persistent hair reduction through Week 34 for eflornithine-treated sides. The safety profile for combination therapy is similar to eflornithine alone. CONCLUSION: Eflornithine is safely used in conjunction with laser hair removal treatments and promotes more rapid hair removal when combined with laser treatment. Patients demonstrate a clear preference for treatment with laser and eflornithine.