If I let all the hairs on my face grow out, I would have eyebrows that thatch my eyelids down to my lashes. I'd have a noticeable moustache and perhaps a faint unibrow. And there'd be a thick black whisker on my chin, just left of center, like a weed sprouting from the sidewalk. No one has ever seen me in this state and, God willing, no one ever will. This is why my heart leapt with anticipation when I heard about Vaniqa, a new topical cream that promises to retard the growth of unwanted facial hair (hereafter abbreviated UFH). By the way, it's VAN-ik-kah, not veh-NEE-kwah.
Since Vaniqa is dispensed by prescription only, my first step is seeing a doctor. I call a Manhattan dermatologist, Kenneth Howe, who works for a ritzy practice that caters to hairy rich ladies. "It's not very exciting," Dr. Howe says to me, referring to his mild disappointment that Vaniqa slows the regrowth of hair but doesn't itself remove hair or permanently stop hair from coming back. "So, by definition," he says, "it's an adjunct." Dr. H. says that the most common misperception he's been hearing from patients since Vaniqa's debut last October is that the cream acts "like Nair," a depilatory that dissolves the protein structure of hair causing it to break away at the surface of the skin. But he reports that women, even after realizing they'd need to continue their usual hair-removal regimens, still want it. After ascertaining that my UFH was not 1) a hormonal imbalance due to a serious medical condition such as polycystic ovarian disease or 2) a side effect from a drug I may be taking, Dr. H. phones in a prescription for me, and I pick it up mere hours later.
Day 1: Upon unwrapping the pharmaceutical parcel, one understands immediately that Vaniqa is "for women." First of all, the name itself is a dyslexic's version of vagina. Then there's the logo: Two crescent moon shaped blobs—one purple, one mauve—nestled together to form a V-shaped base for a single hair, also purple. And the cream comes in a dainty, white 30-gram tube—slim enough to tuck discreetly into a purse or makeup bag. My tube cost $44.99, and it's supposed to last for 60 days, with two applications per day. Dr. Howe told me that no insurance plan that he's seen covers it because it's considered cosmetic.
On my first try, a big splork of cream comes shooting out of the tube—the cream is somewhat watery and loose. I apply a thin layer to areas I have just plucked clean for the purpose of establishing Vaniqa test sites: my right eyebrow region, the right side of my upper lip and a 1-inch-by-1-inch square area in the middle of my right calf. The left-side counterparts will serve as the control. Vaniqa tingles and whitens as it dries.
Day 6: No noticeable change. So far I'm finding that the most difficult part of my new Vaniqa routine is compliance. I can usually remember to apply the cream in the morning, after I've washed my face but before applying moisturizer. But at night it's easier to forget, and I worry that the expensive cream is coming off on my pillows. I chat with Shena Rozar, a longtime user in San Diego, Calif., for support.
Shena says that she puts on Vaniqa in the morning before makeup, after working out, and then once again at night after washing her face before bed. "Rub it in," she tells me. "Just as you would take seasoning and rub it into meat." Shena's been using Vaniqa religiously for five months and is a big advocate. "I have an enormous amount of hair on my face," says Shena, who's 33. "Beard, moustache and hair on the side of the cheeks. And the hairs are thick, like eyebrows." She noticed a fine moustache at age 17, started waxing at 20 and then, out of desperation, began shaving at 21. Over the years, Shena says she's tried everything from expensive salon treatments and $60 per hour electrolysis sessions, to products advertised via late-night TV infomercials—including EpiStop, a topical gel with claims similar to Vaniqa, and Nad's, a sticky sugar substance that offers a cold alternative to hot wax. None of the solutions worked adequately. As soon as Vaniqa appeared on the market, "I picked it up at my lunch hour, went to the restroom, wiped my face and put it on," she says. Shena reports she now goes eight to nine days between home waxings, instead of three to four days, and that the hairs are easier to remove, finer in texture, and lighter in color. She also credits Vaniqa with ridding her face of what she calls "black mold," the dreaded five o'clock shadow that would show up only a day after she'd wax her face.
I'm suddenly feeling a whole lot better about my own UFH.
Day 8: Vaniqa has not kicked in. My stray eyebrow hairs have come back on both the test side and the control side at approximately the same rate, about 2 millimeters. Ditto for my upper lip. Ditto for my legs. The product literature tells you "Vaniqa is not a quick fix. It takes time for results to become visible, as long as eight week for some." Eight weeks? Good grief. Dr. Ken Washenik, a professor at the NYU School of Medicine, tells me that it's not so much that Vaniqa suddenly kicks in after two months. Rather, it can take a while before the drug's effects become noticeable to you. After that, if you don't see any results, Vaniqa may not work at all. "What that two months tells you is that if you have not improved you're probably not going to," he says, noting that in Vaniqa trials conducted at NYU four out of 10 women never saw any effects. He also warns me that my eyebrows—the part I want to keep—may start to thin out if I continue to use Vaniqa there.
Day 15: I go for a waxing, eyebrow and upper lip, so I can try again, this time with a professionally cleaned slate. I chat up Joanna, my excellent waxer at the Paul Labrecque Salon in New York City. She tells me that 99 percent of the women she's seen in her 18 years of doing salon work have hair on the face that one might consider "unwanted." She recalls only two clients who had completely hairless skin. Five of her current clients wax their entire face, including their cheeks and forehead.
Day 22: It's been exactly one week since my waxing, which left my eyebrow area and upper lip smooth as a mirror. Vaniqa seems to be working now! Here are my raw observations: The left eyebrow, the control side, definitely has more growth than the right side. On the Vaniqa-treated right side, there are only seven regrown hairs that catch the eye, as opposed to 17 on the left side, and the hairs on the Vaniqa side are shorter, too. The upper lip looks hairless to my naked eye. Vaniqa is definitely working, but why have some hairs grown back and others not? Does each individual hair have a different response to the drug?
To find out what's going on at the subcutaneous level, I talk to Barbara Mathes, the director of dermatology clinical research at Bristol-Myers Squibb, the maker of Vaniqa. She explains that the active ingredient, a substance called eflornithine hydrochloride, interferes with an enzyme called ornithine decarboxylase. ODC is a necessary ingredient for the growth of a number of human cells, including hair cells. When this enzyme is blocked by eflornithine, the hair cells continue to grow but at a slower rate. Hair cells, it turns out, have a very high amount of ODC, probably because they are some of the most rapidly proliferating cells in the human body. Vaniqa is applied to the skin, the eflornithine molecules get absorbed and then attach themselves to the ODC enzyme, thus preventing it from converting certain amino acids into the proteins that make up hair cells. You must continually use Vaniqa because the body naturally replenishes ODC in an effort to keep you nice and hairy.
In order to understand why Vaniqa works the way it does, it's important to understand one thing: A hair goes through three phases in its short lifespan. The main phase is its active phase (called anagen) during which cells are being created in the hair bulb and the diameter and length of the hair increases or "grows." Then, the body sends a signal telling this hair that its time is up, at which point the root bulb collapses and the follicle prepares to create a new hair in its place (the catagen phase). The outgoing hair is gradually pushed up to the surface and eventually falls out (also known as telogen). Vaniqa's active ingredient, eflornithine, can only affect a hair during its active growing period (anagen), because ODC, the enzyme that it acts upon, is only present during this time. This crucial bit of information explains a lot.
So, returning to the results of my personal trial, why did some hairs appear while others did not? Answer: These were probably hairs that were in the telogen phase of the growth cycle, no longer growing but still being pushed to the surface through the body's natural evacuation process. Since Vaniqa has no effect on "dead" hairs, they will continue to appear until they all fall out. Dr. Mathes answered another residual question: Can you apply Vaniqa to other hairy parts of the body? Yes, and though it's only been safety tested for the face, she doesn't believe there would be horrible consequences if one did. "People are going to use it where ever they want," she says. "But, for the price, if people want to bathe in it, the biggest side effect they're going to have is poverty."
Day 30: Yep. Vaniqa works. And, after a month of regular usage, I have experienced no side effects except for one: The whisker on my chin continues to grow. But it has been structurally weakened by Vaniqa to the point where I can't pluck it out because it breaks when I grasp it with my tweezers. Very, very annoying.
Conclusion: If you already spend a prince's ransom on hair removal, an investment in Vaniqa, approximately $275 a year, is probably smart since it will save money by reducing the number of waxings or laser treatments you get per year. It may also make sense to have a tube on hand so that even if you only occasionally go in for professional hair removal, as I do, you can extend the benefits for as long as possible. In general, though, Vaniqa is too much work for the average gal. When it comes to doing anything twice a day, brushing my teeth is about all I can manage.