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

This randomized controlled trial involving 152 Pakistani women with idiopathic facial hirsutism (IFH) compared the efficacy of intense pulsed light (IPL) combined with a topical agent versus IPL alone over six months. The study found that 89.5% of participants in the combination therapy group achieved a ≥ 1-grade reduction on the modified Ferriman-Gallwey scale at week 24, compared to 69.7% in the IPL alone group, with a significant absolute risk difference of 19.8% (p = 0.003). Additionally, the mean terminal-hair reduction was significantly greater in the combination group (90%) compared to the IPL alone group (59%) (p < 0.001). Both treatments were well-tolerated, with only transient erythema and xerosis reported. The study concludes that adding a topical agent to IPL significantly enhances clinical outcomes and patient satisfaction without increasing toxicity, offering a practical, hormone-free first-line treatment option for South-Asian women seeking effective cosmetic results.