Treatment of idiopathic facial hirsutism with medroxyprogesterone acetate iontophoresis

Background Hirsutism is a major psychosocial problem amongst young girls and women. Medroxyprogesterone acetate (MPA) is a progestational agent with antiandrogen effects, and has a role in the treatment of hirsutism, but very little research has been done to utilize this therapeutic effect of the drug. Objective The aim of the present study was to evaluate the safety and efficacy of iontophoretically administered MPA on idiopathic facial hirsutism independent of reduction in serum androgen levels. Patients and methods The study was conducted in Military Hospital Rawalpindi for 2 years. Thirty women aged 18-30 years (mean age 24 years) having idiopathic facial hirsutism between Ferriman Gallwey grade 2-3 were recruited in the trial. 1 ml of 7.5% aqueous solution of MPA was applied iontophoretically twice weekly for 16-weeks. The target areas were right and left cheeks, while the chin was taken as control. The response to treatment was evaluated by the assessment of hair density, thickness of hair, and rate of hair growth at baseline and end of the study. Blood samples were also taken, at baseline and the end of the study, to measure serum testosterone (T) and dehydroepiandrosterone sulphate (DS) levels. Results MPA iontophoresis significantly reduced the hair length, manifesting as reduction in the rate of hair growth, without any significant local side effects or effects on serum androgen levels. Conclusion MPA iontophoresis is a safe, effective and well-tolerated therapy in idiopathic facial hirsutism