A couple of weeks ago I saw an offer on the online deal site Yazoom for a 12 month supply of tattoo removal cream (Lazer Cream) for $130. While there is the usual ‘*Results may vary’ disclaimer, the photos look pretty impressive. While I don’t actually have any tattoos, the only method for removing them I have ever heard of involves lasers* so I was curious. Now what follows is a rather lengthy and twisty tale but bear with me.

On visiting the company’s (what looked like Australian) website, I found a section where they listed the cream’s ingredients. The main ‘fading’ ingredient was listed as ‘Zyalight’. Riiiight. What’s that then, I wondered? Googling it sent me to a press release from 2000 about “a major breakthrough in skin lightening technology… development of Zyalight, a completely natural lightening ingredient” by a company called Zylepsis, which it turns out went under in 2003. So a dead end.

I also saw a section called ‘Study’ where they described the results of unpublished clinical trials on their product. Below is a screenshot of that section. It’s worth having a quick skim read through.

Now I’ve just finished reading Ben Goldacre’s book Bad Pharma (read it), so I was very excited to see the website list the numbers of the clinical trials:

Two main randomised, double blind, multicentre vehicle controlled studies (DE140-001 and -002) with 282 participants and two open-label studies (DE140-010 and -011) with 310 participants

So I googled the trial numbers and found…. an information leaflet (pdf) from the UK Medicines Information Service for a prescription medicine called eflornithine. Eflornithine cream (sold as Vaniqa) was launched over 10 years ago to reduce the growth of unwanted facial hair in women. That is, for hirsutism**. It acts on a specific enzyme involved in hair growth. So while a cream, it has nothing to do with tattoos. This is what it says about the clinical trials:

The efficacy of eflornithine has been demonstrated in a number of trials, none of which have been fully published….After reviewing the trials submitted for licensing purposes, the EMEA concluded that the data demonstrated that eflornithine cream improves symptoms of hirsutism, reduces darkening appearance of facial skin, and reduces psychological discomfort with the condition.

The two main randomised, double blind, multicentre vehicle controlled studies (DE140-001 and –002) involved a total of 596 women who had facial hirsutism that required removal at least twice a week. The subjects applied (in a ratio of 2:1) either eflornithine 15% or a vehicle-cream twice a day for 24 weeks, and were followed for 8 weeks when they received no treatment. The primary efficacy measure was a four point Physicians Global Assessment (PGA) of improvement or worsening of the condition compared to baseline. Secondary efficacy measures were a self assessment questionnaire and video analysis of reduction in hair growth and spatial mass.

Statistically significant improvements in facial hair growth were seen after week 4 (001 study) and week 8 (002 study) in favour of eflornithine based on PGA. The differences became clinically significant at week 16 (001 study) and week 24 (002 study). At 24 weeks, at least 70% of subjects using eflornithine had at least some improvements in their condition, compared to 41% using the vehicle….

Two open-label studies (DE140-010 and –011) evaluated the use of eflornithine in 970 women who removed hair at least twice a week from their upper lip and chin.6 Study 010 was a 12-month study: 18% of subjects were rated clinical successes after 20 weeks of treatment, rising to 24%.

Now that sounds familiar. Almost cut and paste familiar. At first i just wondered if the trial quoted for the tattoo removal cream was a sub trial of the eflornithine trial – perhaps some tattooed women were part of the original trial and noticed their tattoos fading during the trial. But I can’t find any mention of tattoo fading in any of the leaflets for eflornithine/Vaniqa and I’m sure it would be listed as a potential side effect if it was a possibility.

So is it all a scam? Is there no such thing as a cream that can remove tattoos? I went to PubMed to search for any academic publications and actually did find something. A drug called imiquimod. Imiquimod is approved for treating certain skin cancers and genital warts, but it looks like it also being tested in conjunction with laser treatment for tattoo removal. It’s not yet clear exactly how imiquimod works, except that it activates the immune system, and some pretty nasty side effects have been reported, including itching, irritation, pain, ulcerations, weeping sores, flaking skin and scabbing as well as fatigue, nausea and fever.

In the meantime though, Lazer Creams original website (tattooremovalcream.com.au) is now redirecting to a single page site which, while still about Lazer Cream, has no contact info. Looks like someone is on to them! According to Yazoom’s site, 21 people paid the $130 for their years supply of cream. I’d be interested to know how they get on.

*Well, unless you count the people who resort to using trichloroacetic acid.

**As an interesting aside, according to wikipedia, eflornithine was initially developed to treat cancer but instead was found to be very effective at reducing hair growth (when given topically as a cream), as well as killing the parasites that cause West African sleeping sickness, Trypanosoma brucei gambiense (when given intravenously). The drug was registered for the treatment of gambiense sleeping sickness in November 1990 but Aventis stopped producing the drug in 1995 because it wasn’t profitable. It wasn’t until 2001, when eflornathine began to be marketed for hirsutism, that Aventis bowed to international pressure and formed a partnership with the WHO to begin producing the intravenous form again to treat sleeping sickness.