What is Metformin?
Metformin is a drug that is used in women’s health for polycystic ovarian syndrome (PCOS), problems with excessive facial hair (hirsutism) and is also used for diabetes. Metformin reduces circulating insulin, which decreases the concentration of free levels of androgens. It is most commonly prescribed as an oral dosage form (tablets or solution).
However, unwanted side effects are often seen with taking metformin orally. Nausea, vomiting, gas, bloating, diarrhea, and loss of appetite and can occur in one out of three patients who take it. These side effects cause many patients to discontinue therapy.
Alternative Dosage Form
Topical metformin in a permeation enhancing base may help eliminate those side effects. It must be made by a compounding pharmacy. Topical metformin allows the drug to be absorbed into the body without having to take it orally.
Topiclick METFORMIN dispenser
Topical metformin in a permeation enhancing base may be an effective alternative for those who cannot tolerate taking metformin orally due to side effects, or for those who cannot take large tablets. It must be obtained from a compounding pharmacy and requires a prescription.
If switching from an oral dose to a topical dose in a permeation enhancing base, it is important to reduce the topical dose. Transdermal metformin is typically dosed at only 5-10% of the normal oral dose, and this significantly reduced actual dose has achieved effects that are clinically comparable. Your doctor can speak with the pharmacists at Town & Country Compounding for suggestions. Patients should monitor their blood sugar often, especially when changing dosage forms.
In other words, oral administration often leads to gastrointestinal side effects which causes people to stop taking the drug and stops the progress for their condition.
Transdermal administration may be a way to avoid this and allow the patient to remain on the therapy!
Metformin: Skin Conditions
Metformin is known to improve hyperinsulinemia, therefore it has proven beneficial in hormonal acne and hidradenitis suppurativa, which is a chronic skin condition featuring lumps in places such as the armpits or groin. The skin lesions develop as a result of inflammation and infection of sweat glands. It is also used for acanthosis nigricans, which is a condition characterized by hyperpigmentation of the skin.
Metformin: Excessive Hair Growth (hirsutism) and PCOS
Hirsutism means excessive growth of stiff, pigmented hair (known as “terminal hair”) is often very bothersome for women on the chin, or lip area. The excessive hair growth may be caused by underlying polycystic ovarian syndrome (PCOS) or an unknown cause.
It is well known that metformin reduces circulating androgens, which can decrease the occurrence of excess hair in women, it’s possible that applying metformin topically may inhibit and reduce terminal hair growth.
Studies have shown that hair follicles that are exposed to excessive levels of insulin exhibit a higher growth rate. Conversely, hair follicles maintained in the absence of insulin or at typical levels prematurely entered a catagen-like state.
Metformin is indicated as an off-label drug for polycystic ovarian syndrome because it reduces circulating insulin, which decreases the concentration of free levels of androgens. A few studies have examined the influence of metformin on hirsutism as the primary end point.
Kelly and Gordon—in a 14 month, randomized, double-blind, placebo-controlled crossover trial—demonstrated a modest reduction in hirsutism at the end of treatment.1
Metformin’s antiandrogenic properties allow it to be an adjunct to conventional management of hirsutism associated with polycystic ovarian syndrome (PCOS).2,3
Town & Country Compounding: Metformin Experts
Topical Metformin Formulas
Metformin HCl 10% Lipoderm® has a BUD Study attached to it so it can have a 180 beyond use date.
We have a 10%(100mg/ml) and 20% (200mg/ml) in an anhydrous permeation enhancing base called PermE8® Anhydrous) will have a 180 day beyond use date.
Testosterone /Metformin/Lipoderm Base (Permeation Enhancing)
Metformin/Progesterone/Spironolactone in PermE8 (Permeation Enhancing)
Metformin/Spironolactone/Progesterone in a Topical Gel (for topical use on the face or chin)
Kelly, C. J., & Gordon, D. (2002). The effect of metformin on hirsutism in polycystic ovary syndrome. European Journal of Endocrinology, 147(2), 217-221. Retrieved from http://www.eje-online.org/content/147/2/217.long
Bubna AK. Metformin – For the dermatologist. Indian J Pharmacol. 2016;48(1):4-10. doi:10.4103/0253-7613.174388
Kazerooni T, Dehghan-Kooshkghazi M. Effects of metformin therapy on hyperandrogenism in women with polycystic ovarian syndrome. Gynecol Endocrinol. 2003;17(1):51-56.