Topical Metformin

What is topical metformin?

A cream especially formulated by a compounding pharmacy using crushed metformin tablets. Metformin is traditionally taken orally as the 1st-line treatment for type II diabetes

What can topical metformin be used to treat?

Skin Conditions

• Melasma – “sunspots” often associated with pregnancy and/or UV-ray exposure
• Acanthosis Nigricans – darkening & toughening of the skin often due to diabetes

Unwanted Hair Growth

• Hirsutism – typically in females; coarse hair development on face, chest, or back
• Usually secondary to PCOS

Type II Diabetes

• Topical metformin bypasses gastric metabolism to avoid symptoms of nausea/upset stomach from the oral tablet dosage form of metformin.

Can metformin be absorbed through the skin?

This topical medication, usually applied to the inside of the wrist or thigh, pushes Metformin into the body through the skin where it absorbed into the bloodstream. The process bypasses the gastrointestinal tract altogether.

How does metformin work for hair growth?

It works by activating the enzyme AMP kinase, which increases insulin sensitivity and thereby decreases the circulation of male sex hormones called androgens. Androgens are known to cause an increase in hair growth. A decrease in androgens will decrease unwanted hair growth in females.

Is topical metformin effective?

YES! Topical metformin in a permeation enhancing base is theorized to be an effective replacement for oral therapy AND a unique dosage form to especially treat debilitating skin conditions and unwanted hair growth. Ask a specialty compounding pharmacy if they can formulate topical metformin today!

Zach Atkinson, Pharm D Candidate

Marshall University School of Pharmacy

Class of 2022

References:

1. Banavase Channakeshavaiah R, Andanooru Chandrappa NK. Topical metformin in the treatment of melasma: A preliminary clinical trial. J Cosmet Dermatol. 2020;19(5):1161-1164. doi:10.1111/jocd.13145
2. Dessinioti C, Dreno B. Acne treatments: future trajectories. Clin Exp Dermatol. 2020;45(8):955-961. doi:10.1111/ced.14239
3. Qing L, Fu J, Wu P, Zhou Z, Yu F, Tang J. Metformin induces the M2 macrophage polarization to accelerate the wound healing via regulating AMPK/mTOR/NLRP3 inflammasome singling pathway. Am J Transl Res. 2019;11(2):655-668. Published 2019 Feb 15.
4. Rostamkalaei SS, Akbari J, Saeedi M, Morteza-Semnani K, Nokhodchi A. Topical gel of Metformin solid lipid nanoparticles: A hopeful promise as a dermal delivery system. Colloids Surf B Biointerfaces. 2019;175:150-157. doi:10.1016/j.colsurfb.2018.11.072
5. Rostamkalaei SS, Akbari J, Saeedi M, Morteza-Semnani K, Nokhodchi A. Topical gel of Metformin solid lipid nanoparticles: A hopeful promise as a dermal delivery system. Colloids Surf B Biointerfaces. 2019;175:150-157. doi:10.1016/j.colsurfb.2018.11.072