الفهرس 
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Abstract
Hirsutism is defined as excessive terminal hair growth in women with a typical male pattern distribution e, g. face, chest and areolae. A condition which may be associated with other signs of hormonal imbalance or presented as being idiopathic. It may affect up to 10 ٪ in most populations and is usually associated with severe psychological disorders. The diagnosis of hirsutism is mainly clinical. However some investigations may be needed to exclude possible endocrinal causes of hirsutism. General lines of treatment of hirsutism include weight loss, psychological support. Pharmacological treatment may include OCP, progestins, metformin ,GnRH, finasteride, spironolactone, cyproterone acetate, flutamide and cimetidine. Topical treatment of hirsutism may include topical eflornithine which reduces the rate of hair growth and topical fluridil which is a topical antiandrogen. Cosmetic treatment of hirsutism includes temporary methods such as waxing, sugaring, threading, bleaching and depilation; and permanent methods such as electrolysis and laser. Laser hair removal depends on the theory of selective photothermolysis, a theory which is based on the presence of chromophore (melanin). White and vellus hair are resistant to laser therapy because of lack of the absorbing chromophore. Photodynamic therapy is a treatment modality which depends on three factors: light, PS and oxygen. ROS produced from this process cause damage to various cell membranes with subsequent cellular damage. Drug delivery of the photosensitizer should enable it to selectively target the diseased site without any damage to the surrounding tissues. Liposomes are microscopic vesicles that can incorporate several drugs and work as drug carriers. They are characterized by being biodegradable, having low toxicity and can encapsulate hydrophilic substances. RB is a xanthine photosensitizer which when activated by appropriate light can induce long lasting and time related cell death. LEDs are semiconductors which emitt non coherent wavelength. They are widely used in photodynamic therapy because of being athermal, atraumatic, cheap and available. The aim of the present study was to evaluate topical targeted delivery carrier for the photosensitizer in photodynamic therapy for the treatment of hirsutism. The study is subdivided into animal study and human study. The animal study is responsible for the characterization of the topical used formulae on animals. 2 formulae were prepared: free RB and liposomal RB gel (0.01٪). Prepared formulae were applied on the back of albino mice and biopsies were taken after 0, 15, 30, 45 and 60 minutes of exposure. Free RB gel was proved to cause superficial ulcers and burns in the skin as proved by fluorescent and light microscopy. Liposomal RB selectively target the pilosebaceous unit with excellent deep penetration into the hair follicle and no damage to the skin superficially. hirsute females were included in the study. 20 cases were having black and white hair and 10 patients were having black hair only. Patients had taken 4 sessions 3 weeks apart and a follow up was done 6 months later. Hair count, hair thining, rate of hair regrowth and possible complications were reported. Patients were instructed not to remove hair in between sessions, and to apply sun block in between session. In our study, hair was counted using dermoscope and patients were photographed before each session. Immediately before session, hair was removed using manual tweezers. The prepared 0.01٪ liposomal RB gel was gently applied to the skin. The skin was wrapped with plastic cover and foel thereafter. The gel was left for 1 hour and then the session was done. We had used 80 mW light emitting diode at 530 nm wavelength and energy 4.8 J/Cm to every treatment point for 8 minutes for 4 sessions three weeks apart. For black hair, a 49.3٪ mean decrease of hair count was achieved after 3 months of therapy and 47٪ mean decrease after 9 months of treatment. 56.7٪ of cases had reported marked improvement, while 40٪ of cases reported moderate improvement and only one case (3.3٪) reported mild improvement after 9 months of treatment. There is higher mean days of growth delay of hair after 3 months and 9 months of therapy that is highly significant. White hair analysis revealed 36.1٪ mean decrease of hair count number after 3 months of treatment and 39.6٪ mean decrease of hair count after 9 months and there was significant difference between both means after 3 months and after 9 months. 35٪ of cases with white hair reported marked improvement, whereas 40٪ of cases reported having moderate improvement and 25٪ of cases reported having mild improvement at 9 months of treatment. There is a higher mean days of growth delay of hair after 3 months and 9 months of treatment and the difference is highly significant statistically. There is a higher mean days in regrowth after 9 months (17.1) days compared to 14.7 days after 3 months of treatment and the difference is highly significant statistically. The poor results of white hair in relation to black ones may be related to poor results of white hair in general and not to PDT as reduced melanin content should not affect the PDT effectiveness.