43.    Assessment of safety and efficacy of topical photodynamic therapy using 20% 5-ALA on excessive hair.
Jibu Varghese, Alex Anstey, S Varma, N Nicolau, University of Wales College of Medicine, Cardiff, UK.

The aim of this study was to examine the safety and efficacy of topical 5-ALA PDT on hirsutism. To achieve this thirteen (13) subjects were recruited in a single blind study; nine were healthy volunteers and four were hirsute patients. Two matching test areas measuring 4cmsq of normal hair was selected on the forearm in healthy volunteers. However in patients with hirsuitism two areas of excessive hair measuring 4cmsq was selected. In both the patients and healthy volunteers one of selected area was treated with 20% topical 5-ALA and other area with placebo cream. Hair counting using a video microscope was carried out before and after treatment in both the treated areas. Treated areas were also photographed in a standardised manner before and after treatment. One area of excessive hair was treated with PDT using topical 5-ALA and other sites were treated with topical placebo cream. Subjects treated with 5-ALA sites showed a mean hair loss of 44+/-25 by week one compared with the control sites 16+/-16.This difference was statistically significant (p=0.003).The mean hair loss in the treated site by week four was 57%+/-20 in comparison the placebo site showed a mean hair loss of29+/-22.This difference failed to reach statistical significance (p=0.06). Erythema and pain as assessed by a clinical scoring grade (0-3) according to severity was experienced by all the subjects on the day of treatment but improved by week one and totally disappeared by week four on both the treated site and placebo site. We have concluded that topical PDT using 20% 5-ALA is an effective and cheap therapeutic option for patients with hirsutism. As side effects associated with the treatment are tolerable and reversible, PDT also appears suitable for treatment of larger areas of excessive hair.