Topical Liposomal Rose Bengal for Photodynamic White Hair Removal: Randomized, Controlled, Double-Blind Study

April 2014 | Volume 13 | Issue 4 | Original Article | 436 | Copyright © April 2014


Nevien Samy PhDa and Maha Fadel PhDb

aNational Institute of Laser Enhanced Sciences, Dermatology Unit Cairo University, Cairo, Egypt
bPharmaceutical Technology Unit, Cairo University, Cairo, Egypt

Abstract
BACKGROUND: Blond and white hair removal by laser is a complicated task with weak satisfactory results due to the deficiency in laser-absorbing chromophore.
OBJECTIVE: To investigate if repetitive sessions of photodynamic therapy (PDT) using external application of liposomal Rose bengal (RB) photosensitizer followed by intense pulsed light (IPL) exposure enables removal of gray and white hair.
MATERIALS and METHODS: Rose bengal loaded in liposomes (LRB) was constructed, prepared in hydrogel, and was studied for some pharmaceutical properties. Penetration and selective hair follicle damage in mice skin were studied. Topical gel containing LRB was used for treating fifteen adult females who were complaining of facial white terminal hair. Unwanted facial hair was treated for three sessions at intervals of 4–6 weeks using intense pulsed light (IPL). At each session, the treatment area was pre-treated with topical LRB gel, while a control group of another 15 patients applied placebo gel before IPL treatment. Evaluations included hair regrowth, which was measured 4 weeks after each treatment session and at 6 months follow-up by counting the number of terminal hair compared with baseline pretreatment values. Treatment outcomes and complications if any were also reported.
RESULTS: Average hair regrowth in the LRB group was 56% after 3 treatment cycles. After six-months follow up, average terminal hair count compared with baseline pretreatment showed 40% reduction and no recorded side effects. A significant difference (P<0.05) was seen compared with the control group; the clinical results were promising.
CONCLUSIONS: Photodynamic hair removal using rose bengal-encapsulated liposomal gel in combination with IPL treatment showed significant efficacy in the treatment of white hair compared with a control group.

J Drugs Dermatol. 2014;13(4):436-442.

INTRODUCTION

Laser removal of dark hair can be accomplished with a variety of melanin absorbing chromophore wavelengths. Such light systems include 694-1064 nm laser systems.1
Laser hair removal of blond and white hair was nearly impossible or had disappointing results due to the deficiency in laser energy absorbing chromophore in hair.
Photodynamic therapy as an alternative technique used to target white hair included the use of photosensitizer, such as 5amino-levulinic acid, which also led to targeting of pilosebaceous structures, was carried out.2 Exogenous melanin encapsulated liposomes (Meladyne) also have been studied as introduced target for white, grey, and light blond hair with un-satisfactory results by investigators.3
In the present study, we aimed to evaluate the efficacy of photodynamic therapy using topical application of liposomal RB gel followed by IPL exposure, and its success for removal of white hair.

MATERIALS AND METHODS

Phosphatidylcholine from soy bean (PC), Cholesterol (Chol), Chloroform analar grade, Rose Bengal (RB), and phosphate buffer (PBS) type were purchased from Sigma Chemical Company (St. Louis, MO). Triton X100 was also purchased from Sigma Chemical Company (St. Louis, USA). Gel formulations were prepared from carboxy methyl cellulose CMC (Al Nasr Company ARE). Propyl paraben, methyl paraben of pharmaceutical grade, and USP 25 were purchased from Normest Company for Scientific Development (53-fourth stage, 10th of Ramadan City, Egypt).

Methodology

A mixture of PC and Chol in molar ratios of 1: 0.2 was dissolved in 5 ml chloroform. A thin film formed from the lipids when deposited from the organic solvent using rotary evaporator (type VV2000 Heidolph-Elektso, Germany) under vaccum. Five ml of RB (1 mg/ml) in phosphate buffered saline (PBS) (pH = 7) was added to the dried film in the rotary evaporator above transition temperature (Tc) at 50°C for two hours for complete hydration. To reduce liposomes size liposomal suspension was subjected