Phototherapy

Phototherapy is an established dermatological treatment that utilizes specific wavelengths of ultraviolet radiation (UVR) to treat inflammatory skin problems such as eczema, psoriasis and vitiligo. UVR is naturally found in sunlight. Phototherapy ensures that only the most effective portion of UVR is used, in a controlled manner, to treat skin diseases. This is not the same as going into the sun, because sunlight contains a broad range of UVR, most of which are less effective and may be harmful to the skin. When used correctly, phototherapy can be a very safe treatment option. Because it does not entail taking any oral medications or injections, phototherapy can be used in most people, including people with co-morbidities (such as liver or kidney problems) where they are unable to take medications, and pregnant women.

There are a few types of phototherapy eg. UVB, psoralen-UVA, combined UVB/UVA. At TSN Dermatology, we offer narrowband UVB, which is the form that combines both good efficacy and safety.

In phototherapy, specific wavelengths of ultraviolet radiation are chosen that are absorbed by immune cells in the skin. This suppresses the abnormally active immune cells that are causing inflammation and rash on the skin. The result is reduced inflammation, and resolution of the symptoms of inflammation including redness, itch, flakiness and abnormal thickening of the skin.

The most common form of phototherapy utilizes the full-body cabin unit. The cabin is full height and completely surrounds an individual standing within, so that ultraviolet light will cover all parts of the skin. During treatment, the patient removes all his or her clothing except for coverings to protect the face, eyes and genitals. Each treatment session lasts between less than a minute to a few minutes. This allows patients to have treatment either during lunch break, early in the morning before going into the office, or in the late afternoon after work. Phototherapy should be performed 2 to 3 times a week on a regular basis to get the maximum benefit. Once the skin problem is under control, the frequency of treatment can be gradually reduced to once a week or fortnight to keep the disease in remission.

Phototherapy is generally a safe form of treatment. The ultraviolet light is fully absorbed by the skin, so there is no concern about it affecting the internal organs such as the liver or kidneys. Dryness of the skin, sensation of warmth and redness are some of the more common side effects. These are usually temporary and can be alleviated by taking a cold shower upon reaching home and applying moisturizers. Sunburn-like reactions occur rarely. Patients may develop a tan after multiple treatment sessions. Skin aging is a possibility, and patients should avoid excessive sun exposure when undergoing phototherapy. There is a small risk of skin cancers, usually only seen after many years of continuous treatment and associated with older forms of phototherapy such as PUVA (psoralen-UVA). Short-term treatment, which is usual for most skin problems, brings minimal risk.