A treatment method in which UV light at specific wavelengths is delivered to the skin via a cabin or local device. It is used for conditions such as psoriasis, vitiligo, and eczema.
Indication
- Moderate to severe plaque-type psoriasis
- Generalized vitiligo and non-segmental pigmentation disorders
- Atopic dermatitis unresponsive to topical therapy
- Early stages of cutaneous T-cell lymphoma such as mycosis fungoides
- Controlled prophylactic treatment for polymorphic light eruption
- Generalized pruritic dermatoses (e.g., uremic, cholestatic itch)
Preparation
- Review of the current medication list (with attention to drugs that can cause photosensitivity)
- Detailed skin examination before treatment and questioning of any skin cancer history
- Use of UV-protective goggles during treatment
- Covering of the testicles in men and the nipples in women
- No cosmetics or perfume on the face or exposed areas on the day of treatment
How it's performed
- Narrowband UVB (NB-UVB, 311 nm) is the most commonly used method
- In PUVA therapy, psoralen is taken first, followed by UVA exposure
- The patient is positioned in a full-body cabin or under a local device
- The starting dose is determined according to skin type (Fitzpatrick I-VI)
- Sessions are scheduled 2-3 times per week, with the dose increased gradually
- Each session lasts a few minutes; a course usually involves 20-40 sessions
Post-procedure
- Treatment response is evaluated within 6-12 weeks
- Once a response is achieved, session frequency is gradually reduced
- Annual full-body skin examinations are performed for long-term skin cancer screening
- Use of moisturizer is continued to manage dryness
- Additional sun protection is recommended throughout the treatment period
Risks
- Mild erythema, dryness, and transient itching (the most expected side effects)
- Burn-like reactions (in cases of overdose)
- Risk of premature skin aging and skin cancer related to long-term cumulative UV exposure (especially with PUVA)
- Nausea with PUVA, and risk of cataracts if eye protection is neglected
- Flare-ups of pre-existing herpes simplex infection
FAQ
How is it different from a tanning bed?
A tanning bed delivers broad-spectrum UV for cosmetic tanning and is not a treatment. Phototherapy is delivered under physician supervision at the wavelength and dose specific to the disease.
How many sessions are needed to see results in psoriasis?
Significant improvement is generally seen after 20-30 sessions. The response varies depending on the individual, disease severity, and skin type.
Does phototherapy cause skin cancer?
Skin cancer risk may rise as cumulative dose increases, especially with PUVA. The risk is lower with NB-UVB, but annual skin examinations are still required.
Can it be used during pregnancy?
NB-UVB may be considered an appropriate option during pregnancy. PUVA is not recommended in pregnancy. The decision must be made on an individual basis by the physician.
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