Phototherapy for Skin Conditions

Phototherapy— sometimes called UV light therapy—is the use of ultraviolet light in the treatment of various skin conditions. Generally, the exposure is under medical surveillance, mostly with lasers, lamps, or LEDs. Sometimes, topical drugs are given with the aim of increasing UV sensitivity.

This treatment is safe for all ages and commonly used for conditions like psoriasis, eczema, and even newborn jaundice. This article aims to explain to you the types of UV light therapy that benefit from it, the side effects incurred from the therapies, and safety measures you need to take when carrying out the therapy.

What is Phototherapy?

Phototherapy is the kind of light treatment that applies ultraviolet lights to the skin for medical treatment. The goal of phototherapy is to use the therapeutic characteristics of light with a view of promoting health and well-being. It’s a common treatment for various medical conditions, utilizing different light sources to improve health.

It also helps with skin problems such as psoriasis, eczema, and vitiligo among children and adults. [1] This kind of therapy is usually done in a medical setting under the watch of a medical practitioner.

What is Ultraviolet (UV) Light?

Ultraviolet (UV) light is a form of radiation emitted by the sun, which spreads the Earth. It’s part of the electromagnetic spectrum and comes in different forms. UV radiation occupies the spectrum between visible light and X-rays. [2] The sun emits UV light – important for health – the same type used in phototherapy.

There are three classifications of UV wavelengths: UVA, UVB, and UVC. UVC has the shortest rays and is mostly blocked by the ozone layer. However, both UVA and UVB can penetrate the atmosphere. UV light aids in producing vitamin D, which is crucial for survival.

To provide best efficiency of producing vitamin D and to cure some skin diseases perfectly – best way is usage of UV light  phototherapy units. During phototherapy, your provider adjusts the intensity and exposure time of the light to prevent skin damage.

How Does Phototherapy Work?

Phototherapy, or light therapy, exposes the skin to specific light wavelengths (UVA and UVB) to treat various skin conditions. UV light affects the immune system by reducing the inflammatory cells in the skin, known as T-cell lymphocytes. [3] With fewer of these cells, inflammation decreases, leading to symptom improvement.

Treatment involves regular sessions, typically 2-3 times a week for 12-16 weeks. [4] Sessions start short and gradually increase to around 15 minutes based on individual tolerance. Over several weeks, itching reduces, and eczema clears. Treatment continues until the skin is nearly clear and itching improves.

Types of Ultraviolet Light

There are various types of ultraviolet (UV) light used in medical treatments, each with its unique characteristics:

UVB:

What is a UVB Light?

UVB light has a short wavelength that reaches the skin’s top layer, suppressing DNA synthesis and reducing inflammation.

• Narrow-band UVB (NB-UVB) uses a specific range of wavelengths (311–312 nm) and typically involves two to three sessions per week, with maintenance treatment weekly for symptom improvement. [5] It can also be performed at home, but narrowband UVB light therapy at home requires proper equipment and medical supervision.
• Similarly, broad-band UVB (BB-UVB) treats a broader ultraviolet wavelength spectrum (from 270 to 350 nm), with the treatment times ranging from three to five times in a week. However, there is reduced efficiency with BB-UVB because exposure and treatment times are relatively short.

What is a UVB Light Used For?

This UVB light, therefore, takes part in various medical applications, such as in phototherapy, the production of vitamin D, and in treating skin ailments, including eczema, psoriasis, vitiligo, and some types of dermatitis. But still, for people with such problems as psoriasis, one of the ways is recommended by a dermatologist for treatment.

UVA:

UVA light therapy has an extended wavelength that penetrates the skin’s middle layer, reducing cell turnover and having an immunosuppressive effect. [6]

UVA1 therapy uses wavelengths ranging from 340–400 nm and treats conditions like eczema and cutaneous T-cell lymphoma (CTCL).

PUVA:

Psoralen ultraviolet-A (PUVA) combines UVA light with a plant-derived chemical called psoralen, making the skin more light-sensitive. [7]

PUVA therapy treats various skin conditions, including vitiligo, psoriasis, and CTCL. However, it carries a higher risk of squamous cell carcinoma, a type of skin cancer, particularly with over 350 doses. Experts recommend limiting doses to fewer than 150 to minimize risks. [8]

Different Colors of Phototherapy Lights

Various types of phototherapy lights are used to treat different conditions, each emitting a different color light:

• Blue light therapy: Utilizes blue LED lights, similar to those in cell phones, which emit a blue hue. This type of light, such as neoBLUE®, is commonly used to treat jaundice [15,16].
• Red light therapy: Involves red LED lights or laser lights with a red hue. It’s commonly used to address redness, wrinkles, acne, and scars. [9]

What Medical Conditions Can Phototherapy Treat?

Phototherapy is a versatile treatment that can help with various medical conditions, such as:

• Psoriasis: This is an increased growth of skin cells because the body’s immune system targets the tissues for destruction. It has by far the most common use in phototherapy. [10]
• Chronic eczema: it is a long-term or chronic inflammatory skin problem known as atopic dermatitis. Phototherapy could be very effective if other treatments are unhelpful.
• Vitiligo: In this autoimmune condition, some parts of the skin lose pigments. If topical treatments are proved to be ineffective, then it can take ultraviolet light therapy into account.
• Mood Disorders: Light treatment is a therapy for mood disorders such as seasonal affective disorder (SAD) and other forms of depressive syndromes. It works in the regulation of improved circadian rhythm, which further enhances an individual’s mood.
• Jaundice in Newborns: Babies who are born and exhibit signs of jaundice from high levels of bilirubin have it washed away using special blue light lamps through phototherapy. [11]
• Cancer Therapy: Phototherapy can also be part of the treatment for some cancers, like photodynamic therapy (PDT), where the cancer cells are treated and destroyed by using a photosensitive agent in the cancer cells at targeted light wavelengths.

Who Can Receive Phototherapy?

A healthcare provider can recommend phototherapy as a treatment for various diagnoses. Different individuals can benefit from phototherapy, depending on their specific conditions. It’s suitable for both children and adults. Here’s who it can help:

• Newborns with jaundice
• Patients with inflammatory skin conditions like psoriasis and eczema
• People with mood disorders like SAD or depression
• Cancer patients

Safety and Effectiveness of Phototherapy

The safety and effectiveness of phototherapy are generally high. In a 2021 review, according to multiple studies, UVB treatment reduced eczema symptoms by 60% in children. [12] Another study in children with eczema revealed that after phototherapy, 76% achieved clear or nearly clear skin, with 53% maintaining clear skin at their 12-month follow-up. [13]

Mild psoriasis is best treated by phototherapy, either alone or in combination with other treatments. Moderate and severe levels of psoriasis are best treated with combinations of phototherapy and other therapies, including biologics.

Phototherapy risks being brought up to some people who suffer from particular medical conditions. It may be not recommended if:

• You have a sun allergy.
• You’re pregnant or nursing.
• You have liver disease.
• You have lupus.
• You have a genetic disease like xeroderma pigmentosa, which increases sun sensitivity.
• You’re taking medication that increases sun sensitivity.

Phototherapy Procedure Details

What Happens Before a Phototherapy Procedure?

Before the treatment, your healthcare provider from the hospital or treatment facility that gives the phototherapy will make some arrangements. Protective eyewear for the eyes will be provided, and depending on the area being treated, a face shield or a special blanket may also be provided.

You will be supplied with sunscreen to be applied on the skin prior to the procedure, given the treatment in some specific places, because the skin should not already have any sunscreen. Your provider will give instructions on where and how to apply the sunscreen. Depending on the treatment area, you may be required to remove some or all of your clothing.

What Happens During a Phototherapy Procedure?

During phototherapy, a dermatologist administers the treatment in a doctor’s office or specialty clinic. The procedure varies depending on the prescribed type of phototherapy, your specific condition, and the location of affected areas. For whole-body phototherapy, you’ll wear UV-filtering goggles and may need to cover your face and genitals. Before the session, you might be advised to avoid moisturizer, perfume, and cologne.

Phototherapy methods include:

• Using a whole-body chamber
• Using a whole-body panel
• Using a handheld wand
• Using a tabletop lamp
• Using a smaller panel (for hands and feet)
• Using a specialized blue light blanket for newborns

Your initial dose and exposure duration are determined based on your skin type, with gradual increases guided by your doctor during treatment. Some individuals may undergo UVB light therapy at home, following instructions to spend a specific time under the artificial light from the device.

What Happens After Phototherapy?

After phototherapy, you can reduce side effects by taking care of your skin. This may involve:

• Applying moisturizer daily to prevent dry skin.
• Using sunscreen on treated areas or wearing protective clothing when outdoors.
• Using mild soap for cleansing.
• Wearing eye protection when outside.
• Avoiding sun exposure and tanning beds to prevent burns.
• Avoiding hot water in showers and limiting showers to once a day.

How Long Does a Phototherapy Procedure Take?

The time the phototherapy will last depends on the size of the area to be treated and the strength of the ultraviolet light. In first sessions, it can be short, not lasting more than seconds, but in further sessions, it can last up to minutes if it is UVB light treatment, or approximately an hour if it is UVA. Treatment time and total number of sessions required will vary depending on the condition and individual skin response. Your provider will tailor a treatment plan for you.

Risks / Benefits

Benefits of Phototherapy

• Non-invasive treatment method.
• Reduces inflammation in the skin.
• Minimizes itchiness.
• There are side effects compared to some other treatments.
• Prevents flare-ups of symptoms for conditions like psoriasis and eczema.
• Suitable for various age groups and conditions.

Risks of Phototherapy

Phototherapy is generally safe, but it can lead to some temporary side effects. [14] These side effects are usually mild and may include:

• Skin irritation
• Skin dryness
• Redness
• Itching
• Headache
• Increased risk of skin damage
• Eye damage
• Burns or blisters, similar to sunburn
• Photosensitivity reactions
• Tenderness
• Nausea if taking psoralen

What is the recovery time for a phototherapy procedure?

After phototherapy, one can resume their normal activities immediately. Improvement in your skin may take many sessions, usually 6 to 25 treatments. Your provider will advise protecting the skin from further exposure to ultraviolet rays, most especially the sun. Temporary redness or darkening of the skin in the treated areas may occur, usually resolving within 24 hours. If anyone feels constant burning for too long, he should get in touch with his provider.

When to Call the Doctor

Reach out to your healthcare provider if:

• You develop flu-like symptoms like nausea, vomiting, chills, or fever after the treatment.
• You feel a burning sensation on your skin persisting beyond 24 hours post-treatment.
• Your skin forms blisters.
• You experience vision issues that were not present before treatment.
• You encounter any unexpected or concerning symptoms.
• Your condition worsens or does not improve with treatment.
• You have questions or uncertainties regarding your treatment or recovery process.

Summary

Ultraviolet phototherapy is one of the common modalities in dermatology treatment for many diseases. These include eczema, psoriasis, and vitiligo. It is also used in the treatment of mood disorders, newborn jaundice, and sleep disorders. In other instances, it is used in treating and managing some cancers using natural or conventional methods.

While some therapy can be done at home, it’s crucial to have medical supervision. The treating physician can easily guide you into the number of sessions a person has to undergo for a particular ailment. The recovery period for seeing improvements is, however, different based on the condition and the type of therapy being administered.

If you’re dealing with skin concerns or curious about phototherapy, simply fill out our form at UVTreat. We’ll assist you in understanding your skin issues, potential treatments, and whether light therapy is suitable for you.