Types of Ultraviolet Light Therapy

Ultraviolet light therapy has been proven to help patients with skin conditions like psoriasis, vitiligo, and acne vulgaris, among others. It works very well on dermal conditions that affect large sections of the body or when conventional medications and ointments are not effective. Your dermatologist will likely recommend one of three kinds of phototherapy as ultraviolet light therapy is also called. The number of sessions you need and length of treatment will depend on the severity of the skin issue you have and how well your body responds to the effects of the UV light.

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Three Categories of Ultraviolet Light Therapy

Ultraviolet light therapy can be of two main kinds that depend on the specific wavelength of light that is chosen for the treatment. Accordingly, you have

  • UVB light therapy
  • UVA light therapy
  • PUVA: Your doctor may prescribe topical ointments to apply or oral medications to take just before your UVA therapy. These agents help to enhance the effects of the treatment. This form of ultraviolet light therapy is called PUVA or Psoralen Ultraviolet A therapy.

UVB Therapy

UVB Therapy is typically used to help patients with skin conditions like psoriasis. It uses a wider range of light wavelengths and has the potential to kill the abnormal growth of cells. This growth occurs when the body’s immune system starts attacking the skin cells. As a result, you sense the symptoms of psoriasis such as itching, skin flaking, redness and sometimes, lesions. Here’s everything you need to know about UVB therapy:

  • The strength of the therapeutic doses depends on your skin color. Lighter-skinned people begin treatment with a somewhat weaker dose while darker-skinned people may need a stronger initial dosage for the therapy to work.
  • Your dermatologist will likely test the treatment on a smaller section of your skin to assess its effects before working on larger sections.
  • In the initial sessions, you’ll receive light exposure for around 30 to 60 seconds until the skin turns slightly pink. Over subsequent sessions, you’ll notice that the skin takes longer to show a change in color. Accordingly, your doctor will increase the time for which you take the treatment.
  • You may be asked to come in several times each week until your skin has healed completely. In most cases, patients need 3 to 5 sessions per week over 5 weeks.
  • Typically, patients need around 18 to 30 sessions before they can see significant improvement.
  • UVB therapy is usually given in a light box that resembles a phone booth or in a tanning bed-like booth. Hand-held devices may be used for smaller sections.

How UVB Therapy is Given

Your dermatologist may recommend that you try therapies like:

  • Goeckerman System: Before you step into the light box, coal tar is applied on the skin. This tar acts like a photosensitizing agent that reacts to the UVB light rays and helps to control the growth of the abnormal cells. This system is used to manage moderate to severe levels of psoriasis. If you cannot tolerate the smell, your doctor may choose to use other emollients like petroleum jelly in its place.
  • Ingram System: This form of UVB therapy involves the application of anthralin, mineral oil, or tar products on the skin before the UV session.
  • Oral medications: Doctors may choose to prescribe oral medications like methotrexate, vitamin A derivatives called retinoids like bexarotene (Targretin). These medications also help enhance the effects of the therapy.
  • Laser therapy: In place of the light box as a source of UV rays, doctors use 308-nm excimer lasers. These devices use a particular combination of gases to deliver high-intensity UV light in short pulses.
  • Narrow-band (NB-UVB) is a new form in use today.

UVA Treatments

Depending on the severity of the patient’s symptoms, dermatologists may also prescribe UVA therapy. Here’s what you need to know:

  • UVA rays can pass through the deeper layers of the skin.
  • Each patient is typically given sessions of 20 minutes at a time.
  • A higher dosage of the therapy can help heal lesions.
  • UVA treatments are typically combined with oral medications like psoralens by way of PUVA. However, if you’re taking the medication, exposure to the UVA light is reduced to 2 minutes.

PUVA treatment

Psoralens are medications that can boost the skin’s sensitivity to UVA rays. Doctors use them to provide PUVA therapy to patients with many skin conditions like eczema, vitiligo, psoriasis and cutaneous T-cell lymphoma (CTCL), among others. Psoralen agents can be applied on the skin or taken orally. Here’s everything you need to know about the therapy:

  • The dosage of PUVA treatment depends on your skin type. Doctors test a small area of your skin before proceeding to work on larger areas.
  • A minimum dosage should produce a reaction of uniform redness 72 hours after the therapy. This dosage is called the minimum phototoxic dose (MPD) and is considered the initial point of starting the therapy.
  • If you cannot tolerate taking the psoralens orally, you can opt to apply them on the skin.
  • Psoralen agents are taken orally with water or milk 1 to 2 hours before starting the UVA session.
  • Psoralen agents can have side effects like nausea and taking PUVA over long periods can raise the risk of skin cancer. This factor is especially true for patients with fair skin. For this reason, PUVA therapy is only used on patients that have a very severe case of psoriasis.
  • PUVA sessions are typically given 2 to 3 times a week for about 16 to 18 weeks.
  • It is essential that you take PUVA treatment under the careful supervision of an expert dermatologist and that you follow all directions and precautions completely.
  • If you are taking PUVA therapy, you must take utmost precautions to protect yourself from sun exposure and UV rays of all kinds. You must also avoid using scented products that can irritate the skin.
  • PUVA has several contraindications. Make sure to discuss the treatment in detail with your doctors before opting for it.

Research Conducted into the Effectiveness of Ultraviolet Light Therapy

Ultraviolet light therapy has been proven to help patients with skin conditions. Here are the results of a few studies:

  • The Archives of Dermatology have records of a 2006 study that showed that patients that had chronic plaque psoriasis were given UV therapy. The patients taking PUVA showed an 85% improvement in their symptoms while those receiving NB-UVB showed a 65% improvement.
  • In a medical facility in The Netherlands, a study was conducted on a group of 196 patients with psoriasis. They were given treatments of Ultraviolet B phototherapy using Ultraviolet B lamps. Some were treated at home while others received at home. At the end of one year, all the patients showed a marked improvement in their symptoms. This study shows that patients can conveniently take the treatment in the comfort of their homes at more economical costs.
  • A study was conducted on 95 patients with plaque-like psoriasis. They were given NBUVB phototherapy three times a week for 6 months. All of the patients showed a better quality of life. They noticed that not only did the severity of their symptoms lessen but the area affected by psoriasis also decreased.
Ultraviolet light therapy for skin conditions is only one of the many applications for treatment. The World Health Organization reports that sunbathing and getting adequate sun exposure can ensure adequate levels of Vitamin D in the body that can promote stronger bones. While getting light therapy is beneficial for dealing with skin problems, an excess of exposure can also lead to adverse effects. People must use exposure to UV rays with moderation to get its positive effects.

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