Ultraviolet phototherapy is the use of specific wavelengths of the sun’s natural spectrum for the treatment of a variety of skin disorders and most commonly psoriasis. Due to overwhelming demand for our phototherapy unit, we currently can only provide the service for patients with psoriasis. UVB light produces biological reactions within the skin that lead to clearing of the lesions. UVB is also the wavelength of light that produces Vitamin-D in our skin (not UVA which is found in tanning salons), essential to good health.
Devices to produce artificial light for the treatment of skin disorders have been in use for over 80 years and today there is a phototherapy clinic in most cities, usually in a hospital or a dermatologist’s office. Home units are a more recent phenomenon, as lower costs have made them more attainable to the average person. Our bodies evolved in an environment bathed in ultraviolet light, so we developed responses to use the light beneficially (vitamin D photosynthesis) and to protect us from over-exposure (tanning). Our modern lifestyles; being fully clothed, having protection from the sun, and many of us living in extreme northern/southern latitudes; has significantly reduced our UV exposure, and contributed to health problems in some.
Conventional “Broadband” UVB bulbs emit light in a broad range that includes both the therapeutic wavelengths specific to the treatment of skin diseases plus the shorter wavelengths responsible for sun burning. Sun burning has a negative therapeutic benefit, increases the risk of skin cancer, and limits the amount of therapeutic UVB that can be taken. “Narrowband” UVB bulbs, on the other hand, emit light over a very short range of wavelengths concentrated primarily in the therapeutic range. UVB Narrowband is therefore theoretically safer and more effective than UVB Broadband, but requires either longer treatment times or equipment with more bulbs to achieve the same dosage threshold.
1) Improvement of existing lesions/rash; 2) Reduction of new lesions/rash; 3) Remission – in many cases phototherapy has resulted in a total clearing of the disease process. The duration of this remission varies with each patient, from weeks to months to permanent remission. Maintenance therapy may be required for some conditions or in some persons.
As with natural sunlight, repeated exposure to ultraviolet light can cause premature aging of the skin, sunburn and theoretically skin cancer, although narrow-band UVB has not been shown to do this as of yet. However, when these risks are weighed against the risks of other treatment options, often involving strong prescription drugs or even injections, ultraviolet phototherapy is usually found to be the best treatment option, or at least the treatment option tried if topical drugs such as steroids are insufficiently effective (e.g. for psoriasis). In some jurisdictions, UVB phototherapy must be attempted before “biologic” drugs can be prescribed. UV rays may damage the eyes and increase your risk of cataracts. This is preventable with special protective eye goggles that block these rays. Eye goggles MUST be worn during your phototherapy treatment and sunglasses are not sufficient, as they do not provide adequate protection.
No; not when used properly. If the skin gets burned, that can increase your risk for skin cancer. This is true whether you’re at the beach, working outside in your yard, or simply spend a lot of time in the sun. Studies have repeatedly shown that UVB phototherapy treatments for psoriasis, vitiligo, eczema and other conditions are effective and safe when used as prescribed. Nothing in the medical literature so far indicates that the proper use of UVB light therapy has ever caused any increase in the risk for skin cancer.
Patients are encouraged to come in for phototherapy 2-3 times per week. In all cases, the patient always starts with a sufficiently low treatment time to ensure they will not get a skin burn, in the order of just seconds long. Then, if treatments are taken on a regular basis per the treatment schedule, treatment times are gradually increased possibly up to several minutes long where, at most, the skin exhibits the onset of a very mild burn. The results of each treatment is used to determine the treatment time for the next treatment, and the patient continues treatments on this basis until the skin condition improves, which can take 40 or more treatments over several months or more. Then, to maintain the skin, treatment times and frequency are usually reduced as the patient finds a balance between minimizing ultraviolet light exposure and the condition of their skin.
Our phototherapy is covered by OHIP (no charge) and is available on a first come first serve basis. We have one phototherapy room with both a full body unit and a hand-foot unit, and since the treatments for each patient usually last just a couple minutes long, we are able to move patients through relatively quickly. It may be best to try to avoid coming during our peak times and come when we are less busy – check with our front desk to find out the quieter clinic times.
This is of course an individual matter, but typically improvement is evident after only a few weeks. More advanced clearing requires 2-3 months. Long term low-dose maintenance can go on for many years as determined by the supervising physician.
After you have completed approximately 20-30 phototherapy treatments you will be booked to see the doctor in our follow-up clinic. At this visit the doctor will assess how well or not phototherapy is working for you and a decision will be made to stop, continue or go on maintenance therapy.