Phototherapy

Overview

Phototherapy, or light therapy, is a widely used treatment that involves exposing the skin to bright, ultraviolet (UV) light. This method is effective in managing various skin conditions such as psoriasis and eczema. The treatment utilizes different types of UV light, which are part of the electromagnetic spectrum, similar to the UV light emitted by the sun. UV light plays a crucial role in helping the body produce vitamin D, essential for overall health.

In phototherapy, the UV light used mimics the natural light from the sun, but the exposure is carefully controlled by your healthcare provider. They regulate the intensity of the light and the duration of exposure to ensure the treatment is effective while minimizing the risk of skin damage. This controlled approach allows patients to benefit from the therapeutic effects of UV light without the harmful consequences of excessive sun exposure.

Types of ultraviolet light

There are different types of ultraviolet light for medical procedures based on the type of ultraviolet and the size of the wavelength:

• UVB: Ultraviolet light B (UVB) enters the top layer of your skin with a medium wavelength. Burns from excessive UVB radiation exposure are possible.
• UVA: Ultraviolet light A has a long wavelength that enables it to treat issues affecting the deeper layers of your skin, specifically the first two layers. Long-term exposure to UVA radiation can result in wrinkles and sunburn.

Different phototherapy light colors

There are various kinds of phototherapy lights available to address various medical issues. Every variety employs a distinct hue of light:

• Blue light therapy: Blue LED lights have lights that resemble those on your phone. Blue lights, also known as neoBLUE® lights, emit a blue light and are frequently used to treat jaundice.
• Red light therapy: LED lights with a red tint are known as red light therapy. Red light comes in the form of laser lights. Commonly, these lights are used to treat scars, wrinkles, redness, and acne.

Reasons for undergoing the procedure

If phototherapy is recommended by a physician as a treatment for a diagnosis, it can be undergone by individuals of all ages, including both adults and children. Although phototherapy is generally considered a safe treatment, certain medical conditions may increase susceptibility to adverse effects. A doctor will determine if phototherapy is safe for a patient. Phototherapy might not be advised for individuals with the following conditions:

• Lupus
• Nursing mothers or pregnant individuals
• Hepatic impairment
• Sun allergy, a rare condition where exposure to the sun causes hives, though it is not a true allergy
• A history of certain types of skin cancer, particularly if UVA phototherapy is recommended
• Hereditary conditions like xeroderma pigmentosa, which increase vulnerability to sun exposure
• Use of medications that increase sensitivity to the sun

Phototherapy is also a safe treatment option for infants. Newborns with jaundice have elevated levels of bilirubin in their bodies, causing their skin and eyes to appear yellow. Blue UV light therapy helps infants eliminate bilirubin before it becomes a health risk. In some cases, a lamp or illuminated blanket may be used at home after the baby is discharged from the hospital. Infants receiving phototherapy are closely monitored.

Phototherapy can be used to treat a variety of conditions, including:

• Itching
• Newborn jaundice
• Mycosis fungoides
• Morphea
• Psoriasis
• Eczema
• Vitiligo

Risks

The following are potential dangers associated with phototherapy treatment:

• Dry skin.
• Nausea when taking psoralen.
• Temporary redness on the skin that resolves within a day.
• Burns or blisters resembling sunburns.
• Prolonged treatment may lead to the development of fine lines or wrinkles (premature aging).
• Extended use of UVA therapy can increase the risk of skin cancer, including melanoma, squamous cell carcinoma, and basal cell carcinoma.

Before starting therapy, the doctor will discuss the associated risks and side effects. It is also essential to mention any current prescriptions or supplements to avoid conflicts with the treatment.

Before the procedure

Before a phototherapy session, the provider will prepare the equipment at a hospital or treatment center. Protective eyewear will be provided to shield the eyes. Depending on the area being treated, additional protective gear, such as a face shield or a blanket to cover areas not receiving treatment, may also be necessary. The doctor will provide sunscreen to apply to the skin before the procedure. If only a specific part of the body is being treated, instructions will be given on how and where to apply the sunscreen. Removal of some or all clothing may be required, depending on the treatment area.

During the procedure

Before turning on the UV light during a phototherapy session, the doctor will ensure that personal safety equipment, such as eye protection, is being worn. Each form of treatment affects how UV radiation travels over the skin differently.

• UVB light: For UVB treatment, the patient will stand inside a box-like structure, similar to an upright tanning bed, where a light source will shine on the skin. The lights will turn on for a specific duration set by the doctor. If only a small area of the skin needs treatment, the patient will sit or lie down on a table while the doctor uses a wand with a light to target the affected area.
• UVA light: The procedure for UVA light is similar to UVB, but medications may sometimes be used to enhance the treatment’s effectiveness. Psoralen, a plant-derived chemical, increases the skin’s sensitivity to UVA light. For psoralen UVA treatment, the doctor may instruct the patient to soak in a bath containing psoralen, take it orally, or apply it to the skin before the session.
• Excimer laser light: This method uses lasers to deliver concentrated ultraviolet light to smaller, targeted areas of the body. After exposing the area to be treated, the patient will lie on a table while the provider directs the laser over the specific section of the skin that needs treatment.

The length of the phototherapy process depends on the size of the UV lamp employed and its strength. Repeated treatments are required for the best outcomes. With UVB therapy, the first and last sessions could last a few seconds and minutes, respectively, whereas UVA therapy sessions could continue for up to an hour. The duration of therapy and the total number of treatments required can differ significantly, depending on the condition and the state of the skin. The doctor will assist in creating a customized treatment plan.

After the procedure

Following phototherapy, the doctor may provide instructions on skin protection measures. These may include:

• Applying sunscreen to the treated skin areas and/or covering up to shield the skin from the sun.
• Using eye protection when going outside.
• Applying moisturizer daily to prevent dry skin.
• Avoiding tanning beds and sun exposure, as these can increase the risk of burns.

Outcome

After phototherapy, regular activities can be resumed immediately, but multiple sessions are required to see improvements in the skin. Typically, six to eight treatments are needed to notice changes, though it may take up to 25 sessions for some. When UVA light is used, treatment durations are longer. Precautions against further UV exposure, especially from the sun, are recommended post-treatment. Some skin redness or hyperpigmentation may occur, usually resolving within a day or two. If the burning sensation lasts longer than a few days, it is important to consult a doctor.