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What is Phototherapy?
Phototherapy, or light therapy, is a form of treatment for skin conditions using artificial light wavelengths from the ultraviolet (blue light) part of the sun’s spectrum. In this way, light of certain wavelengths can be delivered with a higher intensity, but without the light of all the other wavelengths that are present in sunlight, e.g. visible light and infrared (heat producing light).
What is Phototherapy Used for?
Whilst it was first used in the treatment of psoriasis, a number of other skin conditions including eczema, vitiligo (where pigment cells are damaged resulting in white patches), skin-based lymphoma and some cases of generalised itchy skin (especially due to kidney or liver disease), can be treated this way if they haven’t responded to other treatments. Phototherapy is not suitable for all forms of psoriasis and eczema and may even aggravate some forms of these diseases.
How Does Phototherapy Work?
This probably varies for different skin conditions but may involve a number of factors, including a change in the skin’s immune system, reduction in inflammation and removal of abnormal cells. To do this, some damage to normal cells will usually be produced. Hence, there is the potential for short-term (e.g. burns) and long-term (skin cancer) side-effects to occur, but this will vary with the type of light treatment/phototherapy used.
Who May NOT be Suitable for Phototherapy?
- People with very fair skin who burn with very minimal sun exposure
- Small children
- People with medical problems which increase susceptibility to sunburn (e.g. lupus)
- People who have previously had certain types of skin cancer
- People whose immune system is suppressed.
What Types of Phototherapy are There?
There are two types of phototherapy – UVA and UVB.
UVA phototherapy is usually given in conjunction with a light sensitising tablet called psoralen (PUVA therapy). Sometimes a light sensitising cream or lotion containing psoralen can be used in localised skin areas, e.g. feet (topical PUVA).
UVA is part of the UV spectrum associated with pigmentation.
UVB phototherapy utilises the sunburning part of the UV spectrum. “Narrowband” UVB uses light of one wavelength only.
How is Phototherapy Given?
Phototherapy is usually given in a stand-up cabinet with lights at a fixed distance around the walls. Depending on the dose, the patient stands in the centre, usually for ½ minute to 10 minutes. However, it is also possible to target localised areas, such as hands and feet, using modified machines with a row of lights, or half-body therapy can be given using a battery of lights lowered from above. The eyes are always protected, as are areas not needing treatment, e.g. the face.
Treatments are normally given two or three times each week, with dosages being carefully increased, leading to longer times spent in/under the light source.
Does Phototherapy Have Side-Effects?
Yes, the most obvious one is burning, but treatment doses and schedules are designed to avoid this. However, sometimes this may still occur. Depending on the type of light treatment used, the burn may be like a mild sunburn, but rarely blistering may occur. Sometimes the skin feels very dry and may be itchy. Long-term increased risk of skin cancer may occur, but this depends on the type of phototherapy and the number of treatments given.
Other possible long-term side-effects include freckling and premature aging of the skin.
How Many Phototherapy Treatments will I Need?
Treatment usually continues until the rash has virtually cleared. This often takes 20 to 30 treatments, but may take longer.
What if Phototherapy Doesn’t Work …
The success rate of phototherapy depends on the condition being treated and its severity. Usually alternative forms of therapy are available if problems arise during treatment or if treatment is not effective.
Where is Phototherapy Given?
Phototherapy is given by trained personnel under the supervision of dermatologists at several major hospitals throughout Australia, Skin and Cancer Foundations in each state, and many dermatologists’ private rooms.
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