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Phototherapy

Phototherapy for Various Skin Conditions: Methods and Uses

What is Phototherapy?

Phototherapy, or light therapy, is a medical treatment involving controlled exposure of the skin to ultraviolet (UV) light to manage various inflammatory and pigmentary skin disorders. It mimics beneficial effects of sunlight while minimizing harmful exposure.

Types of Phototherapy and UV Light Used

• Broadband UVB (BB-UVB): Traditional full-spectrum UVB light (280-320 nm).
• Narrowband UVB (NB-UVB): Emits a narrower wavelength (311-313 nm), more effective with fewer treatments and longer remissions.
• UVA (Ultraviolet A): Longer wavelength (320-400 nm) penetrates deeper skin layers, usually combined with psoralen (PUVA therapy) to enhance photosensitivity.
• Excimer Laser: Delivers high-intensity, targeted UVB light to specific lesions, sparing surrounding skin.

Common Indications

• Psoriasis: NB-UVB and PUVA reduce keratinocyte proliferation and inflammation, leading to plaque clearance.
• Atopic Dermatitis/Eczema: UVB light controls inflammation and itchiness.
• Vitiligo: NB-UVB and excimer laser stimulate melanocyte regeneration and repigmentation.
• Cutaneous T-cell Lymphoma: PUVA and NB-UVB therapies reduce malignant T cells in the skin.
• Other conditions: Lichen planus, pityriasis lichenoides, chronic urticaria, photodermatoses, morphea, and more.

Mechanism of Action

• UV light suppresses the immune response by inducing apoptosis of pathogenic T-cells and altering cytokine profiles.
• Phototherapy promotes keratinocyte normalization and melanocyte activation (in pigmentary disorders).
• PUVA combines photosensitizing agents (psoralen) with UVA to enhance DNA damage in abnormal cells, aiding clearance.

Treatment Protocol

• Frequency: Typically 2-3 sessions per week, duration and total number depending on condition severity.
• Patients must wear eye protection and avoid direct sunlight outside treatment.
• Treatment courses may last weeks to months for optimal results.

Benefits and Safety

• Effective and FDA-approved for several chronic skin diseases.
• Avoids systemic side effects of oral medications.
• Risks include redness, phototoxicity, premature skin aging, and long-term increased risk of skin cancer, which are minimized with careful dosing and monitoring.

Novel Phototherapy Applications

• Targeted excimer laser allows precise treatment of small areas, reducing exposure to uninvolved skin.
• Home phototherapy units provide convenience for chronic management with medical supervision.

Summary

Phototherapy is a versatile and effective treatment modality for a range of inflammatory, pigmentary, and neoplastic skin conditions. With advancements like narrowband UVB and excimer lasers, phototherapy offers targeted, well-tolerated options typically integrated into comprehensive dermatologic care.

Consult with Our Team of Experts Now!

For personalized phototherapy plans tailored to your specific skin condition, consult with our dermatology specialists experienced in delivering cutting-edge light-based therapies.

References:

1. Lim HW, Collins SAB, Resneck JS Jr, et al. The Safety of Phototherapy in Dermatology: An Update. J Am Acad Dermatol. 2021 Jan;84(1):163-174. doi:10.1016/j.jaad.2020.06.094. Available at: https://doi.org/10.1016/j.jaad.2020.06.094
2. Stern RS, Nijsten T, Feldman SR, et al. Phototherapy for Dermatologic Diseases: A Review of the Evidence. JAMA Dermatol. 2012 Jul;148(7):695-703. doi:10.1001/2013.jamadermatol.309. Available at: https://jamanetwork.com/journals/jamadermatology/fullarticle/1146910
3. Elmariah SB, Silpa-Archa N, Lim HW. Modern Approaches to Phototherapy: NB-UVB and Excimer Laser. Dermatol Clin. 2016 Apr;34(2):123-131. doi:10.1016/j.det.2015.12.002. Available at: https://doi.org/10.1016/j.det.2015.12.002