Phototherapy for dermatology

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Contents

Introduction

Different Types of Phototherapy

Drawbacks

Home Phototherapy

Risks

Introduction

Phototherapy can treat psoriasis, eczema, or vitiligo. By exposing skin to measured amounts of ultraviolet (UV) light, under the care of a trained dermatologist. Phototherapy also works on a variety of other non-dermatological conditions.

When skin disease resists the first levels of treatment, a dermatologist might consider phototherapy. It is not without drawbacks and risks though. Read on to learn more about this fascinating treatment that improves the quality of life for many people globally.

Dermatological Benefits

  • Suppresses the immune system
  • Slows skin cell growth
  • Reduces inflammation
Dermatology Phototherapy Graphic

Phototherapy is administered at a dermatology practice or hospital. In some cases, treatments can be performed at home using specialized devices. These devices are costly, both in clinical settings and for home use. It is crucial to follow a doctor’s instructions closely to avoid harm

There are three types of devices for phototherapy:

Full Body Light Cabinets:

Used for treating large areas or the entire body.

Tabletop Panels:

Suitable for smaller areas and more targeted treatment.

Handheld Wands:

Ideal for spot treatments and hard-to-reach areas.

light treatment. Device for dermatology diode therapy - treatment with red light close-up.
hands of a patient with psoriasis close-up under an ultraviolet lamp. Light therapy, phototherapy
Treatment of skin diseases with narrow-band ultraviolet with a wavelength of 311 nm

Full Body Light Cabinets:

light treatment. Device for dermatology diode therapy - treatment with red light close-up.

Used for treating large areas or the entire body.

Tabletop Panels:

hands of a patient with psoriasis close-up under an ultraviolet lamp. Light therapy, phototherapy

Suitable for smaller areas and more targeted treatment.

Handheld Wands:

Treatment of skin diseases with narrow-band ultraviolet with a wavelength of 311 nm

Ideal for spot treatments and hard-to-reach areas.

Calendar Representing the Time Commitment of Phototherapy
Time Icon Representing the Gradual Change in Treatment Intensity and Results
PPE Icon to protect against skin damage - dermatology
Top and Bottom Icon representing the diversity of reality

Treatment plans can take several weeks or a few months, and often require 3-4 appointments per week. Missing any appointments is detrimental, and may reduce the effect of the treatment significantly.

The first few appointments are about measuring the intensity of the light on the patient’s skin. Treatment length gradually becomes longer, to a maximum of 15-30 minutes, and after one month symptoms should gradually be calmed by the therapy.

If full body treatment is required patients will be asked to strip down to their underwear and wear protective equipment over sensitive areas like eyes, and genitals. 



Some patients have extremely resistant skin conditions. When phototherapy fails, the next step might be biologics.

Calendar Representing the Time Commitment of Phototherapy

Treatment plans can take several weeks or a few months, and often require 3-4 appointments per week. Missing any appointments is detrimental, and may reduce the effect of the treatment significantly.

Time Icon Representing the Gradual Change in Treatment Intensity and Results

The first few appointments are about measuring the intensity of the light on the patient’s skin. Treatment length gradually becomes longer, to a maximum of 15-30 minutes, and after one month symptoms should gradually be calmed by the therapy.

PPE Icon to protect against skin damage - dermatology

If full body treatment is required patients will be asked to strip down to their underwear and wear protective equipment over sensitive areas like eyes, and genitals. 



Top and Bottom Icon representing the diversity of reality

Some patients have extremely resistant skin conditions. When phototherapy fails, the next step might be biologics.

Different Types of Phototherapy

When used to treat skin conditions there are three main types of phototherapy.

Ultraviolet Light B - (UVB)

UVB light is the most used type when treating dermatology conditions, but sometimes there are better options. This type of light is divided into either broadband UVB or narrowband UVB. Narrowband UVB is more popular due to needing less appointments and less potential for side effects. 

Ultraviolet Light A - (UVA)

UVA therapy is used when dermatologists need to reach the second layer of skin, the dermis. These longer wavelengths of light are more like the sun’s light and penetrate deeper into skin.

This might be used on:

 

  • Whole Body Skin Disease: Effective for widespread conditions.
  • Thick Psoriasis Plaques: Penetrates deeper to treat resistant plaques.
  • Topical Resistant Severe Eczema: Helps manage severe cases that do not respond to topical treatments.
Dermatology Light Therapy Infographic

Psoralen Ultraviolet A - (PUVA)

For deeper more intense light therapy, dermatologists use PUVA; using the medicine psoralen to increase the skin’s sensitivity to light before treatment. This allows light to reach even further into the skin layers.

PUVA is more effective, but carries higher risk. You could get severe sunburn, premature skin aging, or skin cancer. There is also a risk of developing cataracts if the eyes are exposed to direct sunlight within 24 hours of taking psoralen.

Psoralen chemical composition

Psoralen is a chemical found in plants that increases light sensitivity.

Drawbacks

Due to the need to visit a dermatologist multiple times a week for months at a time, phototherapy can potentially deliver not-great results. If the patient does not follow all the guidelines and show up to every appointment there is a chance that the phototherapy wont work as well. This can be difficult because of the time and cost, especially for rural patients.

Phototherapy doesn’t work for everyone, and home phototherapy equipment is quite expensive. The equipment can cost between $2500-$5000.

A Red X

Home Phototherapy

Units cannot be sold without a prescription. Recent studies have shown phototherapy at home can be as effective as at a dermatologist’s office. In their post on the research in February 2024, the National Psoriasis Foundation calls for insurance coverage of phototherapy units at home. 

For safety, phototherapy equipment comes equipped with locks against unauthorized use; software that allows dermatologists to control the light dose, time-limits, and fail-safes that disable the unit if needed.

An AI rendition of a home phototherapy cabinet

Risks

Phototherapy is not recommended for:

  • Those with sun allergies. While rare, this condition results in hives as a result of contact with light.
  • Pregnant or nursing people.
  • Those with liver disease.
  • People with lupus.
  • Those who take medications that can make you more sensitive to light.
  • Those who are sensitive to the sun through a genetic disease.
  • Those with certain types of skin cancer.
  • And a variety of other health concerns.

Potential side effects include:

  • Skin redness and irritation: Skin may turn red and feel sore.
  • Dry skin and itching: Skin can get dry and itchy.
  • Increased pigmentation: Skin may get darker.
  • Premature aging of the skin: Skin may look older, with more wrinkles.
  • Photosensitivity: Skin burns more easily in the sun.
  • Risk of skin cancer: There’s a chance of getting skin cancer.
  • Eye damage: Eyes can get hurt if not protected.
  • Nausea and headache: You might feel sick or have a headache.
    Reactivation of herpes simplex virus: Cold sores or herpes may come back.

Conclusion

Phototherapy is agreed to be a relatively safe and effective second line of defense against dermatological conditions.

It can be used on its own or combined with other treatments, and sits between prescribing topical creams and biologics for the severity of skin disease it is used to treat. We do not do phototherapy here at SimcoDerm. Once our dermatologists have evaluated your condition we will propose a treatment plan specifically for you to help you reduce your symptoms quickly and effectively.

 
 

SimcoDerm is a full service, comprehensive dermatology clinic located in Barrie. We provide our services to all the patients in Simcoe County and beyond.

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