Ultraviolet light therapy

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Phototherapy UVB or PUVA Booth.jpg
Ultraviolet light therapy
Other namesUtraviolet phototherapy
ICD-10-PCS 6A8
ICD-9-CM 99.82
MeSH D014467

Ultraviolet light therapy or ultraviolet phototherapy is a treatment for psoriasis, atopic skin disorder, vitiligo and other skin diseases.

Contents

There are two main treatments: UVB that is the most common, and PUVA.

There are four UVB types of lamps: Fluorescnt Broad-Band UVB that emit 280-330 nanometer, Fluorescent Narrow-Band that emit 312 nanometer, Excimer that emit 308 nanometer and LED that emit 290-300 nanometer.

PUVA means UVA + psoralen. It consists of irradiation of the skin with the UVA ultraviolet light, from a fluorescent bulb or LED lamps.

Tanning beds are used both in dermatology practices for the treatment of cosmetic skin conditions (such as psoriasis, acne, eczema and vitiligo) and in indoor tanning salons for cosmetic tanning.

Typical treatment regimens involve short exposure to UVB rays 3 to 5 times a week at a hospital or clinic, and repeated sessions may be required before results are noticeable. Almost all of the conditions that respond to UVB light are chronic problems, so continuous treatment is required to keep those problems in check. Home UVB systems are common solutions for those whose conditions respond to treatment. Home systems permit patients to treat themselves every other day (the ideal treatment regimen for most) without the frequent, costly trips to the office/clinic and back, mainly when the area is small, and the price of the lamp is low.

Small lamp for Psoriasis.jpg

Side effects

Side-effects may include itching and redness of the skin due to UVB exposure, and possibly sunburn, if patients do not minimize exposure to natural UV rays during treatment days. Cataracts can frequently develop if the eyes are not protected from UV light exposure. To date, there is no link between an increase in a patient's risk of skin cancer and the proper use of narrow-band UVB phototherapy. [1] [2] "Proper use" is generally defined as reaching the "Sub-Erythemic Dose" (S.E.D.), the maximum amount of UVB your skin can receive without burning. Certain fungal growths under the toenail can be treated using a specific wavelength of UV delivered from a high-power LED (light-emitting diode) and can be safer than traditional systemic drugs.[ citation needed ]

See also

Related Research Articles

<span class="mw-page-title-main">Ultraviolet</span> Form of electromagnetic radiation

Ultraviolet (UV) is a form of electromagnetic radiation with wavelength shorter than that of visible light, but longer than X-rays. UV radiation is present in sunlight, and constitutes about 10% of the total electromagnetic radiation output from the Sun. It is also produced by electric arcs; Cherenkov radiation; and specialized lights; such as mercury-vapor lamps, tanning lamps, and black lights. Although long-wavelength ultraviolet is not considered an ionizing radiation because its photons lack the energy to ionize atoms, it can cause chemical reactions and causes many substances to glow or fluoresce. Many practical applications, including chemical and biological effects, derive from the way that UV radiation can interact with organic molecules. These interactions can involve absorption or adjusting energy states in molecules, but do not necessarily involve heating.

<span class="mw-page-title-main">Vitiligo</span> Skin condition where patches lose pigment

Vitiligo is a chronic autoimmune disorder that causes patches of skin to lose pigment or color. The cause of vitiligo is unknown, but it may be related to immune system changes, genetic factors, stress, or sun exposure. Treatment options include topical medications, light therapy, surgery and cosmetics.

<span class="mw-page-title-main">Psoriasis</span> Skin disease

Psoriasis is a long-lasting, noncontagious autoimmune disease characterized by patches of abnormal skin. These areas are red, pink, or purple, dry, itchy, and scaly. Psoriasis varies in severity from small localized patches to complete body coverage. Injury to the skin can trigger psoriatic skin changes at that spot, which is known as the Koebner phenomenon.

<span class="mw-page-title-main">Blacklight</span> Light fixture that emits long-wave ultraviolet light and very little visible light

A blacklight, also called a UV-A light, Wood's lamp, or ultraviolet light, is a lamp that emits long-wave (UV-A) ultraviolet light and very little visible light. One type of lamp has a violet filter material, either on the bulb or in a separate glass filter in the lamp housing, which blocks most visible light and allows through UV, so the lamp has a dim violet glow when operating. Blacklight lamps which have this filter have a lighting industry designation that includes the letters "BLB". This stands for "blacklight blue". A second type of lamp produces ultraviolet but does not have the filter material, so it produces more visible light and has a blue color when operating. These tubes are made for use in "bug zapper" insect traps, and are identified by the industry designation "BL". This stands for "blacklight".

<span class="mw-page-title-main">Sun tanning</span> Darkening of skin in response to ultraviolet light

Sun tanning or tanning is the process whereby skin color is darkened or tanned. It is most often a result of exposure to ultraviolet (UV) radiation from sunlight or from artificial sources, such as a tanning lamp found in indoor tanning beds. People who deliberately tan their skin by exposure to the sun engage in a passive recreational activity of sun bathing. Some people use chemical products which can produce a tanning effect without exposure to ultraviolet radiation, known as sunless tanning.

<span class="mw-page-title-main">Indoor tanning</span> Tanning using an artificial source of ultraviolet light

Indoor tanning involves using a device that emits ultraviolet radiation to produce a cosmetic tan. Typically found in tanning salons, gyms, spas, hotels, and sporting facilities, and less often in private residences, the most common device is a horizontal tanning bed, also known as a sunbed or solarium. Vertical devices are known as tanning booths or stand-up sunbeds.

<span class="mw-page-title-main">Light therapy</span> Therapy involving intentional exposure to sunlight

Light therapy, also called phototherapy or bright light therapy is the exposure to direct sunlight or artificial light at controlled wavelengths in order to treat a variety of medical disorders, including seasonal affective disorder (SAD), circadian rhythm sleep-wake disorders, cancers, and skin wound infections. Treating skin conditions such as neurodermatitis, psoriasis, acne vulgaris, and eczema with ultraviolet light is called ultraviolet light therapy.

PUVA is an ultraviolet light therapy treatment for skin diseases: vitiligo, eczema, psoriasis, graft-versus-host disease, mycosis fungoides, large plaque parapsoriasis, and cutaneous T-cell lymphoma, using the sensitizing effects of the drug psoralen. The psoralen is applied or taken orally to sensitize the skin, then the skin is exposed to UVA.

Light sensitivity or photosensitivity refers to a notable or increased reactivity to light. Apart from vision, human beings have many physiological and psychological responses to light. In rare individuals an atypical response may result in serious discomfort, disease, or injury. Some drugs have a photosensitizing effect. Properties of natural or artificial light that may abnormally affect people include:

<span class="mw-page-title-main">Methoxsalen</span> Chemical compound

Methoxsalen, sold under the brand name Oxsoralen among others, is a medication used to treat psoriasis, eczema, vitiligo, and some cutaneous lymphomas in conjunction with exposing the skin to ultraviolet (UVA) light from lamps or sunlight. Methoxsalen modifies the way skin cells receive the UVA radiation, allegedly clearing up the disease. Levels of individual patient PUVA exposure were originally determined using the Fitzpatrick scale. The scale was developed after patients demonstrated symptoms of phototoxicity after oral ingestion of methoxsalen followed by PUVA therapy. Chemically, methoxsalen belongs to a class of organic natural molecules known as furanocoumarins. They consist of coumarin annulated with furan. It can also be injected and used topically.

<span class="mw-page-title-main">Psoralen</span> Chemical compound

Psoralen is the parent compound in a family of naturally occurring organic compounds known as the linear furanocoumarins. It is structurally related to coumarin by the addition of a fused furan ring, and may be considered as a derivative of umbelliferone. Psoralen occurs naturally in the seeds of Psoralea corylifolia, as well as in the common fig, celery, parsley, West Indian satinwood, and in all citrus fruits. It is widely used in PUVA treatment for psoriasis, eczema, vitiligo, and cutaneous T-cell lymphoma; these applications are typically through the use of medications such as Methoxsalen. Many furanocoumarins are extremely toxic to fish, and some are deposited in streams in Indonesia to catch fish.

<span class="mw-page-title-main">Polymorphous light eruption</span> Medical condition

Polymorphous light eruption (PLE) presents with itchy red small bumps on sun-exposed skin, particularly face, neck, forearms and legs. It generally appears 30 minutes to a few hours after sun exposure and may last between one and 14 days. The bumps may become small blisters or plaques and may appear bloody,often healing with minimal scarring.

<span class="mw-page-title-main">Tanning lamp</span> Device which produces ultraviolet light used for indoor tanning

Tanning lamps are the part of a tanning bed, booth or other tanning device which produces ultraviolet light used for indoor tanning. There are hundreds of different kinds of tanning lamps most of which can be classified in two basic groups: low pressure and high pressure. Within the industry, it is common to call high-pressure units "bulbs" and low-pressure units "lamps", although there are many exceptions and not everyone follows this example. This is likely due to the size of the unit, rather than the type. Both types require an oxygen free environment inside the lamp.

<span class="mw-page-title-main">Solar urticaria</span> Medical condition

Solar urticaria (SU) is a rare condition in which exposure to ultraviolet or UV radiation, or sometimes even visible light, induces a case of urticaria or hives that can appear in both covered and uncovered areas of the skin. It is classified as a type of physical urticaria. The classification of disease types is somewhat controversial. One classification system distinguished various types of SU based on the wavelength of the radiation that causes the breakout; another classification system is based on the type of allergen that initiates a breakout.

UV-B lamps are lamps that emit a spectrum of ultraviolet light with wavelengths ranging from 290–320 nanometers. This spectrum is also commonly called the biological spectrum due to the human body's sensitivity to light of such a wavelength. UV-B light does not tan the skin very much, compared to the UV-A lamps that are used in tanning beds.

<span class="mw-page-title-main">Pseudoporphyria</span> Medical condition

Pseudoporphyria is a bullous photosensitivity that clinically and histologically mimics porphyria cutanea tarda. The difference is that no abnormalities in urine or serum porphyrin is noted on laboratories. Pseudoporphyria has been reported in patients with chronic kidney failure treated with hemodialysis and in those with excessive exposure to ultraviolet A (UV-A) by tanning beds.

<span class="mw-page-title-main">Sunburn</span> Burning of the skin by the suns radiation

Sunburn is a form of radiation burn that affects living tissue, such as skin, that results from an overexposure to ultraviolet (UV) radiation, usually from the Sun. Common symptoms in humans and other animals include red or reddish skin that is hot to the touch or painful, general fatigue, and mild dizziness. Other symptoms include blistering, peeling skin, swelling, itching, and nausea. Excessive UV radiation is the leading cause of (primarily) non-malignant skin tumors, which in extreme cases can be life-threatening. Sunburn is an inflammatory response in the tissue triggered by direct DNA damage by UV radiation. When the cells' DNA is overly damaged by UV radiation, type I cell-death is triggered and the tissue is replaced.

<span class="mw-page-title-main">Nevus depigmentosus</span> Medical condition

Nevus depigmentosus is a loss of pigment in the skin which can be easily differentiated from vitiligo. Although age factor has not much involvement in the nevus depigmentosus but in about 19% of the cases these are noted at birth. Their size may however grow in proportion to growth of the body. The distribution is also fairly stable and are nonprogressive hypopigmented patches. The exact cause of nevus depigmentosus is still not clearly understood. A sporadic defect in the embryonic development has been suggested to be a causative factor. It has been described as "localised albinism", though this is incorrect.

<span class="mw-page-title-main">Health effects of sunlight exposure</span>

Exposing skin to the ultraviolet radiation in sunlight has both positive and negative health effects. On the positive side, exposure allows for the synthesis of vitamin D3. Vitamin D has been suggested as having a wide range of positive health effects, which include strengthening bones and possibly inhibiting the growth of some cancers. A dietary supplement can also supply vitamin D, but there are also benefits to exposure not obtainable through Vitamin D supplementation. Long-term sun exposure is associated with reduced all-cause mortality and reduced mortality risk from cardiovascular disease (CVD), some forms of cancer, and non-CVD/noncancer related disease, with indications in these studies that Vitamin D is not the mediator. Supplementation offers limited bioavailability and no synthesis of subdermal nitric oxide. UV exposure also has positive effects for endorphin levels, and possibly for protection against multiple sclerosis. Abundant visible light to the eyes gives health benefits through its association with the timing of melatonin synthesis, maintenance of normal and robust circadian rhythms, and reduced risk of seasonal affective disorder.

Goeckerman therapy is a regimen for treatment of moderate to severe plaque psoriasis using a combination of crude coal tar and artificial ultraviolet radiation. It is a specialized form of light therapy.

References

  1. Hearn, R.M.R.; Kerr, A.C.; Rahim, J.; Ferguson, R.S.; Dawe, R.S. (2008). "Incidence of skin cancers in 3867 patients treated with narrow-band ultraviolet B phototherapy" (PDF). British Journal of Dermatology. 159 (4): 931–5. doi:10.1111/j.1365-2133.2008.08776.x. PMID   18834483. S2CID   26754520.
  2. Black, R.J.; Gavin, A.T. (2005). "Photocarcinogenic risk of narrowband ultraviolet B (TL-01) phototherapy: early follow-up data". British Journal of Dermatology. 152 (154): 551–7. doi:10.1111/j.1365-2133.2005.06537.x. PMID   15840109. S2CID   45148256.