UV Light Therapy Is
A Second Line Treatment
Helping Manage Severe Eczema

UV Light Therapy, is also known as UV Light Treatment, Ultraviolet Therapy or Phototherapy.

It is used to treat moderate to severe eczema. Normally atopic dermatitis, irritant contact dermatitis and allergic contact dermatitis.

If UV light therapy is prescribed it is just one part of your eczema treatment. To help prevent flare ups, topical corticosteroids and emollients are used along side.

The UV rays used are the same rays that are in natural sunlight, UVA and UVB.

Natural sunlight has a positive effect on skin in some eczema patients.

When you go on a summer holiday you may notice that the condition of your eczema improves.

This can happen from small, regular spells in the sun.

It is important to remember to protect your skin from too much sun.

This can help prevent sunburn, skin damage and potentially, skin cancer.

UV light therapy is usually done by a dermatologist at a hospital. One of the advantages of using artificial rays compared with natural rays from the sun is that it can be controlled.

The dose given and the amount of time it is given for can be monitored. This ensures that no damage is done to the skin.

There are two types of UV light therapy

• UVB
• PUVA

UVB Treatment

As the name suggests, the treatment uses UVB rays. These are short wave rays.

There are two types

• UVB Broadband
• Narrowband

UVB Broadband

In the past Broadband has been the more widely used of the two. That has been until recently, since the start of the use of Narrowband.

Broadband has been used since the 1920's. It is still effective for some people.

It uses a wide range of rays. The rays used are beneficial for eczema, but also can cause sunburn and damage.

A course of treatment usually lasts for between 15-35 doses. The doses are normally given 3 times a week on a regular basis. For example, Monday, Wednesday and Friday

.

Narrowband

Narrowband has been used more recently. It uses a certain ray. This ray is beneficial for the skin, helping to treat eczema.

The skin is often exposed for a shorter time than with broadband. This is because it is more effective, as only the effective ray is used in treatment.

A course of treatments can last between 6-10 weeks, having around 3 a week. So a total course could be between 18-30 times.

The rays can be exposed to all areas of the body, except the genitals and eyes. The genitals are kept covered, usually by wearing underwear. The eyes are protected by wearing special goggles.

With both UVB treatments the length of time the skin is exposed for is increased each time. The first time could be less than a minute, and over time extend to 10-15 minutes.

How much time the uv light therapy is given for is decided by

• your skin type
• your skin's response to treatment
• severity of eczema
• age of patient

PUVA Therapy

Also known as Photochemotherapy.

This treatment uses UVA rays, along with Psoralen (P).

UVA are long wave rays. Psoralen is a drug that makes the skin more sensitive to UVA.

Before receiving the light treatment, the psoralen is given.

The psoralen can be applied to the body in 3 ways

• orally
• directly on the skin
• in the bath

Orally

The tablet or capsule is taken around 2 hours before the light treatment.

Psoralen taken orally makes your skin sensitive for up to 24 hours. It also affects your eyes. It is advised to stay out of the sun or wear protection on the skin after treatment.

To protect the eyes it is advised to wear sunglasses that have 100% protection from UVA and UVB. They normally need to be worn the rest of the day. There is a risk of cataracts if the eyes are not protected properly.

Directly on the Skin

The solution or gel is usually applied 15 minutes before the light treatment. This allows the psoralen solution or gel enough time to absorb into the skin. A topical solution is used when small areas of skin are affected.

Bath Solution

A solution of psoralen is used in your bath. It is mixed with the water, and needs to be mixed well.

Soaking for around 15 minutes is required before the light therapy. The whole body needs to be in the water, except the face. Avoid getting any of the solution in your eyes.

Side Effects Of UV Light Therapy

There are some potential side effects to having UV light treatment. They are more likely to occur in PUVA treatment, because of the use of psoralen, making your skin more sensitive.

The short term effects can usually be easily remedied.

• Redness of the skin. The skin will be a little red after the treatment. If the skin displays the signs of sunburn like blistering or hotness, contact the treatment centre
• Skin dryness. May occur during and for a little time after. It is recommended to apply an emollient. It needs to be applied to the whole body, preferably at least twice a day
• A rash. Sometimes develops. Again contact the treatment centre if one does
• Inflammation of the hair follicles. Also known as folliculitis. It is not painful and is easily treated
• Itchy skin. Can occur during the first two weeks. Using an emollient and an antihistamine may be helpful

There are 2 main long term effects which can occur. There is only a small chance of being affected if there is a very frequent use of UV light therapy.

• Skin cancer. There is a risk if you have more than 200 treatments. Just like sunlight, if you have a lot of exposure to it, it can be very damaging
• Ageing of the skin. If you have frequent doses it can cause changes in the skin. Wrinkles and freckles may appear

A treatment centre will usually only allow you to have a certain number of treatments in a lifetime. This is to minimize the risk of any damage.

PUVA therapy can also cause a feeling of sickness. This occurs in some people, and is usually associated with taking psoralen orally.

If nausea occurs let your nurse know. They may suggest changing the tablet or capsule being used. Also taking it with food can help to reduce the nausea.

There is the option of buying a special lamp and treating your eczema at home.

This is definitely convenient but safety is much more important. If you are thinking of administrating UV light therapy yourself then speak to a specialist before you even think of starting.

They will give you all the advise you need including how much, how often. You don't want to cause more damage to your skin, or more seriously, risk getting skin cancer.

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