Phototherapy: A Treatment Option for Some Types of Eczema
exposes a patient to ultraviolet (UV) light for a controlled amount
of time and
may be prescribed to treat moderate to severe:
phototherapy is likely to be part of a total treatment plan.
Typically, a treatment plan includes lifestyle modifications to
prevent flare-ups, topical (applied to the skin) treatment, and if
needed, stronger therapy, such as medication that is swallowed or
Two types of
phototherapy are used to treat eczema:
UV Light Therapy
This may be used alone or with a topical treatment, such as coal
tar. Ultraviolet A (UVA), ultraviolet B (UVB) or a combination
of UVA and UVB therapy may be used. During therapy, the
patient's body, or just the affected skin, is exposed to the UV
light. Goggles are worn during treatment to protect the eyes.
Patients usually receive treatment in a dermatologist's office.
There are two types
of UVB therapy:
UVB therapy has been around for more than 80 years, and it is still
highly effective. The biggest drawbacks are that the patient must
travel between 3 and 5 times per week to a site that offers this
therapy and that broadband light does not effectively treat the scalp and areas
where skin folds occur.
newer form of UVB therapy is called “narrowband” because it emits a
narrower band of UVB wavelengths. Narrowband UVB therapy is proving
more effective than the traditional broadband therapy.
However, it does have the potential to produce severe burning. Like
broadband, it is still not known if narrowband UVB therapy poses a
long-term risk for development of skin cancer.
PUVA combines medication with light therapy and stands for
"psoralen" + "UVA". Psoralen is a prescription medication that makes the skin
more sensitive to UVA rays. Before UVA exposure, the patient
swallows, bathes in, or applies psoralen to the skin. After
treatment, patients must wear UVA-blocking sunglasses for 1 or 2
days when exposed to sunlight because psoralen remains in the eyes
for a while.
effectiveness is limited to carefully selected patients whose
condition is likely to respond to this therapy. PUVA has a
number of side effects, which may include nausea, headache, fatigue,
burning skin, itching, and irregular skin pigmentation. A
series of treatments is usually needed, and a full course of
treatment may take six months. In several studies, patients
have had substantial improvements when PUVA was combined with
UV light of certain wavelengths affects the immune system. By
carefully exposing patients to these UV wavelengths for specified
amounts of time, dermatologists are able to prevent the exaggerated
immune response that causes the inflammation.
The beneficial effects of phototherapy vary from person to person.
improve, and even clear, atopic dermatitis. One study conducted in
Germany investigated the effects of phototherapy on severe atopic
dermatitis. Investigators found more than 80% of the patients with
atopic dermatitis who were treated with phototherapy showed
significant improvement, and in some cases, complete clearance
within three weeks.
bacterial infections, which are common in the skin of patients
with atopic dermatitis.
the strength of topical corticosteroids required, and in some
cases, eliminate the need for topical corticosteroids.
phototherapy can significantly improve a patient's skin and even
completely clear atopic dermatitis in some cases, phototherapy does carry these
Dermatologists Carefully Weigh Risks and Benefits
Phototherapy is not appropriate for every patient who has eczema.
It is not recommended for patients whose eczema flares when exposed
to sunlight or anyone who develops a sun-induced allergic reaction.
In some patients, phototherapy can worsen eczema.
Dermatologists have the medical
training and experience needed to carefully weigh the risks and
benefits of phototherapy to determine if this treatment is right for
a patient. In considering whether or not phototherapy is
appropriate, dermatologists look at a number of factors, including
the patient's age, health, medical history, severity of the
condition, and history of previous treatment.
Guidelines of Care for Atopic Dermatitis.
July 26, 2003
Von Kobyletzki G et
al. “Phototherapy in severe atopic dermatitis. Comparison between
current UVA1 therapy, UVA1 cold light and combined UVA-UVB therapy.”
Der Hautarzt 1999:
“Therapeutic photomedicine: phototherapy.” In: Freedberg IM et al
(Eds.). Fitzpatrick’s Dermatology in General Medicine. 5th
ed. New York: McGraw-Hill; 1999:2870-2879.
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