Light therapy, also known as phototherapy, is the use of ultraviolet (UV) light for its healing effects. Phototherapy has been used worldwide for nearly a century to treat chronic skin conditions such as psoriasis, vitiligo and severe eczema.
While many treatments decrease the overall immune system, UV light can be used to decrease the local immune system in the skin. In conditions such as psoriasis, light therapy can also slow down the development of thick, scaly skin. UV light therapy is used in vitiligo for its additional ability to stimulate melanocytes, the skin’s pigment-producing cells. This makes phototherapy a nice treatment option for just about anyone—especially those who don’t like creams, those wanting a natural treatment, a steroid-free treatment, and those wanting additional control using a combination of therapies. Phototherapy is also a good option to consider for children and women during pregnancy.
Is phototherapy safe?
Dermatologists consider NB-UVB light therapy to be safe when it’s used responsibly.
In the few human studies evaluating this concern, an increased incidence of skin cancer has not been established. In the largest study to date in which 3867 psoriasis patients were treated with NB-UVB, with the median number of treatments being 29 and with 352 patients receiving more than 100 treatments, there was no significant association found with basal cell carcinoma, squamous cell carcinoma or melanoma. The median follow-up period was 5.5 years.
However, we need additional studies looking at what happens beyond that timeframe. And we need to take into consideration that newer, targeted forms of phototherapy like the Clarify System, have recently been developed. Targeted therapy is designed to focus healing light to the affected skin, sparing unnecessary light going onto surrounding skin. With recent advances in photomedicine and when used in combination with other therapies, healing can occur sooner and thus reduce overall UV exposure. Sunlight and tanning beds contain UVA which can damage the deeper layers of your skin. The Clarify Handheld light technology filters out UVA and only emits NB-UVB, which helps to reduce the potential for long-term side effects like skin cancer to develop over time.
Experts do agree there is likely an association with NB-UVB and the development of nonmelanoma skin cancer. Thus, a prescription for these treatments is required by law in the United States and many other places. So before you use a phototherapy treatment, it is recommended that you discuss all of the benefits and potential side effects. Together you and your physician can make an informed decision.
How often is phototherapy needed?
Phototherapy treatments are typically administered three times a week. In psoriasis, significant improvement may be seen within two weeks. Most people with psoriasis may need 15 to 20 treatments to achieve clearance and experience a remission rate of 38% after one year. For people with vitiligo, phototherapy treatment is more complex. The length of time you have had vitiligo, the body locations you want to treat and the activity of your vitiligo all influence the rate of repigmentation. Potential for response is greatest in those who have initiated treatment within 2 years of diagnosis, treat the face and neck, and who have stable, unchanged vitiligo without signs of activity. Those with signs of active vitiligo warrant more aggressive treatment often including full body phototherapy and oral steroids. Signs of activity include: Koebner phenomenon, trichrome appearance and confetti appearance.