Phototherapy

What is Phototherapy?

Light is made up of energy particles, so-called photons, that travel in a wave form. Just like when a pebble is dropped in a container of water, and as a result a wave is generated that transmits a portion of the energy that was moving the pebble, so does light that is generated from a source travels in a wave format, having a wavelength and a frequency. Frequency means how many oscillations there are per second. The cells on the back screen of our eyes, i.e., the retinal cells, detect light with wavelengths in the range of 390 nanometer (nm) to 700 nm. The invisible light with wavelengths of 280 nm to 390 nm that reaches the surface of the earth is classified as ultraviolet light. Although our eyes cannot detect this spectrum of light, ultraviolet light plays a key role in biochemical reactions to produce vitamin D along with the feel-good compounds that are called endorphins in our skin. Ultraviolet light rays induce deleterious binding of certain key components of the DNA molecules in our skin cells (keratinocytes), pigment cells, and immune cells that home within the skin.

The ultraviolet (UV) light spectrum (280 nm to 390 nm) that reaches the surface of the earth is further divided into UVB (280 nm to 315 nm), and UVA (315 nm to 390 nm). When the earth tilts toward the sun, and, as a result, the days become longer, much more UVB reaches the earth's surface; hence, people experience a lot more sunburns, or more severe sunburns during that time of the year. 1,000 times more UVA reaches the earth's surface than UVB. UVB exposure is much more conducive to sunburns than UVA. UVB is what our skin cells require to produce vitamin D. Tanning beds emit UVA. UVB rays around 311 nm were found to be quite efficacious in clearing immune-cell mediated inflammatory skin conditions, such as psoriasis, eczema, and even vitiligo. Narrow band UVB rays do not induce as severe of sunburn reaction as in patients who are treated with what is now called broad band UVB, the entire spectrum of UVB, (280 mm to 315 nm). Narrow band UVB treatment has not been found to increase the incidence of skin cancer. At Brentwood Dermatology we offer narrow band UVB treatments. Patients usually require three treatments per week for the first few weeks. Each treatment takes one to three minutes of exposure in the ultraviolet-light booth. Patients walk in at their own convenient time during the business hours.

How does Phototherapy work?

Phototherapy is quite a popular technique which is equipped with Light Heat Energy (LHE) technology. Phototherapy is mostly performed at doctor’s office and it most likely differs for different skin condition. It is currently being used to treat several diseases including: acne and psoriasis. The basic principle behind this treatment is to expose the skin to Ultraviolet light (UVB), more specifically green and red light. Green light penetrates deep below the surface of the skin to destroy the bacteria responsible for acne formations while the red light act as more of an anti-inflammatory agent. The “H” in LHE is the heat, when combined with the entire LHE process, it is extremely effective in opening and exfoliating skin pores.

What is Phototherapy used for?

Phototherapy is used to treat different skin conditions. Moreover, it was first used in the treatment of psoriasis, a number of other skin conditions including:

  • Eczema, vitiligo where pigment cells are damaged resulting in white patches)
  • Skin-based lymphoma
  • Some cases of generalized itchy skin-- especially due to kidney or liver disease-- can be treated this way if they haven’t responded to other treatments. Phototherapy is not suitable for all forms of psoriasis and eczema and may even aggravate some forms of these diseases.

What Types of Phototherapy are there?

There are two types of phototherapy – UVA and UVB.

  • UVA phototherapy is usually given in conjunction with a light sensitising tablet called psoralen (PUVA therapy). Sometimes a light sensitising cream or lotion containing psoralen can be used in localised skin areas, e.g. feet (topical PUVA). UVA is part of the UV spectrum associated with pigmentation.
  • UVB phototherapy utilises the sunburning part of the UV spectrum. “Narrowband” UVB uses light of one wavelength only.

What can be the possible side effects?

Generally, phototherapy is regarded as a well-tolerated and safe procedure. Some mild side effects can be experienced, especially initially; but possibility of severe side effects is rare. Some mild side effects that can be experienced during the treatment include headache, insomnia, eyestrain, nausea and fatigue. Irritability can also occur and if this persists or worsens, the duration of treatment may have to be decreased. There have been reports of manic episodes. With properly adjusted and maintained equipment there is no evidence that phototherapy can damage the retina.

What are the benefits of phototherapy?

  • Helps in increasing the formation of new capillaries that speed up the healing process by carrying more oxygen and more nutrients needed for healing.
  • It increases collagen production as a result less scar tissue is formed at the damaged site.
  • Helps damaged cells to be replaced more promptly.
  • Stimulate tissue granulation and connective tissue projections, which are part of the healing process of wounds, ulcers or inflamed tissue.

What should NOT use Phototherapy?

  • Who those have very fair or sensitive skin that burn with very minimal sun exposure,
  • Small children,
  • Who those have medical problems which increase susceptibility to sunburn (e.g. lupus),
  • Who have previously had certain types of skin cancer, and
  • Who those immune system is suppressed.

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