UVB Phototherapy

What is UVB Phototherapy?

UVB phototherapy uses shortwave ultraviolet radiation to treat various skin conditions, like eczema, psoriasis, vitiligo and lichen planus. This treatment works by suppressing DNA synthesis, thereby reducing inflammation.

Sunlight naturally produces three types of ultraviolet radiation: UVA, UVB, and UVC. As sunlight passes through the ozone layer, all UVC and most UVB radiation are absorbed, leaving approximately 95% UVA and 5% UVB to reach Earth. While UV radiation can provide relief for some psoriasis patients, uncontrolled exposure to sunlight may lead to skin cancer and premature aging.

Unlike UV radiation from the sun, which is not safe to expose your body to in uncontrolled dosages, UVB phototherapy utilises a specific wavelength of the UV spectrum, which is highly controlled and artificially produced through medical bulbs. This is a much safer alternative and a standalone treatment which does not require oral medications. Though many imagine UVB phototherapy to resemble a solarium and attribute it with the same risks, it is a highly researched, medically proven, safe wavelength of light treatment which does not resemble natural UV exposure.

UVB Phototherapy for eczema generally requires patients to attend sessions 2–3 times per week for an initial period of approximately six weeks. Treatment then continues at a reduced frequency until the condition is well-managed. The duration and frequency of sessions vary for each patient and are closely monitored by the treating doctors. For psoriasis, UVB Phototherapy is typically needed for about 12 weeks, while vitiligo treatment may take between 3 to 6 months.

Types of UVB Phototherapy

1. Narrowband UVB:

• Emits a specific wavelength of 311–312 nm.
• Offers shorter treatment times, better results, and longer remission periods compared to broadband UVB.
• Preferred for its safety and effectiveness.

2. Broadband UVB:

• An older technology with a broader wavelength range (290–320 nm).
• Requires longer exposure times and is less effective than narrow band UVB.

Key Benefits of Narrowband UVB

• Effective Treatment: Provides relief for conditions like psoriasis, eczema, and vitiligo.
• No Photosensitizing Drugs: Unlike UVA treatments, narrow band UVB does not require additional medications.
• Convenience: Requires fewer and shorter treatment sessions compared to broadband UVB.

How UVB Phototherapy Works

• UVB phototherapy is delivered using specialised cabinets equipped with fluorescent light tubes that target the affected areas.
• Initial sessions involve very short exposure times (a few seconds) to assess skin tolerance. Treatment duration gradually increases to 10–15 minutes per session.
• Phototesting is often performed to determine the minimum dose that produces skin redness (MED testing). The starting dose is typically 70% of the MED, escalating by 20% per session, provided there are no side effects.
• For full-body treatments, patients are undressed, with genitalia covered and eyes protected using goggles or a face mask.

Uses of UVB Phototherapy

• Psoriasis
• Dermatitis (Eczema)
• Vitiligo
• Cutaneous T-cell lymphoma
• Lichen planus
• Polymorphic light eruption
• Pruritus

Disadvantages of UVB Phototherapy

Requires frequent visits to the clinic, typically three times a week

Instructions for Patients Receiving UVB Phototherapy

1. Attend Scheduled Appointments: Ensure punctuality and allocate time for preparation.
2. Inform the Clinic: Report any medical conditions (e.g., eye diseases) and medications that may heighten UVB sensitivity.
3. Avoid Unapproved Products: Do not use ointments, cosmetics (perfumes, coal tar), or any other products unless advised by your doctor.
4. Moisturisers and Sunscreens: Avoid applying these within two hours before treatment, as they can interfere with UVB absorption. Apply them as directed after treatment.
5. Limit UV Exposure: Avoid additional ultraviolet exposure, including sunlight and tanning beds.
6. Use Protective Gear: During treatment, wear goggles or a face mask to protect the eyes, and ensure sensitive areas are covered.
7. Report Side Effects: Notify the phototherapy team of any adverse effects.
8. Follow Up Regularly: Maintain consistent follow-ups with your doctor to monitor progress and adjust treatment as needed.

This structured and monitored approach ensures UVB phototherapy remains a safe, effective, and controlled treatment for a variety of skin conditions.