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PHOTOTHERAPY

Sun worship has been a practice in many ancient civilizations.  Many diseases have been believed to be helped and many are believed to be prevented sun exposure.  While uncontrolled sun exposure is no doubt harmful careful use of ultraviolet light is very useful in treatment in many skin diseases.

Ultraviolet light is used in specialized chambers to treat the skin in phototherapy.

Two main methods exist ( three types of UV exist UVA, UVB, UVC)

1. PUVA (Psoealen with UVA)

Psoralen ( 8 methoxy psoralen, 5 methoxy psoralen) in either tablet, solution or gel form is used to sensitise the skin.  The patient is then asked to stand in a small chamber.  The inner walls contain fluroscent tubes that emit ultraviolet light (UVA spectrum).  The patient is then exposed to the UVA light.  Gradually the exposure time is increased.  The light given is noted and carefully monitored.  Increasing suddenly or undue long term usage can increase risk of sunburn like reaction in the short term and skin cancers in the long term.  At most centers that use this treatment the dosage schedules are carefully monitored making such concerns a thing of the past.

 Another variation of this treatment is UVB

 Plain light treatment without the need for any tablets has been used for many years.  In this the patient is exposed to the light source in a similar chamber.  Recent introduction of specialized machines that emit only 311nm (TLO1UVB) have enhanced the effectiveness while lowering the side effects.

 Variations of phototherapy include

 1.    Hand and feet treatment

 Localized areas on the body including hands & feet are treated by small units.

 2.    Bath therapy

 Exposure to psoralen to sensitize the skin to light is done by psoralen solution mixed in the bath.

3.    Scalp treatment

Specialized units  have been developed to treat the scalp.