What Other Safety Measures Should You Take
While you get phototherapy for atopic dermatitis, itâs important to limit how much sun you get. Apply sunscreen with at least 30 SPF every 2 to 3 hours while youâre outside, and wear a wide-brimmed hat.
Donât sunbathe or use a tanning bed. It could severely burn you. Using a tanning bed can also raise your chances for skin cancer.
The Lowdown On Light Therapy For Eczema
Eczema light therapy, or phototherapy, refers to the use of ultraviolet light to treat the skin rash and itching of eczema. Exposing the skin to UV light suppresses overactive skin immune system cells that cause inflammation, explains Elizabeth H. Page, MD, a dermatologist at Beth Israel Lahey Health and assistant clinical professor of dermatology at Harvard Medical School in Boston. Light therapy works by chasing away the white blood cells that trigger the inflammation, so light therapy is anti-inflammatory.
Another payoff? Light therapy also smoothes the lesions, decreasing skin thickening, says Emma Guttman-Yassky, MD, PhD, a dermatologist and the director of the Laboratory of Inflammatory Skin Diseases at the Icahn School of Medicine at Mount Sinai in New York City.
What Should I Expect With Phototherapy
During your visit, you will apply a moisturizing oil to the skin and stand in a large cabinet undressed except for underwear and goggles to protect the eyes. The light-emitting machine will be activated for a short time usually just seconds to minutes and it will either treat the entire body or just certain exposed areas. It may take one or two months of steady treatment with phototherapy to start to see improvement in eczema symptoms, and at that point, the frequency of the visits can sometimes be reduced or stopped for a period to see if the eczema is in remission.
Potential side effects of phototherapy include:
- Sunburn and skin tenderness
- Premature skin aging
Knowing The Risks Of Uv Light Therapy
While those who have benefited from UV light therapy are quick to sing its praises, Dr. Jack points out that its important for patients to understand that there can be certain risks involved.
When youre being monitored by a doctor, you have a lowered risk of side effects, but they can still occur, he says.
Some of the most common side effects of UV light therapy are:
- Burning or stinging sensation after treatments
- Premature aging of the skin, particularly for people with fair skin
Possible Disadvantages Of Eczema Light Therapy
Cost may be a con of eczema light therapy: For insured patients, there may be a copay involved for each time you receive treatment, plus deductible considerations. Another potential drawback is that it’s time-consuming and requires many trips to a doctor’s office over several weeks, Page says. If youre driving 30 minutes to your doctors office, waiting for your appointment, taking your clothes off, standing in the booth, then putting your clothes back on and driving home, it might be too much of a time commitment for you, says Piliang. If you live close to your doctors office, it may be convenient, but if not, it might be too difficult to do this several times a week.
Other drawbacks of eczema phototherapy may include these considerations:
Burning Artificial UV light, like natural sunlight, can result in tender sunburn and even blistering. Skin may redden and itch. Though, according to NYU Langone Health, side effects to phototherapy happen infrequently and tend to go away quickly. Also worth noting: “People who have a light complexion have more tendency to burn, and dosing needs to be adjusted accordingly,” says Page.
Skin Damage Over time, age spots and other signs of aging like wrinkles may appear, says Page.
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Is There Anything I Need To Avoid While Having Phototherapy
- Certain medicines can make you more sensitive to ultraviolet light, so let the phototherapy staff know what you are taking .
- Avoid additional UV exposure from natural sunlight or sunbeds.
- It is important to avoid perfumes, deodorants, aftershave lotions and other cosmetics before UV treatment as some of these products may make you more sensitive to UV light and cause patchy discolouration of the skin, which may take months to fade. Follow the advice of phototherapy staff about applying emollients on treatment days.
- Do not have your hair cut short while on a course of phototherapy if your skin has not been exposed to light for some time, it can burn easily.
- Avoid growing facial hair while receiving phototherapy .
- Avoid eating excessive quantities of carrots, celery, citrus fruits, figs, parsley and parsnips, as these foods can increase your sensitivity to light.
Uvb Phototherapy For Eczema
Beyond topicals, the next treatment in line for many types of eczema is clinical or in-home UVB-Narrowband phototherapy, which within weeks of slowly building up treatment times can provide significant remission. Low-dose maintenance treatments can then be used to control the condition indefinitely and drug-free with practically no side effects. Plus there is the immense benefit of making large amounts of Vitamin D naturally in the skin, carried away by the skins tiny blood vessels for health benefits throughout the body.
In practice, UVB-Narrowband light therapy works well in professional phototherapy clinics , and equally well in the patients home4,5. There are many medical studies on the subject search for Narrowband UVB on the US Governments respected PubMed website and you will find more than 400 entries!
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What Is Ultraviolet Light
In nature, UV radiation is part of the electromagnetic spectrum that reaches the Earth from the sun. UV wavelengths are classified as UVA, UVB or UVC. The latter has the shortest rays and is mostly absorbed by the ozone layer, so does not reach Earth. However, both UVA and UVB penetrate the atmosphere . UV light is important for health and is responsible for tanning and burning the skin. Excessive UV radiation causes skin cell damage, which can lead to skin cancer.
Sensitivity To Light Is A Burning Question
Before you begin your treatment, your doctor will have you undergo a test session to make sure that you react well to the phototherapy. Some people have greater sensitivity to light than others and are more prone to rashes or sunburn-like irritation when exposed to sunlight. For some people, such light can even trigger eczema flares.
The main thing you want to avoid is a burn, says Dr. Green. The first time you get a very small dosage.
Because the dose starts very small and is increased very slowly, burnsthink sunburnsare very rare, says Dr. Massick.
After your session, you should avoid sun exposure for the rest of the day. This is mainly because youd be doubling up on the amount of ultraviolet light you are exposed to, Dr. Massick explains. Your goal is to be exposed to the least amount of ultraviolet rays that provide you with benefit.
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Can I Do Phototherapy At Home
Yes. If your newborn has jaundice and no other health complications, your provider might offer a treatment plan that lets you do phototherapy at home. You can use a phototherapy lamp or fiber-optic blanket safely while staying in the comfort of your own home.
Some adults also use at-home phototherapy. People who experience seasonal affective disorder can have depressed mood during the winter, when theres less sun. UV lamps replicate sunlight and are used to make your body think that its warmer and sunnier than it really is. This helps your body release serotonin, which is a neurotransmitter that can improve your mood. Be sure to look for 10,000 lux lamps if you use one for SAD.
During at-home therapy, you and/or your baby must wear eye protection to prevent eye damage from the light.
Suitability For Light Therapy
Your dermatologist will meet you to discuss the benefits, risks and alternatives to the procedure, and assess whether light therapy is suitable for you.
They may examine you and ask you questions about your medical history, including the following.
- Whether youre taking any other medicines, including anything you put on your skin.
- If you have any allergies to medicines.
- Whether you have any history of eye conditions, especially cataracts.
- If you have any conditions that affect other organs in your body, such as your kidney or liver.
- If you have allergy to the sun, or if you have a rare health condition called lupus.
- If youre pregnant or trying to get pregnant. PUVA is not recommended during pregnancy but you should be able to have UVB.
- Your risk of developing skin cancer. Light therapy may not be recommended if youve had skin cancer or you have a family history of the disease.
Youll need to be able to attend regular sessions of phototherapy and be able to stand up unaided for at least 10 minutes.
If your dermatologist thinks that light therapy is suitable for you, theyll arrange for you to have an assessment with a phototherapist. Theyll run through all the practical details about light therapy treatment with you. Be sure to ask any questions you have. If youre happy to go ahead with the procedure, youll be asked to sign a consent form so its important to make sure you feel you have all the information you need.
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What Is The Recovery Time For A Phototherapy Procedure
After a phototherapy procedure, you can immediately go back to your normal activities. It takes multiple treatments to see results on your skin. Most people see improvements to their skin after six to eight treatments, but it could take between 15 and 25 treatments until you see results. Certain conditions treated with UVA light take much longer to treat.
Your provider will recommend you take steps to protect your skin from further UV exposure, especially from the sun, after treatment. You may experience some skin redness or hyperpigmentation, where your skin appears darker after treatment, this may go away after 24 hours. If you feel a burning sensation on your skin that lasts more than a couple of days after treatment, contact your provider.
How Can Phototherapy Ease Atopic Dermatitis
When youâre living with this skin condition, your bodyâs defenses overreact to certain triggers in the environment, and they make too much inflammation in your skin. Thatâs what sets off your atopic dermatitis symptoms.
Natural sunlight gives off ultraviolet rays, which ease some peopleâs symptoms by turning down the inflammation process in the skin. But UV rays can also cause sunburns if youâre not careful. With phototherapy, your doctor exposes your skin to a certain dose of UV light for a precise amount of time. Experts say this lowers the inflammation that leads to atopic dermatitis symptoms.
Your dermatologist can treat your skin with one of two types of UV light: UVA or UVB. Or they can use a combination of both. Theyâll choose the type of UV light and the dosage thatâs most likely to be safe and effective for you.
Treatment with ânarrowbandâ UVB light — which gives off a shorter wavelength than âbroadbandâ UVB light — is the most common type of phototherapy that doctors use for atopic dermatitis. Limiting the light spectrum with narrowband UVB can lower your chances of having side effects.
To figure out the right treatment plan for you, your dermatologist will consider things like:
- The type of skin you have
- The type and number of past treatments youâve gotten
- Whether youâve had other health conditions, like skin cancer
- Whether youâre taking any meds that make your skin more sensitive to light, like antibiotics or NSAIDs
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What Are The Adverse Effects Of Uvb Phototherapy
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The Best Facial Cleansing Brushes And Tools
This manual brush might not look like much but the finely tapered, plush bristles are absolutely brilliant for gently cleansing and exfoliating the skin, especially around the nose and chin where pores tend to get most clogged and you have ultimate control when using it. Wet the brush head, pour a little cleanser on top and massage it over the your face using circular motions.
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Disadvantages Of Phototherapy For Eczema
- While rare, light therapy may increase your risk of developing skin cancer.
- The treatment may worsen eczema if sunlight happens to be one of your triggers.
Unlike an indoor tanning bed, phototherapy is carefully administered by a technician who controls not just the amount of time you spend under the lamps, but the intensity too.
Before your treatment, the technician will apply a moisturizer to the treatment area. They will also provide you with goggles to protect your eyes.
You may need to take off some of your clothing to ensure the UV radiation effectively targets your areas of concern.
Your treatment may be performed as you stand in a large cabinet-like area that contains UV bulbs, via a hand-held wand, or hand-foot units that you may insert your hands or feet in for treatment.
According to the National Eczema Association, treatments last for several seconds or just a few minutes, depending on the extent of eczema rashes being targeted.
Should I Still Use My Emollients And Topical Treatments
You should continue to use emollients during the course of phototherapy. However, do not apply them shortly before phototherapy treatment unless advised to do so by your healthcare professional. You may need to use a greater quantity of emollient, especially after treatment, as the skin will be dry. Some people with eczema find that phototherapy makes them itchier, so using emollients for washing and bathing will also help.
You may be advised to continue with topical steroids during the course of phototherapy because of the risk of irritation and flare. If the eczema is improving, the potency of topical steroids will be reduced depending on the individual and their flare pattern. Topical steroids can be stopped if all eczema has cleared .
Occasionally, small localised areas of eczema remain e.g. on the ankles or wrists after a course ofphototherapy, and these will require continued treatment with topical steroids.
Topical calcineurin inhibitors Elidel and Protopic should not be used on phototherapy days as they make the skin more sensitive to light, which may increase the risk of burning. Patients may be advised to continue with TCIs on non-treatment days
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How Long Does It Take For Light Therapy To Work For Eczema
Light therapy can be done in a doctors office or at home with a portable device. Treatment typically lasts between 10 and 20 minutes, though it may be longer or shorter depending on your individual needs. Most people need to have light therapy two to three times per week for several weeks to see results.
So, light therapy is typically done 3-5 times per week for a period of several weeks. Most people see an improvement in their symptoms after just a few treatments.
According to a 2012 study, light therapy can be an effective treatment for eczema. The study found that 63% of participants who underwent light therapy saw their eczema improve after just four weeks. However, it is important to note that not all people will respond to light therapy in the same way. Some may need to continue treatment for longer before seeing results.
How Light Therapy Works To Help Treat Eczema
Years ago, doctors used three types of eczema phototherapy, but these days one has come out on top. The most common form of phototherapy is narrowband UVB, which has largely replaced other forms of phototherapy such as broadband UVB and PUVA, says Page. Dr. Guttman-Yassky adds, Narrowband UVB may be best as its safe and effective.
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Who Should Try Light Therapy
About 70% of people with eczema see an improvement in symptoms after light therapy.
Light therapy is generally reserved for adults and adolescents with widespread eczema symptoms. Also, those with atopic dermatitis who do not respond to first-line treatments, such as gentle moisturizers or topical steroids, receive light therapy.
Still, light therapy is not a cure-all for every person with eczema. And experts stressed that people with atopic dermatitis should speak to their healthcare provider about the benefits and risks of the treatment before trying it.
“We don’t necessarily like to put people into it unless there’s nothing else that’s keeping them controlled,” Jon Hanifin, MD, professor of dermatology at Oregon Health & Science University in Portland, Ore., told Health.
For those people, Dr. Hanifin described using an immunosuppressant medication, such as cyclosporine, for a limited time until their skin isn’t “all thickened and red and scratched.”
Dr. Hanifin then recommended tapering off the treatment while building up their UV treatments to stop inflammation. Dr. Hanifin explained that light therapy could be a bridge to healthier skin for those people.
“UV is really good for ,” said Dr. Hanifin. “But it’s not for everybody.”