UVB Phototherapy

UVB Phototherapy Treatment For Psoriasis

Narrowband UVB (nbUVB) phototherapy is a second line treatment option that is regularly prescribed by dermatologists for psoriasis patients who have failed topical therapy.

It is a safe, effective treatment that has been used with great results for many years for the relief of psoriasis.

Sunlight produces three regions of ultraviolet radiation – UVA, UVB & UVC.  As sunlight passes through the ozone, all UVC and most UVB are absorbed in the atmosphere, leaving approximately 95% UVA and 5% UVB  to reach earth (cancer.org). While UV does provide relief to some psoriasis patients, it is not safe to expose your body to uncontrolled dosages of UV from the sun as this may lead to skin cancer and premature skin-ageing.

UVA and UVB can be produced artificially and in a controlled, concentrated way through medical bulbs.

UVA was  previously used in a number of skin conditions such as eczema and psoriasis, in combination with oral or topical  photosensitising drugs. This has since been largely replaced with nbUVB which is a stand alone treatment, does not require oral medications, and has a greater safety profile.

UVB can be classified into two different groups of wavelengths:

– Narrowband UVB (nbUVB) refers to the specific wavelength of UV radiation of between 311-312nm, which is a very safe wavelength providing excellent outcomes for eczema, psoriasis and vitiligo patients.  There has been extensive research into nbUVB, that has corroborated its efficacy and safety profile.

– Broadband UVB (bbUVB) is an older technology that has a broader treatment wavelength between 290-320nm.

NbUVB requires less exposure time than with bbUVB, is more effective and leads to longer intervals between flares than the previously used bbUVB.  It also delivers better results and without the complications of UVA treatment which requires oral/topical photosensitising medication to be used in conjunction with the UVA therapy.

NbUVB phototherapy requires patient attendance 2-3 times per week for an initial period (usually approximately 6 weeks) to test if there is any response to this treatment. Treatment usually then continues until the psoriasis is under control and clear. The length of treatment is very patient specific and carefully monitored by our specialist dermatologist.

There are many scientific articles on the safety and efficacy of UVB phototherapy treatment for eczema patients, and it is a very standard level of care for dermatologist’s psoraisis patients.   This is not a solarium and is a medically proven, safe wavelength of light treatment.

Initially, during a patient’s first dose of UVB phototherapy, treatment duration is often only a few seconds. Over time, treatment duration extends slowly and carefully, and can be of a 10-15 minute duration towards the end of a treatment course. It is important to do this incremental dosage increase slowly to ensure that the skin is not burned and there is a gradual increase in tolerance to the UVB light treatment. If some of the prescribed treatments are missed, then the dosage is dropped slightly (depending on the period of time lapsed since your last treatment) to ensure that your tolerance is built up gradually again.

Let’s delve deeper into the specific benefits of UVB phototherapy in the treatment of psoriasis.

1. Targeted Immune Modulation:

UVB phototherapy exerts a targeted immune-modulating effect on the skin, a pivotal aspect in the treatment of psoriasis. By selectively inhibiting the aberrant immune response responsible for skin cell overproduction, UVB light helps restore a more balanced and controlled immune activity. This targeted modulation contributes to a reduction in inflammation and the visible symptoms of psoriasis.

2. Controlled Inflammation Reduction:

Chronic inflammation is a key contributor to the development and exacerbation of psoriasis lesions. UVB phototherapy provides a controlled means of reducing inflammation in affected skin areas. This modulation of the inflammatory response not only soothes the discomfort associated with psoriasis but also promotes healing and prevents the formation of new plaques.

3. Normalisation of Cell Proliferation:

UVB light helps normalise the accelerated skin cell turnover characteristic of psoriasis. In individuals with psoriasis, skin cells reproduce at a much faster rate than in healthy individuals, leading to the accumulation of dead cells on the skin surface. UVB phototherapy slows down this abnormal proliferation, allowing for a more regulated and balanced growth of skin cells. This, in turn, contributes to the smoothing of psoriatic plaques and a more even skin texture.

4. Minimal Systemic Absorption:

Unlike systemic treatments, UVB phototherapy has minimal systemic absorption, reducing the risk of widespread side effects. This makes UVB phototherapy a safer option for individuals who may not be suitable candidates for systemic medications or those who prefer to avoid such treatments due to concerns about potential side effects.

5. Versatility in Treatment Options:

UVB phototherapy offers versatility in treatment options, with both broadband and narrowband UVB modalities available. The choice between the two depends on factors such as the severity of psoriasis, skin type, and individual response to treatment. Dermatologists can tailor the approach based on the specific needs of each patient, ensuring a personalised and effective treatment plan.

6. Combination Therapy Enhancements:

UVB phototherapy can be seamlessly integrated into combination therapy approaches. Dermatologists often combine UVB phototherapy with other treatment modalities, such as topical corticosteroids, vitamin D analogs, or oral medications, to enhance overall treatment efficacy. This synergy allows for a comprehensive and multifaceted strategy in managing psoriasis.

7. Short-term Side Effects:

While UVB phototherapy is generally well-tolerated, any short-term side effects that may occur, such as redness or itching, are usually mild and transient. These effects tend to diminish with continued treatment, and dermatologists can adjust the treatment parameters to minimise discomfort while maintaining efficacy.

8. Convenience and Accessibility:

UVB phototherapy sessions are typically conducted in outpatient settings, making the treatment convenient and accessible for many individuals. The non-invasive nature of UVB phototherapy allows patients to resume their daily activities immediately after a session, contributing to improved patient compliance and adherence to treatment plans.

9. Positive Psychological Impact:

Beyond its physical benefits, the visible improvement in skin appearance resulting from UVB phototherapy often has a positive psychological impact. Individuals experience enhanced self-esteem and reduced anxiety, contributing to an overall improvement in mental well-being. The positive shift in perception can be a significant factor in the comprehensive management of psoriasis.

10. Maintenance and Home Phototherapy Units:

For individuals requiring ongoing treatment, dermatologists may recommend maintenance sessions or home phototherapy units. Home phototherapy units, when used under the guidance of healthcare professionals, provide flexibility and convenience while maintaining the efficacy of UVB phototherapy. This approach allows for sustained treatment benefits without frequent visits to medical facilities.

Conclusion

UVB phototherapy stands as a valuable and versatile treatment option in the comprehensive management of psoriasis. Its targeted immune-modulating effects, ability to reduce inflammation, and normalisation of cell proliferation contribute to visible improvements in psoriatic lesions. The minimal systemic absorption and versatility in treatment options make UVB phototherapy a well-tailored solution for many individuals, especially those who may have concerns about systemic medications.

The convenience, positive psychological impact, and potential for combination therapy underscore the multifaceted benefits of UVB phototherapy. As ongoing research refines treatment protocols and enhances our understanding of its mechanisms, UVB phototherapy continues to shine as a beacon of hope for individuals navigating the complexities of psoriasis. Through the strategic application of UVB light, dermatologists illuminate the path to relief, improved quality of life, and a positive outlook for those affected by this chronic autoimmune condition.