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Narrowband UVB Phototherapy to Treat Psoriasis

What is Phototherapy?

Phototherapy is the use of specific wavelengths of light that have been shown to be very effective in the treatment of psoriasis. This light occurs naturally as a component of sunlight and is called ultraviolet light. It is also very effective in the treatment of many other skin conditions, such as pruritis (itching), atopic dermatitis (eczema), contact dermatitis, alopecia (hair loss), lichen planus, and dyshidrotic eczema.

What is UV Light?

Phototherapy, or the use of ultraviolet light to treat illness, is defined as either mid wave light energy (Ultraviolet-B light [UVB]) or long wave light (Ultraviolet-A [UVA]). UVB is available as narrowband or broadband. It has been known for many years that UVA, UVB, and narrowband UVB light (or ultraviolet phototherapy) slows abnormal growth of normal skin cells which is associated with psoriasis. Narrow band (NB) UVB and PUVA are often used to start the repigmenting process for vitiligo.

What is Narrow Band UVB Light?

Narrow band UVB is light energy that is emitted in a narrow band portion of the UVB light range, 311 nm to 313 nm. UVB-NB has been shown to be the optimal part of the UV light spectrum which slows growth of psoriasis lesions.

What is UVB Narrowband Phototherapy Lamp Technology?

A UVB narrow band lamp emits light energy. Narrowband UVB phototherapy (UVB-NB) comprises a subset of the UVB wideband, or broadband, spectrum centered at roughly 311 nm. This is less than 1% of total range of wavelengths from sunlight.

Narrow band UVB has been shown to be the optimal part of the UV light spectrum which slows growth of psoriasis lesions. Since the narrowband wavelength is shorter than broadband, exposure time to narrow band UVB phototherapy treatment lights can be increased. The result is powerful targeted phototherapy treatment.

Another clear advantage of narrowband UVB is that skin is most sensitive to erythemic response, (sun burning) at 297 nm, so narrow band phototherapy nearly eliminates this problem.

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Why Use Narrow Band UVB for Psoriasis and Vitiligo?

For Psoriasis - Research shows that Narrow Band UVB lights have a therapeutic advantage over traditional Broad Band UVB lights. This is because Narrowband UVB lights provide faster clearing, less sun burning, and more complete disease resolution.
For Vitiligo - Narrowband UVB light treatment is replacing traditional PUVA phototherapy treatment. UVB Narrow Band for vitiligo requires no photo-sensitizing agents and thus is more easily tolerated and has fewer side effects.

Which Form Of Ultraviolet Phototherapy Is Best - UVA, UVB, or UVB-NB?
All of these light treatments are quite effective, and the form of ultraviolet phototherapy you need will be prescribed by your doctor. However, UVA light must always be used with an oral or tropical drug named Methoxsalen. Consequently, treatment with UVA light requires very active participation by a physician who must supervise your treatment closely. In most cases, it is preferable to use narrow band UVB (UVB-NB) light, since there is no need for systemic drugs like Methoxsalen and treatment times are short. Recent studies show that the use of UVB narrow band light (UVB-NB) results in faster responses and longer remissions than with UVB broadband. Using narrowband UVB, results are similar to a PUVA treatment without the adverse effects of the drug. Also, it is relatively easy for both you and your physician to monitor and control treatment. Narrowband UVB is often replacing conventional UVB because in many cases, it is safe and effective while taking less time. UVB-NB is generally considered to be safe for children and lactating mothers. A significant reduction in psoriasis scaling is seen after the first 3 to 6 treatments and improvement may be noted after 6 to 9 treatments. Repigmenting vitiligo is a longer process.

Is Phototherapy Safe?
As we all know, virtually every treatment for any type of illness carries with it some level of risk. We know that excessive exposure to UV light over a long period of time may increase the chances of skin cancer. However, unlike oral, IV or IM medications, the safety of UV light therapy (ultraviolet phototherapy) has been proven for over 100 years. Recent studies show that narrowband UVB lamps (UVB-NB) has virtually NO incidence of causing skin cancer. Ultraviolet phototherapy in general, and particularly narrow band phototherapy light has been proven for long-term use and for treatment of children with minimal side effects. Ultraviolet phototherapy has been shown to be an extremely effective treatment for controlling Psoriasis and Vitiligo.

How Does Phototherapy Compare With Other Forms Of Psoriasis Treatment?
Other forms of treatment require the use of very strong steroids, immunosuppressive drugs, other systemic drugs or over the counter topical medications. These alternatives, while heavily promoted by drug companies, are costly, not effective for long term use, and have the potential for serious side effects. Ultraviolet phototherapy has been recognized as safe, effective, and economical and has stood the test of time.

How Often are Treatments Taken and How long Are Treatment Times?
This depends on your condition. For psoriasis, treatments are taken 3 to 5 times per week, with ultraviolet phototherapy treatment times beginning at a few seconds and increasing to several minutes over time. Once clearing is achieved, your doctor will determine whether your maintenance needs require regular phototherapy or whether your remission needs only periodic checkups.

 
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