The Healing Power of Light
We have long known that light can heal. Phototherapy is the use of therapeutic rays to treat specific skin conditions. Over time, researchers have mimicked specific wavelengths to harness the therapeutic light rays while eliminating the damaging ones.
Phototherapy is safe, effective, and time tested, making it an essential tool to dermatologists in the 21st century. It is safe for pregnant women and children and has none of the serious side effects associated with competing biological drug therapies. Daavlin consistently lead the clinical marketplace with innovations such as integrating dosimetry and built-in treatment protocols, making the delivery of phototherapy safe for patients and trouble-free for physicians and their staff.
How it Works
Phototherapy is the use of light to treat psoriasis, vitiligo, and other skin disorders. The skin is exposed to a special type of light from a medical device referred to as a phototherapy unit. These units range from hand-held devices for spot treatment to “walk-in” units for patients with full body involvement. The medical lamps in these units emit ultraviolet (UV) light in a wavelength that creates changes within the skin cells. The cells in most patients then begin to behave normally, which reduces or eliminates the symptoms of the skin disease.
At first, patients may require several treatments spaced close together to improve their skin. Once the skin has shown improvement, a maintenance treatment once each week may be all that is necessary.
Benefits to Patients
Phototherapy is safe and painless to administer to children and pregnant women. Biologic therapies are contraindicated for many patients, including pregnant or nursing mothers and patients with liver or kidney disease and coexisting immunocompromising conditions.
Statistics consistently show high clearance rates for Narrow Band UVB phototherapy, with a median clearance time of only 4-5 weeks.
Phototherapy is affordable. Other treatments, such as biological drug therapies, can cost more than the average price of a car each year, making them out of reach for many patients. Further, phototherapy may also be prescribed for home use; the one-time cost of a home unit is reasonably priced and covered by Medicare and most insurance companies.
Four out of 10 psoriasis patients are not currently under the care of a physician for their condition. Patients often cite dissatisfaction with their current treatment or progress for the lapse in treatment.1 A majority of alternative treatments require regular injections and have severe side effects. Phototherapy is an opportunity for physicians to expand their services and market to new customers, but the administration of phototherapy by a trusted physician can also be comforting to patients using phototherapy for the first time.
Types of Phototherapy
UVB Phototherapy
There are two types of UVB treatments: broadband and narrowband. The major difference between them is that narrowband UVB units emit a more specific or “narrow” range of UV wavelengths. Narrowband UVB is now more frequently used than broadband UVB.
Narrow Band UVB
Narrowband UVB has proven to be the most effective phototherapy treatment option for thousands of psoriasis patients all over the world. With more research being done every day on conditions such as eczema, vitiligo, and mycosis fungoides, Narrowband UVB continues to show its versatility with its promising results.
Why Narrowband UVB is Different
- Conventional broadband UVB lamps emit a variety of wavelengths ranging from 280-330nm.
- Narrowband UVB virtually eliminates superfluous and harmful UV by emitting only wavelengths 311-312nm.
- Clinical studies for psoriasis show the peak therapeutic effectiveness of UVB to be within the range of 295-313nm, but wavelengths below 300nm can cause erythema or severe burning and increase the potential risk of skin cancer. Broadband UVB has NOT been associated with cancer risk in humans.
Benefits of Narrowband UVB
Benefits of Narrowband UVB Therapy
- Eliminating UV in wavelengths below 311nm permits higher intensities and longer exposure times, so patients can derive the maximum benefit from phototherapy.
- The lack of sub-300nm photons allows physicians to run higher doses of the effective 300-320nm range without burning the patient, resulting in a shorter course of treatment.
- Extensive research2 confirms that psoriasis patients not only avoid the danger of serious burning from suberythemal exposure, they may also enjoy longer remission periods after treatment.
- Remission periods are similar to those with PUVA therapy and markedly superior to broad band UVB treatment. Studies show 38-40 percent of narrow band treated psoriasis patients require no additional therapy for at least 12 months.
PUVA
PUVA combines a Psoralen drug (the product name is Oxsoralen) with exposure to ultraviolet light A (UVA). Psoralen makes the body very sensitive to UVA rays and comes in oral or topical form. It may be used on a short- term basis to bring a severe or disabling case of psoriasis under control. The main long-term side effect of PUVA is the increased risk of skin cancer.
UVA1
UVA1 (340-400nm) is the range of long wavelength ultraviolet light immediately next to visible light in the electromagnetic spectrum. Consequentally, UVA1 photons have the deepest penetration into the body, but the lowest energy per photon of any type of ultraviolet light. UVA1 has many different biological effects, including up-regulating Collegnase, changing cytokine ratios, and inducing Heme-Oxygenase-1. Typical diseases treated by UVA1 light include sclerotic skin conditions (morphea, scleroderma, graft vs. host) and atopic dermatitis(eczema). UVA1 has been used therapeutically for nearly 20 years, with an excellent safety and effectiveness record.
Phototherapy vs. Biologics
While biological drug therapies have become popular in the last few years, it is important to evaluate the safety of these medications.
References
1 “New Kantar Health Study Shows 4 in 10 Patients Do Not See a Physician for Their Condition”, PR Web, June 6, 2013 (2) “Biologics 101”, The Dermatologist, Feb. 2012
2 Philips, A.G., manufacturer of the ultraviolet lamps used in Daavlin’s narrow band UVB phototherapy cabinets, has amassed an exhaustive library of studies from around the world documenting the therapeutic effectiveness and safety benefits of narrow band UVB treatment. This information is available upon request from the Daavlin Company.
