- What to know about light therapy for psoriasis
- How Phototherapy Works
- Before Your Photherapy
- Planning Your Phototherapy
- Giving Yourself Phototherapy at Home
- After Your Phototherapy
- Call Your Doctor or Nurse if You Have:
- What is phototherapy?
- What should I expect with phototherapy?
- What are the risks of phototherapy treatment?
- The Risks and Benefits of Light Therapy for Atopic Dermatitis
- Phototherapy for Eczema & Dermatitis
- Blog & News
- Pediatric Eczema? Try Home Phototherapy!
- Ultraviolet light B (UVB)
- Psoralen + UVA (PUVA)
- Tanning beds
- Phototherapy Risks
- What to Expect from Phototherapy
- The Pros and Cons of Eczema Light Therapy
- What is light therapy?
- What does light therapy do?
- How does light therapy work?
- What types of light are there and what do they do?
- 4 Of The Best At-Home Light Therapy Treatments
- What skin types should try light therapy?
- Does light therapy hurt?
- Can you get a tan from light therapy?
- The Best Facial Cleansing Brushes And Tools
- Pros and cons of phototherapy
- Laser therapy may ease type of eczema
- Recent Posts
- Eczema and Psoriasis Treatments
What to know about light therapy for psoriasis
Share on PinterestThe best phototherapy method will depend on which body parts psoriasis affects.
There are many different ways to deliver light therapy for psoriasis, including different types of light and equipment.
A healthcare professional will choose which phototherapy method to use based on the following factors:
- how much of the body the psoriasis affects
- which body parts psoriasis affects
- how much psoriasis affects an individual’s quality of life
- a person’s overall health
- a person’s skin type
One key difference between the various forms of phototherapy is the type of UV light used in treatment:
- UVA has a long wavelength. It can go through glass windows and penetrate to deeper levels of the skin. People must use UVA treatments in combination with psoralen, which makes the skin more receptive to the UVA rays.
- UVB has a shorter wavelength. It only reaches the upper levels of the skin and does not require psoralen.
The different types of light therapy for psoriasis include:
- Narrow-band UVB. Narrow-band phototherapy, the most common light therapy, limits the light wavelengths used in treatment to 311–313 nanometers, to keep possible side effects in check.
- Broad-band UVB. Broad-band phototherapy is the oldest form of light therapy for psoriasis. It uses a wider wavelength than narrow-band therapy.
- Laser UVB. Laser techniques use a smaller, more targeted beam of UVB. Healthcare professionals prefer this technique when psoriasis affects less than 5 percent of the body.
- Topical PUVA. With PUVA, a person either soaks in a bath or applies a lotion containing psoralen, which makes the skin more receptive to the UV light treatment that follows.
- Oral PUVA. With oral PUVA, a person takes pills containing psoralen before phototherapy. This form of treatment may be especially helpful for very thick plaques.
- Pulsed dye laser (PDL). Healthcare professionals most often use PDL for small lesions on the surface of the skin or nail psoriasis.
- Balneophototherapy. Here, a person will undergo UV light treatments either while bathing in a salt-based solution or immediately afterward.
- Low-level light or laser therapy. Sometimes called “cold laser” treatment, doctors also recommend this treatment for other forms of inflammation and chronic pain.
- UVB phototherapy at home. Physicians may prescribe at-home follow-up treatment, with individuals using hand-held or smaller-scale light boxes to stay on top of their psoriasis and manage any increases in itchiness and plaques, or “flares.”
This information explains what phototherapy is and what to expect before, during, and after your procedure.
The goal of phototherapy is to reduce the growth of your skin cells and to treat underlying skin inflammation. Phototherapy, also known as light therapy, does this by exposing your skin to ultraviolet (UV) light.
Phototherapy can be used to treat several skin conditions, including:
- Psoriasis (raised, red, scaly patches on your skin)
- Vitiligo (loss of color on patches of your skin)
- Eczema, a condition that makes your skin red and itchy
- Lichen planus (small bumps on your skin)
- Cutaneous T-cell lymphoma (a type of lymphoma that appears as patches or scaly areas on your skin)
- Itchy skin
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How Phototherapy Works
Phototherapy uses UV light, which is also found in sunlight. There are 2 kinds of rays in UV light, ultraviolet A rays (UVA) and ultraviolet B rays (UVB). Phototherapy can also be used in combination with other topical (applied on the skin) therapies.
Phototherapy can be given to a specific area of your body or to your entire body. It’s given to your entire body if more than 5% of your skin is covered with the rash or skin condition.
There are 2 main types of phototherapy:
- Ultraviolet B (UVB)
- There are 2 types of UVB phototherapy, including broadband and narrowband (NB-UVB). The difference is that NB-UVB gives off a shorter wavelength of UV light.
- Psoralen-UV-A (PUVA)
- This type of therapy uses UVA light and an oral (by mouth) medication called psoralen that makes your skin more sensitive to light.
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Before Your Photherapy
Your doctor will determine if phototherapy is safe for you. To do this, they will:
- Do a total body skin exam by looking at all your skin. They will also ask about your reaction to sunlight.
- Ask you about your personal and family history of skin cancer and photosensitizing disorders (disorders that make your skin more sensitive to the sun).
- Ask if you are pregnant or if you are breastfeeding.
Tell your doctor what medications you’re taking, including patches, creams, herbal supplements, and over-the-counter medications. Some medications, such as retinoids (including tretinoin), certain antibiotics, cancer medications, and others can make your skin more sensitive to UV light.
If you’re having PUVA light therapy, you will need to see your ophthalmologist (eye doctor) to have an eye exam before you begin.
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Planning Your Phototherapy
Phototherapy can be done in your home or in a doctor’s office.
Phototherapy in your doctor’s office
Memorial Sloan Kettering (MSK) does not currently do this procedure. If you’re having phototherapy in a doctor’s office, you will need to find a local dermatologist (skin doctor) that does this as an in-office procedure.
We can recommend a dermatologist(s), but if they do not accept your insurance, you can find a dermatologist at: www.psoriasis.org/health-care-providers/physicians-directory or www.aad.org/for-the-public. Your nurse can also give you a list of dermatologists that do phototherapy in their office from the www.aad.org website.
Your dermatologist will explain what you need to do and how long you will receive your phototherapy.
Phototherapy at home
If you’re having phototherapy at home, you will need a home phototherapy machine. Your doctor’s office will send information to the company that will send you the machine and instructions for how to use it.
You can find more information about home phototherapy units and companies that supply them at: www.psoriasis.org/about-psoriasis/treatments/phototherapy/uvb/home-equipment
Depending on the type of home phototherapy machine you use, you will need to:
- Fill out a home phototherapy patient order form and any other needed forms. Your doctor who ordered phototherapy for you will give you these.
- Have your doctor’s prescription that includes the type of therapy and the dose.
You will receive phototherapy at home about _____ times for _______ weeks
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Giving Yourself Phototherapy at Home
- Don’t put on lotion or moisturizer for 24 hours before each treatment.
- For each treatment, you will need:
- Protective goggles. You will get these from the company that supplies your phototherapy machine.
- The home phototherapy machine.
- If you’re only giving phototherapy to certain areas of your body, make sure all other areas are covered. You can cover them with clothing or sunscreen. This keeps your skin from getting burned. If you have any questions about covering your body, ask your doctor or nurse.
- Wear protective goggles during every treatment, as instructed by your doctor or nurse. Wearing goggles will help prevent damage to your eyesight.
- If your eyelids are the area being treated, you don’t need to wear the goggles but be sure to keep your eyes closed during your entire treatment.
- The dose of phototherapy will be calibrated (pre-set) for you by the company that makes the machine.
- Stay the correct distance from the unit throughout your treatment, as directed by your doctor or your home phototherapy machine instructions.
- Expose your affected skin to the phototherapy light, as directed by your doctor.
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After Your Phototherapy
- You may experience redness, itching, or a burning sensation after your phototherapy treatment. These are all normal side effects of this therapy.
- Phototherapy can dry out your skin. Moisturize your skin with a fragrance-free moisturizer, such as Aquaphor® or Cetaphil®, at least once a day.
- It may take 6 to 8 treatments before you start to notice any improvement in your skin. For some people, it may take 2 months to see improvement.
- You may need to follow-up with your dermatologist who is managing your skin condition, your ophthalmologist, and your doctor at MSK.
- Ask your doctors when you should schedule these appointments.
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Call Your Doctor or Nurse if You Have:
- A temperature of 100.4°F (38°C) or higher
- Blistering, cracking, drainage, or a rash on your skin
- One or more new lesions (skin growths or patches that don’t look like the skin around them) on the affected area after your treatment
- Flu-like symptoms, such as:
- Headaches or body aches
- Nausea or vomiting
- Diarrhea (loose or watery bowel movements)
- Sore throat
- Runny or stuffy nose
- Any open areas on your skin, including cuts, tears, blisters, burns, or ulcers
- Redness on the skin that was treated that lasts for more than 24 hours
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American Academy of Dermatology
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Signs and Symptoms
Patients should apply sunblock to uninvolved areas that may become exposed to UV light during the treatment session. Telling your doctor of any moisturizers and topical medications used on a regular basis might help maximize therapy, as some may affect the outcome of the treatment in a positive or negative way. For PUVA therapy, the patient takes a light-sensitizing medication (psoralen) 1–2 hours before UV treatment.
Phototherapy treatments are usually performed at a doctor’s office or a psoriasis center. With the patient undressed to expose the affected areas and spare unaffected areas from the side effects of UV light, special goggles are used to prevent the risk of UV-induced cataracts. Additionally, genitalia are protected to minimize the risk of skin cancer, which is more problematic in that area. The patient stands in front of a light box lined with vertically oriented fluorescent UV lamps.
Each therapy session is supervised by a physician experienced in phototherapy treatments. The first few therapy sessions are brief in duration and are gradually increased once the patient’s response to therapy is assessed. Patients with lighter skin start with shorter times of exposure compared to people with darker skin.
What is phototherapy?
Phototherapy, also called light therapy, means treatment with a special kind of light. It is prescribed to treat atopic dermatitis, contact dermatitis, dyshidrotic eczema, nummular eczema and seborrheic dermatitis.
The most common type of phototherapy used to treat eczema is narrowband ultraviolet B (UVB) light. This uses a special machine to emit UVB light, which is the best part of natural sunlight for treating eczema.
Broadband UVB phototherapy, PUVA (Psoralen and UVA), and UVA1 are other forms of phototherapy that may be used in special circumstances to treat eczema.
Phototherapy helps to:
- Reduce itch
- Calm inflammation
- Increase vitamin D production
- Ramp up bacteria-fighting systems in the skin
Phototherapy is used for eczema that is all over the body (widespread) or for localized eczema (such as hands and feet) that has not gotten better with topical treatments.
About 70% of people with eczema get better with phototherapy. Some people find that phototherapy puts their eczema in a “remittive” or “quiet” state long past the end of the treatment.
What should I expect with phototherapy?
- During your visit you will apply a moisturizing oil to the skin and stand in the cabinet undressed except for underwear and goggles to protect the eyes.
- The machine will be activated for a short time, usually just seconds to minutes, and will treat the entire body, or just certain exposed areas.
- Careful records are kept of your response and the light is slowly increased with each treatment.
- After several months of treatment, the frequency of the visits can sometimes be reduced to once or twice weekly.
- If things continue to improve, phototherapy can be stopped for a period to see if the eczema is in remission.
- If successful, some patients may restart the cycle or simply come once or twice weekly to maintain their improvement.
- When it does work, it is not a rapid improvement like some treatments. Generally it takes 1-2 months of steady treatment with phototherapy to start to see improvement in eczema symptoms.
What are the risks of phototherapy treatment?
Overall, phototherapy is considered safe. Known risks of phototherapy include:
- Skin aging
- Headaches and nausea (with PUVA treatment)
- Cataracts from insufficient eye wear during treatment
The Risks and Benefits of Light Therapy for Atopic Dermatitis
Light therapy, also known as phototherapy, is a skin treatment that harnesses the power of ultraviolet (UV) light to ease severe eczema symptoms. It can be a potent weapon in the arsenal of treatments for people with difficult-to-treat atopic dermatitis, the most common type of eczema. But while light therapy can help improve symptoms, it also comes with risks.
Light therapy is generally reserved for adults and adolescents with widespread eczema symptoms, or for those whose atopic dermatitis is not responding to first-line treatments (such as gentle moisturizers or topical steroids). The treatment involves emitting UV light from special medical therapy lamps, and can help reduce inflammation and itch. About 70% of people see an improvement in symptoms after light therapy, according to the National Eczema Association.
Narrowband ultraviolet B (UVB) light is the type of phototherapy usually recommended for the treatment of atopic dermatitis, but there are also other types, such as UVA1 and broadband UVB phototherapy.
“Some may say is time-consuming because it includes many treatments and visits to the doctors, but its results are unrivaled,” said Kim Nichols, MD, a Greenwich, Conn., dermatologist and cosmetic surgeon. “A successful response returns the skin to a normal appearance.”
RELATED: 9 Things You Should Never Do If You Have Eczema
Still, light therapy is not a panacea for every eczema sufferer. And experts stress that people with atopic dermatitis should speak to their doctor about the benefits and risks of this treatment first.
“We don’t necessarily like to put people into it unless there’s nothing else that’s keeping them controlled,”says Jon Hanifin, MD, professor of dermatology at Oregon Health & Science University in Portland.
For such patients, Dr. Hanifin usually puts them on an immunosuppressant medication such as cyclosporine for a limited period of time (cyclosporine can have worrisome side effects)until their skin isn’t “all thickened and red and scratched.” He then tapers them off the treatment while they’re building up their ultraviolet treatments with the goal of stopping inflammation.For these people, he explains, light therapy can be a bridge to healthier skin. “UV is really good for them,” he says. “But it’s not for everybody.”
As with ultraviolet radiation from the sun, light therapy has risks. The most obvious is that exposure to UV radiation can produce genetic mutations that eventually lead to skin cancer or, in rare cases, melanoma, the deadliest form of skin cancer. Men whose genitals are exposed to UV light may be at risk for genital cancer. Light therapy can prematurely age the skin, especially in people who are fair-skinned.
Patients typically wear goggles during light therapy sessions to guard against eye damage. Treatment can also cause burning, stinging, and redness.
Dermatologists are mindful of these risks, which is one reason why light therapy for atopic dermatitis is given in controlled doses, usually two to three times a week, and generally under physician supervision.
Phototherapy for Eczema & Dermatitis
Exposure to these altered UV rays, called narrow band UVB rays, may shut down the immune system cells in the skin that have caused the inflammation. Phototherapy may relieve symptoms of eczema and dermatitis without the need for medicated skin creams or medications taken by mouth. Phototherapy poses minimal risk of skin cancer and may be safe for children and pregnant women.
Each phototherapy unit is a chamber lined with long, tubular UVB light bulbs. These bulbs emit therapeutic light rays, and the effects of therapy may be noticeable after just a few weeks of treatment. Your dermatologist may suggest medication in addition to phototherapy to enhance the results of both types of treatment.
For people with moderate-to-severe eczema or dermatitis, dermatologists may recommend two or three phototherapy sessions a week. Our dermatologists and staff offer appointments throughout the week, including evenings and Saturdays, to make scheduling treatments convenient for you.
Possible side effects include redness, burning, or stinging of the skin, although research shows that side effects to phototherapy are infrequent and usually go away quickly.
Blog & News
Pediatric Eczema? Try Home Phototherapy!
A child’s skin – there are few things more delicate or sensitive. Unfortunately, eczema can affect between 7% and 17% of all infants and children in some form, usually in the first 6 months to 5 years of life. The most common type of eczema is atopic dermatitis, and children with a family history of atopic dermatitis, asthma, or hay fever are more likely to develop the problem.
Eczema and atopic dermatitis are chronic conditions and may last well into a child’s teenage years and beyond. So, when contemplating a long-term treatment plan for your pediatric patient, consider the following:
- Phototherapy is used for eczema that is widespread or for localized eczema (such as hands and feet) that has not improved with topical treatments. It helps to reduce itch, calm inflammation, increase vitamin D production and ramp-up bacteria-fighting systems in the skin.
- About 70% of people with eczema resolve their disease with phototherapy and many patients find that phototherapy puts their eczema in remission long past the end of the treatment. One study of UV phototherapy in children with eczema showed that the effects lasted approximately 6 months after treatment before returning.
- There are no age restrictions for Narrowband UVB, but treatments at home are less frightening for young children, who may be distressed by frequent visits to a clinic. It is also more convenient for working parents and school aged children, as treatment can take place on weekends and evenings, allowing for a consistent treatment regimen.
- The most common challenge treating children with UV light is keeping the child calm and still while undergoing therapy in a clinical booth or cabinet style phototherapy unit. Home phototherapy units, such as an open panel device or a treatment wand, feel less intimidating, and allow the parent and child to see each other during the treatment.
- The child’s anxiety can be reduced by playing their favorite music, placing a sticker on the floor for them to stand on, or pretending that their UV goggles have super powers!
For more information about prescribing home phototherapy for your patients, contact Daavlin today!
Find a provider who offers phototherapy in our Health Care Provider Directory “
Learn more about phototherapy by contacting our Patient Navigation Center “
Learn about different types of light therapy:
- Ultraviolet light B (UVB)
- Psoralen + UVA (PUVA)
- Tanning beds
Ultraviolet light B (UVB)
Ultraviolet B, which is present in natural sunlight, is an effective treatment for psoriasis. UVB penetrates the skin and slows the growth of affected skin cells. Treatment involves exposing the skin to an artificial UVB light source for a set length of time on a regular schedule. This treatment is administered in a doctor’s office or clinic or at home with a phototherapy unit.
There are two types of UVB treatment: broad band and narrow band. The main difference between them:
- Narrow-band UVB light bulbs release a smaller range of ultraviolet light.
- Narrow-band UVB may clear psoriasis faster and produce longer remissions.
- Narrow-band UVB may require fewer treatments per week.
UVB treatment is offered in different ways. This can include small units for localized areas such as the hands and feet, full-body units or hand-held units. Some UVB units use traditional UV lamps or bulbs, and others use LED bulbs.
Home UVB phototherapy
Treating psoriasis with a UVB light unit at home can be an economical and convenient choice. Like phototherapy in a doctor’s office or clinic, it requires a consistent treatment schedule. Individuals are treated initially at a medical facility and then begin using a light unit at home.
It is critical when doing phototherapy at home to follow a doctor’s instructions and continue with regular check-ups.
All phototherapy treatments, including purchase of equipment for home use, require a prescription.
The excimer laser, approved by the Food and Drug Administration (FDA) for treating chronic, localized psoriasis plaques, emits a high-intensity beam of ultraviolet light B (UVB).
The excimer laser can target areas of the skin affected by mild-to-moderate psoriasis. Research indicates it is a particularly effective treatment for scalp psoriasis. However, there is not yet enough long-term data to indicate how long improvements will last following a course of laser therapy.
Although both UVB and ultraviolet light A (UVA) are found in sunlight, UVB works best for psoriasis. UVB from the sun works the same way as UVB in phototherapy treatments.
However, using sunlight to treat psoriasis is not recommended for everyone. Sunlight is not as effective for the treatment of psoriasis as prescription phototherapy. Talk with your doctor to find out if treating with sunlight is right for you.
Note: Some topical medications can increase the risk of sunburn. These include tazarotene, coal tar, Elidel (pimecrolimus) and Protopic (tacrolimus). Individuals using these products should talk with a doctor before going out in the sun.
People who are using PUVA (see below) or other forms of light therapy should limit or avoid exposure to natural sunlight unless directed by a doctor.
Psoralen + UVA (PUVA)
UVA is relatively ineffective for psoriasis unless it’s used with the light-sensitizing medication psoralen. This process, called PUVA, slows down excessive skin cell growth and can clear psoriasis symptoms for varying periods of time. Stable plaque psoriasis, guttate psoriasis, and psoriasis of the palms and soles are most responsive to PUVA treatment.
Some people visit tanning salons as an alternative to natural sunlight. Tanning beds in commercial salons emit mostly UVA light, not UVB. The beneficial effect for psoriasis is attributed primarily to UVB light. NPF does not support the use of indoor tanning beds as a substitute for phototherapy performed with a prescription and under a doctor’s supervision. Read more on NPF’S position on indoor tanning beds “
The American Academy of Dermatology, the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention all discourage the use of tanning beds and sun lamps. Indoor tanning raises the risk of melanoma by 59 percent, according to the AAD and the World Health Organization. In May 2014, the FDA reclassified sunlamps (which are used in tanning beds and booths) from Class I (low risk) to Class II (moderate risk) products.
The ultraviolet radiation from these devices can damage the skin, cause premature aging and increase the risk of skin cancer.
Get the facts on phototherapy
NPF’s fact sheet on phototherapy will help you get up to speed on the popular treatment option.
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Phototherapy uses lightwaves to treat certain skin conditions. The skin is exposed to an ultraviolet (UV) light for a set amount of time. Phototherapy uses a man-made source of UV light. UV light also comes from the sun. When combined with a medication called psoralen, the procedure is known as psoralen UVA (PUVA).
UV light shuts down immune system cells in the skin. It can help in skin conditions that are caused by an overreaction of the immune system. Skin conditions that are treated with phototherapy include:
- Psoriasis — a skin disorder that causes red, silvery, scaly patches on the skin
- Eczema — an itchy, red skin condition, or dermatitis due to allergies
- Mycosis fungoides — a type of lymphoma confined to the skin
- Vitiligo — a skin disorder where normal skin pigment is lost due to destruction of pigment-producing cells by the immune system
The UV lights may negatively affect your skin in a number of ways, including:
- Skin conditions could temporarily worsen
- Itchy skin
- Red skin due to exposure to the lights
- Burning of the skin
PUVA treatment may also cause:
- Burning skin
- Cataracts — lens of eye becomes cloudy, affecting vision
If you have received a great number of phototherapy treatments, you may be at risk for:
- Premature aging of the skin, such as wrinkling and dryness
- Age spots or freckles
Factors that may increase the risk of complications include:
- Allergy to sunlight
- Pregnancy or nursing
- Medical conditions, such as skin cancer or lupus, that require you to avoid the sun
- History of skin cancer
- Liver disease — phototherapy may increase medication levels in the blood
What to Expect from Phototherapy
Preparing for Phototherapy
You will be asked to remove any clothes that cover the skin being treated. Areas that do not need treatment should be covered and protected as much as possible. Some safety steps include:
- Sunscreen to protect your neck, lips and the backs of your hands
- Special glasses or goggles to protect your eyes from UV light
- Cover for genitals in men
- Sunscreen for nipples and areola in women
Make sure to inform your doctor about any medication that you are currently taking. Some medications, including over-the-counter medication, can increase the risk of side effects.
The Phototherapy Procedure
Types of phototherapy include:
- Broad band UVB — Uses UV light, type B. It cannot be used in areas where there are skin folds.
- Narrow band UVB (nbUVB) — Uses a narrower range of UVB wavelengths. It can reach more specific areas, even skin folds.
- PUVA — This UVA light treatment includes a medication called psoralen that is taken before treatment. It makes your skin more sensitive to the light. Psoralen can be taken as a pill or applied to the skin.
- Lasers — An excimer laser emits a UV light. It can be directed at specific areas of the skin.
Treatment over a large area may be treated in a treatment unit. You can stand in this unit during treatment. Smaller areas may be treated with smaller units. A laser treatment will use a laser light that is focused on the specific area.
Phototherapy Session Length
The first treatment is usually very short, even a few seconds. Your phototherapy sessions will vary in length. It will depend on your skin type and the strength of the light chosen by your doctor. Treatments rarely last longer than a few minutes.
Generally, several treatments are required each week. The length of treatment will depend on the type of phototherapy:
- Broad band therapy requires approximately 3-5 treatments each week.
- Narrow band therapy requires 2-3 treatments each week.
- PUVA treatments generally require about 25 treatments over a 2-3 month period.
- Laser treatments are usually given twice a week and fewer sessions are required to clear the skin.
Treatments will continue until your skin is clear. Sometimes, occasional maintenance treatments are needed. The maintenance sessions can usually be done in your doctor’s office or with a home UV light unit.
What Phototherapy Feels Like
You may feel a warm sensation on your skin, similar to a mild sunburn. Your doctor can recommend medication if you have discomfort after treatment.
It is important to avoid natural sunlight when you are receiving UV light treatment:
- Clothing and sunscreen should be used when outdoors. They will help you avoid overexposure to UV light.
- There is an increased risk of sunburn after PUVA treatment. This is due to increased sensitivity from the psoralen.
- It is important to protect your eyes from sunlight exposure for the next 24 hours. This will help you to avoid cataracts after PUVA treatment.
- Antihistamines and other medication may be given to ease the itching.
Your doctor should regularly examine your skin for skin cancer. UV light exposure from sunlight causes skin cancer. Long-term PUVA treatment can also increase the risk of skin cancer. No studies have found a direct link from nbUVB phototherapy to skin cancer.
Be sure to follow your doctor’s instructions.
After arriving home, contact your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Redness around the skin lesions or any discharge
- Severe skin burning, pain or blistering
- Side effects you experienced due to the treatment continue or worsen
- Development of new symptoms
In case of an emergency, call for medical help right away.
Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.
The Pros and Cons of Eczema Light Therapy
Eczema light therapy refers to the use of ultraviolet (UV) 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. As you might guess, the use of light to treat eczema is not without its downsides.
“Natural sunlight can help symptoms of eczema, but artificially produced UV light is best for eczema treatment because it can be controlled and given under supervision,” says Elizabeth Page, MD, a dermatologist at the Lahey Clinic and an instructor in dermatology at Harvard Medical School in Boston. “Light therapy can be an effective treatment for adults and children older than 12 for moderate to severe eczema that does not respond well to other eczema treatments.” According to Dr. Page, there are three different types of eczema phototherapy:
- Broadband UVB phototherapy. UVB stands for type B ultraviolet light, which has been used to treat skin conditions since the 1920s. Eczema treatment involves standing in a light box three times per week for a total course of 20 to 30 treatments. The length of each treatment increases until the skin becomes slightly pink. After the first phase of treatment, weekly maintenance treatments may be given.
- UVA phototherapy. UVA stands for type A ultraviolet light. UVA is also present in sunlight, but acts differently on the skin than UVB. In order for UVA eczema light therapy to be effective, an oral medication, psoralen, must be taken an hour prior to the treatment to make the skin more sensitive to the light therapy. This combination of psoralen and UVA is called PUVA phototherapy. PUVA eczema treatments are given two to three times per week for 12 to 15 weeks. As with UVB, the length of exposure is increased gradually, and weekly maintenance treatments may be given after the first phase of treatment. Some people are unable to tolerate PUVA because of nausea from psoralen.
- Narrowband UVB phototherapy. “Narrowband UVB is gradually replacing both broadband UVB and PUVA,” says Page. “It is as effective as other types of eczema phototherapy and has fewer side effects because you don’t need to take a pill. Narrowband UVB uses a very small part of the UVB spectrum, which cuts down on exposure to UV radiation.” Because eczema treatments can be given more safely, narrowband UVB may be more effective and require a shorter course of treatment.
“The benefits of using eczema light therapy are that these therapies often work when other eczema treatments have not, and if done properly they actually have fewer side effects than many of the prescription medications used for eczema,” Page says.
Risks of Eczema Light Therapy
The biggest drawback of eczema light therapy is that it’s very time consuming and requires many trips to the doctor’s office over several weeks, Page says. Although there are light therapy units available by prescription to use at home, most dermatologists prefer to have treatments done in the office where UV light exposure can be controlled.
Here are some of the other risks of eczema phototherapy:
- Burning. Artificial UV light, like natural sunlight, can cause sunburn and blistering. Skin may redden and itch. “People who have a light complexion have more tendency to burn and may not be able to tolerate too much UV light therapy,” warns Page.
- Skin damage. Over time skin can become wrinkled and freckled. The skin will darken as with a suntan, and brown spots may form.
- Skin cancer. “Although there is no proof that light therapy causes skin cancer, we know that prolonged exposure to UV light can cause skin cancer, so this is a theoretical possibility and it is important to limit exposure as much as possible,” says Page.
- PUVA. The medication that is given with PUVA eczema light therapy can cause headache and nausea. The UVA in PUVA can cause cataracts if eye protection is not sufficient.
UV light and eczema therapy is an effective treatment for moderate to severe eczema if it is carefully controlled and the proper precautions are taken. Talk to your dermatologist to see if eczema light treatment might work for you.
Whether you’re going in-salon or trying it at home, here’s everything you need to know about light therapy for your skin…
What is light therapy?
Dermalux™ LED Phototherapy is a non-invasive hand and facial treatment that uses narrow band, non-thermal LED light energy to trigger your body’s natural cell processes to accelerate rejuvenation and repair of the skin. It’s recommended for skin rejuvenation, sun damage, acne, rosacea, eczema, psoriasis, dermatitis, sensitive and inflammatory conditions, wound healing and scarring as well as anyone looking to restore skin’s radiance.
What does light therapy do?
LED Light Therapy is great in every single facial to calm any areas of irritation and it’s also brilliant at brightening the skin.
When used consistently, over time, LED lights are thought to penetrate your skin at different depths and cause various reactions in your skin, such as fighting acne-causing bacteria, plumping skin and reducing wrinkles.
A course of treatments offers corrective and long-lasting results, although you’ll be able to see a difference after the first session. Light therapy is also particularly calming, so you’ll leave feeling refreshed.
How does light therapy work?
LED Light Therapy uses colour wavelengths of visible light which have specific skin benefits. As a result of ageing, skin disorders or trauma, healthy skin cells are compromised and unable to renew themselves normally.
The skin uses the light as a source of energy to fuel the repair and rejuvenation of damaged cells, or, in the case of treating acne, kill bacteria. The energy stimulates the production of collagen and elastin, boosts circulation and accelerates tissue repair. During the treatment, you’ll simply lie underneath a light screen while the device does all the work.
We use LED in every single facial. We start with the cleaning of the skin which includes a Lactic brightening peel and extractions if needed. We then go onto the advanced side of the facial and finish with a full session (20 minutes) of LED.
If someone is coming only for LED we clean the skin, then apply LED and SPF to finish.
What types of light are there and what do they do?
This is a powerful antibacterial properties for the treatment of acne without irritation, reduces oil production, prevents future breakout and offers a UV-free alternative for the treatment of eczema and psoriasis.
This increases natural hydration levels, reduced redness and inflammation, shrinks the appearance of pores, regulates oil production, improves circulation, accelerates skin repair as is a medically-approved treatment for rosacea.
Near Infra-Red Light
This is the most deeply absorbed wavelength, it increases cell permeability and absorption, smooths lines and wrinkles, improves elasticity, reduces pain and inflammation, accelerates wound healing and heals cystic acne.
4 Of The Best At-Home Light Therapy Treatments
MZ Skin Light-Therapy Golden Facial Treatment Device – £385
Dr.Denis Gross SpectraLite EyeCare Pro – £175
Foreo Espada Blue Light Acne Treatment – £129
Neutrogena Visibly Clear Light Therapy Targeted Treatment – £29.99
What skin types should try light therapy?
Light therapy is good for all skin types, literally everyone, and incredible for rosacea.
Does light therapy hurt?
No, LED light therapy is completely non-invasive and does not hurt. All you’ll feel is a tiny bit of warmth.
Can you get a tan from light therapy?
Nope! Light Therapy doesn’t use UV light so there’s no risk of tanning whatsoever.
The Best Facial Cleansing Brushes And Tools
Panasonic Micro-Foaming Cleansing Device – £149.99
This dual-ended powerhouse makes the chore of double cleansing feel more like a luxury facial. The first step is quite cool: simply smooth on a cleansing oil and glide the satisfyingly warm plate over your skin to melt away make-up.
Then, squeeze a little foaming cleanser and a capful of water into the compartment above the handle. Once switched on, the bristles create a lather that removes the dirt you missed during the initial cleanse. There’s also a silicone brush head with smaller bristles to target your nose. Buh-bye, blackheads.
Foreo Luna 2 Sensitive/Normal Skin – £169
Oh Foreo Luna, how we love thee. Unlike cleansing brushes, this egg-shaped contraption harnesses teeny tiny and ultra-gentle silicone bristles which oscillate back and forth to target every single nook and cranny of your face. The result? Skin that is much clearer, brighter and smoother. If you’re prone to the odd breakout or suffer with congested skin all year round, invest and team with an AHA/BHA cleansing formula.
Clarisonic Smart Profile Uplift Anti-Ageing Massage And Cleansing – £225
Clarisonic’s Smart Profile takes the humble cleanse to clever new heights – really clever. Thanks to the hidden microchip technology, it has the ability to adjust to the frequency required for each brush head – including the new Revitalising Cleanse, a super-soft brush which can purge pores of dirt, oil and make-up 6 times better than fingertips alone – and the new Firming Massage.
A bit like a workout for your face, this head firms and tones for a plump, pillowy look and feel. Alternate between them for skin even a supermodel would be jealous of.
Erborian Charcoal Konjac Sponge – £10
Made from an Asian plant, the springy konjac sponge has been a staple tool in the cleansing rituals of beauty journos for years, but this goes one step further. It’s infused with bamboo charcoal, which has the knack of making skin feel matte, fresh and just generally cleaner for longer. Paired with a dollop of your favourite cleanser, it’ll make 11AM oil slicks a thing of the past. P.S. You can re-use it over and over.
Darphin L’Institut Facial Sonic Cleansing And Massaging Expert – £130
You can expect real, visible pore-shrinking and radiance-enhancing results from this kitsch-looking device by the skin experts at Darphin, which rarely ever needs charging.
The cleansing brush head is pretty unique thanks to the combination of synthetic bristles which sweep away grime and the six silicon nubs that mimic the microcirculation boosting technique of the brand’s iconic Deep Massage. It’s a totally worthy splurge if you like your skin to feel pampered as well as sparklingly clean.
Nurse Jamie Exfoliband Silicone Loofah – £14
The fancy skincare products currently lining your bathroom shelf? They’re less likely to penetrate your skin if it isn’t cleansed properly, making those amazing promised results elusive. Enter Nurse Jamie’s savvy silicone Loofah.
It may look a little bit like perler bead art (Google it for a dose of 90s nostalgia) but the clever ridges work a treat to slough away make-up and dead skin cells for brighter skin that absorbs ingredients better. Simply apply cleanser to damp skin like usual and gently massage it over the face.
Magnitone London BareFaced2 Daily Cleansing and Skin Toning Brush – £63
Believe us when we say that this is a fast-track to immaculate skin. In twenty seconds to a minute, sonic oscillations and pulsed vibrations ensure no pore is left unturned so you can say a big fat see ya to the grime, oil and dead skin cells that often lead to spots. Oh, and another thing: It’s 100% waterproof, which means you can take it into the shower with you – YAS.
Real Techniques Miracle Cleansing Sponge – £5.99
This is a fast, convenient and all-round much kinder-to-skin alternative to using scrubs. Whether you prefer a foaming, cream or gel cleanser, all you need to do is soak it through and squeeze, apply a little product to the flat end and work it over the skin. The sponge feels soft but exfoliates away the dead skin cells you can’t see, creating a f-l-a-w-l-e-s-s canvas for make-up. Sam and Nic, we salute you.
Clinique ‘Sonic System’ Purifying Cleansing Brush – £79
If you’re going to put your trust in any cleansing tool, make it one that has been developed by dermatologists! With a tilted head that makes its way into the hard-to-reach areas, Clinique’s cleansing brush is especially brilliant for those with bumpy, rough skin texture and blackheads.
After one use, our skin looked and felt a hell of a lot more refined and foundation virtually floated on.
Clarisonic Mia Smart Facial Cleansing Device – £185
Cult for a reason, Clarisonic’s water-resistant brush cleanser uses a sonic frequency of more than 300 movements per second (impressive, right?) to turf the gunk out of pores, leaving skin crystal clear, insanely smooth to the touch and more receptive to skincare products so that they have a better chance at working their magic.
Super sleek, the gadget sits really neatly in your hand and gives good grip – even when wet or covered in cream cleanser!
Sisley Paris Gentle Brush For Face And Neck – £26
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.
Pros and cons of phototherapy
“I’d be crying all night because of the pain,” Leeolou says. “It was very difficult to treat when I was a child because my parents did not feel comfortable with biologic medications.”
Biologics had not yet been approved for children, and topical treatments had little effect. Desperate for relief, the family poured their life savings into a month-long sojourn for the 3-year-old to the Dead Sea, known for the healing effects of its mineral-laden water. By the time they returned home, Leeolou’s skin had almost completely cleared, and it stayed that way for a year. But soothing water wasn’t the only therapeutic benefit the family discovered beneath the bright sunshine of the Israeli desert.
“That was my first introduction ,” says Leeolou, a former professional ballerina who is now applying to medical school. “After that, we always prioritized getting sun exposure.”
Like Leeolou, many people with psoriasis discover on their own the remarkable effect ultraviolet (UV) rays can have on the disease. But they also know the downsides of getting too much sun, from premature aging to skin cancer.
For many patients, the solution is phototherapy. Regular, medically supervised exposure to UV light — which provides the benefits of sunbathing while minimizing its risks — can serve as a powerful tool in the treatment of psoriasis.
“The majority of patients are good candidates for it,” says Joel Gelfand, M.D., director of the Psoriasis and Phototherapy Treatment Center at the University of Pennsylvania. “When patients are selected and treated properly, they usually do very well.”
Leeolou, now 26, started phototherapy when she was about 14. Throughout high school, regular light treatment halved the percentage of her skin covered in plaques.
“It did not cure my psoriasis, but it alleviated a lot of the pain, a lot of the redness, and it did minimize the thickness of my plaques and how much of my body was covered,” Leeolou says. “It did provide a lot of relief.”
Reaping the benefits
In 2012, Gelfand and several co-researchers conducted a survey of 1,000 dermatologists nationwide to learn their preferences for treating moderate to severe psoriasis. Researchers found that ultraviolet B (UVB) phototherapy was the most commonly favored first-line intervention for healthy adults, recommended for about half of such patients.
Safety is a big reason many doctors prefer this time-tested treatment, even in the age of revolutionary psoriasis drugs.
“Light therapy is considered to be the safest way to treat psoriasis because you’re treating from the outside in,” Gelfand says. While biologics can increase the chance of infections and require monitoring for other adverse effects, the risks associated with phototherapy are fairly minor, ranging from nausea to the possibility of sunburn on freshly exposed skin.
“We’re using the wavelengths that are the most effective and least detrimental,” says Jerry Bagel, M.D., director of the Psoriasis Treatment Center of Central New Jersey. “This is not the kind of light you get in a tanning salon.”
Wavelengths on the UV light spectrum are measured in nanometers, or billionths of a meter. UVA light (the type generally used in tanning beds and most closely associated with skin aging and melanoma) spans from 320 to 400 nanometers. UVB light ranges from 280 to 320 nanometers, with the window from 311 to 313 nanometers — called narrowband UVB — the most common for treating psoriasis. Narrowband UVB replaced broadband UVB, as it was found to be the most effective wavelength to treat psoriasis without causing sunburn.
For each phototherapy treatment, patients typically step into a light box at a dermatologist’s office nude (although men must cover the genital area, and most people wear goggles, plus a towel over the eyes and face). Bulbs emit a short burst of narrowband UVB light, ranging from a few seconds to a few minutes, depending on the person’s skin type and how many treatments he or she has had. The rays penetrate bared skin, slowing the growth of affected skin cells and decreasing inflammation. And it’s remarkably effective in doing so: People with psoriasis who receive light therapy three times per week for 12 weeks have a 75 percent chance of clearing the skin by 90 percent for six months or longer, says Bagel, a member of NPF’s Medical Board.
“It’s a very valuable therapeutic method for people with psoriasis, especially because it’s very safe,” he says.
The combination of safety and efficacy makes phototherapy particularly appealing to patients who aren’t good candidates for biologics because of age, pregnancy or other medical conditions.
“It’s so comforting having a treatment option that doesn’t have internal side effects,” Leeolou says.
Assessing the limitations
For much of her adult life, Nancy Renner’s silver hair hung below her ribs, making a ponytail as thick as her wrist. Then her psoriasis flared in 2015, and she says the disease morphed from a nickel-sized lesion on her head to an excruciating inflammation that covered about a third of her body. The lesions ravaged her scalp, causing so much hair to fall out that her ponytail was reduced to the size of her pinky. Renner noticed improvement elsewhere on her body during a sunny vacation, but beneath her thinning hair, the skin remained broken and bloodied.
“My scalp just did not heal,” says Renner, a 67-year-old former school counselor in Cottage Grove, Oregon. So when a dermatologist suggested phototherapy, Renner made a difficult choice: She decided to shave her head so the UV rays could reach her scalp.
“I went to my son’s house and said, ‘I need you to take my hair off,’” Renner recalls. “I was careful not to look at myself in the mirror.”
After just 10 days and a few light treatments, her wounded scalp had healed of all lesions. Nearly a year later, Renner has a healthy head of short hair and her skin remains free of psoriasis — a transformation she attributes only partly to phototherapy, and largely to changes in her diet, exercise habits and stress management.
“The light therapy was fabulous to give me comfort,” she says. “It diminished the symptoms while the inside of my body healed.”
As encouraging as it is, Renner’s success story underlines one of the drawbacks of light therapy: Its effectiveness is limited to areas of the body where the rays can shine. Though handheld units can help access hard-to-reach areas, psoriasis of the scalp, genitals and nails generally don’t respond well to traditional UV treatment, experts say. Furthermore, phototherapy doesn’t treat psoriatic arthritis, which affects about a third of people with psoriasis.
Another disadvantage is inconvenience. Although office visits for light therapy typically last just 15 minutes from start to finish, the necessary frequency of treatment can be a burden. “It’s obviously cumbersome to come into the office three times per week,” Bagel says. “But if you’re only coming in twice a week, it’s not going to work.”
The strain can be especially great for rural patients like Renner, who for months drove 60 miles round trip to Eugene, Oregon, for each session. Additionally, some insurance plans require a separate copay for each visit.
“From a patient perspective, it can get quite costly,” Bagel says.
And although phototherapy is considered the safest treatment for psoriasis, even narrowband UVB isn’t without risk of skin damage. “There really haven’t been definitive studies to rule that out,” Gelfand says, although he adds that after decades of clinical use, such side effects have not been observed. “If it does increase , it’s probably modest enough that it’s not a major concern.”
Lighting the future
Narrowband UVB emitted from a light box may be the most common type of phototherapy for psoriasis, but it isn’t the only kind — and innovations continue to expand the options. Excimer laser treatments, which target localized psoriasis lesions with doses of narrowband UVB, can be especially helpful for hard-to-reach places. For instance, this therapy can treat the scalp without having to trim back hair. Additionally, some patients still benefit from PUVA, a less common treatment dating to the 1970s that combines exposure to UVA rays with a pill, psoralen, that causes the skin to become more sensitive to light. The skin damage associated with UVA, however, limits the recommended duration of this treatment.
“You can treat the psoriasis with really high doses of UV light,” Gelfand says. “You don’t have to treat the entire body.”
Home-based narrowband UVB units have also become safer and easier to use, says Gelfand, who is conducting a study comparing the effectiveness of office-based versus home-based phototherapy. Prior research shows that 82 percent of people with psoriasis would prefer home-based treatment if it proved equally effective.
“The overarching goal is to make research and treatment more patient-centered,” Gelfand says.
After relying on phototherapy for the majority of her youth, as an adult, Leeolou eventually turned to biologics. But when her mother suddenly developed psoriasis a decade ago, she followed her daughter’s lead and first tried several months of phototherapy — and the disease has been in remission ever since.
“That’s all she really needed,” Leeolou says. “It’s great to have phototherapy as a first-line intervention.”
And then there was LITE
In 2017, the Patient-Centered Outcomes Research Institute awarded an $8.6 million contract to Joel Gelfand, M.D., for a clinical trial called LITE, to be conducted in partnership with NPF. LITE’s purpose: To study the effectiveness and safety of 12 weeks of home-based versus office-based phototherapy for the treatment of psoriasis. Gelfand and his team are also studying whether patients with fairer skin are more prone to problems with tolerability, such as burns from increased light penetration, and whether those with darker skin are more prone to problems with effectiveness due to decreased ultraviolet light penetration.
LITE, which launched in 2019, involves a controlled study of patients age 12 and older under real-world conditions – either at home or at their health care provider’s office. LITE could someday provide the data necessary to better inform treatment decisions for hundreds of thousands of phototherapy candidates.
LITE is not scheduled to end until 2023. We are still recruiting sites and patients. If you are a provider or clinician and you offer narrowband UVB phototherapy, we invite you to join LITE.
Editor’s note: The section above has been updated to reflect that the LITE study has launched and is underway.
Learn more about phototherapy – or other treatment options
NPF Patient Navigators can answer your questions and share information about psoriatic disease treatments. Through our resources and one-on-one support, we help you live your healthiest life with psoriasis or psoriatic arthritis.
Laser therapy may ease type of eczema
NEW YORK (Reuters Health) – Laser therapy that delivers a concentrated beam of ultraviolet light may help ease a hard-to-treat form of eczema, a small study suggests.
The study, published in the British Journal of Dermatology, compared the effects of laser therapy versus corticosteroid ointment in 13 patients with what is known as the prurigo form of atopic dermatitis.
Atopic dermatitis is a type of eczema, or skin inflammation, that arises from an allergic reaction; the prurigo form is marked by small, hard, intensely itchy nodules on the skin.
Only a small proportion of people with atopic dermatitis have the prurigo form, but the condition can be challenging to manage, according to Dr. Elian E.A. Brenninkmeijer, a dermatologist at the University of Amsterdam, in the Netherlands, and the lead researcher on the study.
The current findings, while based on only a small number of patients, suggest that when topical treatments fail to improve prurigo atopic dermatitis, laser therapy may be a suitable option, Brenninkmeijer told Reuters Health in an email.
Specifically, a device called the 308-nm excimer laser is approved in the U.S. for treating atopic dermatitis and certain other skin conditions, including psoriasis and vitiligo. It works by emitting a concentrated beam of ultraviolet B (UVB) light directly to patches of affected skin, avoiding the healthy surrounding skin.
UVB light has long been used to treat some cases of atopic dermatitis; it is thought to help by quelling the exaggerated immune response causing the skin inflammation. The purported advantage of the excimer laser over traditional UVB therapy is that it more precisely targets the problem areas of the skin.
However, there are only limited study data on the effectiveness of the laser therapy for atopic dermatitis, and almost nothing known about how it works for the prurigo form.
To investigate, Brenninkmeijer and his colleagues recruited 13 adults with atopic dermatitis and prurigo nodules on the upper or lower extremities on both sides of the body.
Over 10 weeks, the patients received twice-weekly laser treatments on one side of the body, and used prescription corticosteroid ointment — clobetasol propionate — on the other side of the body. Both the laser treatment and the ointment were applied directly to the prurigo nodules.
By the end of the treatment period, the study found, both therapies were similarly effective in reducing the number of skin nodules, inflammation and itchiness. All but one patient showed improvements; for three patients, the laser-treated side of the body showed greater improvements, while for four, the corticosteroid-treated side fared better.
However, the benefits of the laser tended to be longer lasting. Six months after treatment, eight patients had maintained a significant improvement on the laser-treated side, while only three showed similar results on the corticosteroid-treated side.
According to Brenninkmeijer, larger clinical trials are now needed to confirm the effectiveness of laser therapy for this form of atopic dermatitis, as well as its cost-effectiveness.
Topical corticosteroids have an obvious advantage in that they are inexpensive and convenient. But for people whose skin condition does not improve with topical treatment, Brenninkmeijer said, “the excimer laser might be a good alternative.”
The potential short-term risks of the laser therapy include burns (similar to a sunburn), blistering and skin darkening. Little is known about the possible long-term side effects, including whether there is any increase in skin cancer risk, according to Brenninkmeijer.
Researchers are still unsure whether traditional UVB therapy carries a heightened risk of skin cancer in the long term. It’s possible, Brenninkmeijer noted, that any such risk would be less with the excimer laser, since it targets only small areas of affected skin, but that remains to be seen.
SOURCE: here British Journal of Dermatology, online May 20, 2010.
Our Standards:The Thomson Reuters Trust Principles.
The Toronto Dermatology Centre is one of the premiere places in Canada to manage eczema. Our staff of outstanding dermatologists and estheticians can offer both a comprehensive assessment and diagnosis of your skin, and also discuss all the treatment options including: moisturizer selection, discussion of clothing choices, humidifiers, and other behaviours that affect skin hydration, and physician-grade skin products exclusive to our clinic. In some cases prescription creams are required and occasionally pills to treat itch or infection; in other cases, our dermatology clinic provides OHIP-covered phototherapy to treat widespread or poorly controlled eczema.
The terms “eczema” or “dermatitis” are used to describe a group of skin conditions characterized by inflamed skin. Eczema can be red, blistering, oozing, scaly, brownish, or thickened and usually itches. A special type is called atopic dermatitis or atopic eczema.
Atopic Dermatitis or Atopic Eczema
The word “atopic” means there is a tendency for excess inflammation in the skin and linings of the nose and lungs. This often runs in families with allergies such as hay fever and asthma, sensitive skin, or a history of atopic dermatitis. Although most people with atopic dermatitis have family members with similar problems, 20% of them are the only ones in their family with the condition.
Atopic eczema is very common in all parts of the world. It affects about 10% of infants and 3% of the total population in North America. Atopic eczema can occur at any age but is most common in infants to young adults. The skin rash is very itchy and can be widespread, or limited to a few areas. The condition frequently improves with adolescence, but many patients are affected by atopic eczema throughout life, although not as severely as in early childhood.
When the disease starts in infancy, it is called infantile eczema. This is an itchy, oozing, crusting rash and occurs mainly on the face and scalp, but patches can appear anywhere. Because of the itch, children may rub their head, cheeks, and other patches with a hand, a pillow, or anything within reach. In many cases children eczema disappears before two years of age. Proper treatment can help until time solves the problem.
Eczema in Later Life
In teens and young adults, the patches of eczema typically occur on the hands and feet. However, any area such as the bends of the elbows, backs of the knees, ankles, wrists, face, neck, and upper chest may be affected. When eczema appears on the palms, backs of the hands, fingers, or on the feet, there can be episodes of crusting and oozing.
Other eczema patches in this stage are typically dry, red to brownish-gray, and may be scaly or thickened. The thickened areas may last for years without treatment. The intense, almost unbearable itching can continue, and may be most noticeable at night. Some patients scratch the skin until it bleeds and crusts. When this occurs, the skin can get infected.
Since the eczema does not always follow the same pattern, proper, early, and regular treatment can bring relief and may reduce the severity and duration of the disease.
Questions and Answers About Atopic Dermatitis
Q. Since the atopic dermatitis is associated with allergies, can certain foods be the cause?
A. Rarely (perhaps 10%). Although some foods may provoke atopic dermatitis, especially in infants and young children with asthma, eliminating those foods is rarely a cure. You should eliminate any foods that cause immediate severe reactions or welts/hives.
Q. Are environmental causes important and should they be eliminated?
A. Rarely. The elimination of contact or airborne substances does not bring lasting relief. Occasionally, dust and dust-catching objects like feather pillows, down comforters, kapok pillows and mattresses, cat and dog dander, carpeting, drapes, some toys, wool, and other rough fabrics, can worsen atopic dermatitis.
Q. Are skin tests, like those given for hay fever or asthma, of any value in finding the causes?
A. Not usually. A positive test means allergy only about 20% of the time. If negative, the test is good evidence against allergy.
Q. Are “shots” such as those given for hay fever and other allergies, useful?
A. Not usually. They may even make the skin condition worse in some patients.
Q. What should be done to treat the atopic dermatitis?
A. See your dermatologist for advice on avoiding irritating factors in creams and lotions; rough, scratchy, or tight clothing; and woolens. Softening your water may be helpful. Rapid changes of temperature and any activity that causes sweating can aggravate atopic dermatitis. Proper bathing, moisturizing (see Dry Skin section), and dealing with emotional upsets which may make the condition worse can be discussed. A cool mist humidifier in your bedroom is a good idea.
Your dermatologist can prescribe external medications such as steroids and newer non-steroid creams (e.g. Protopic, Elidel, Epiceram). Internal medications such as antihistamines can help with the itch when taken at night time. Oral antibiotics may be prescribed if there is a secondary infection. For moderate to severe cases, your dermatologist may recommend ultraviolet light treatments (phototherapy), or other treatments. Phototherapy is available at our dermatology clinic and is covered by OHIP so there is no charge for its use.
Atopic dermatitis is a very common condition. With proper treatment, the disease can be well-controlled in the majority of people.
Here is a selection of medical scientific articles by our expert dermatologists Dr. Benjamin Barankin and Dr. Anatoli Freiman as they pertain to eczema/atopic dermatitis:
Call 416-633-0001 or email us today to find out which eczema or atopic dermatitis treatment is the best choice for you.
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