Phototherapy, also referred to as light therapy, is a type of prescription skin care therapy used to treat psoriasis. The treatment involves exposing affected skin to an artificial ultraviolet light source at regular intervals. When skin is exposed to UVB rays either naturally or artificially, the growth of psoriatic skin cells is slowed, giving skin a clearer appearance for up to a year at a time. Treatment is delivered in numerous sessions over a period of several weeks, performed either by a physician or using a physician-prescribed, at-home light therapy box.
- Alternatives to Light Therapy
- Phototherapy and Tanning Beds
- Prescription Therapy
- The Trouble with Tanning
- Tanning risks
- Shining light on the facts
- Reduce your risk
- Can UV light benefit skin conditions?
- Should You Treat Psoriasis in a Tanning Bed?
- The Appeal of Tanning Beds
- Safety Issues Surrounding Tanning Beds
- How to Use a Tanning Bed Safely
- Better Than Beds: Other UVB Options
- Phototherapy vs. Tanning: To UV Or Not To UV?
- Debunking Psoriasis Myths: Does UVB Phototherapy Cause Skin Cancer?
- A Guide to Using Light Therapy for Psoriasis
- Does tanning help eczema?
- VITAMIN D AND ECZEMA
- TANNING TO HELP ECZEMA
- UV LIGHT FOR ECZEMA
- TANNING BEDS FOR ECZEMA
- ECZEMA LIGHT THERAPY / PHOTOTHERAPY FOR ECZEMA
- DOES SUN TANNING HELP ECZEMA?
- THE IMPORTANT THINGS TO NOTE ABOUT TANNING FOR ECZEMA
- CONCLUSION: TANNING YOUR WAY TO HEALTHY SKIN
- Scientists uncover how sunlight on skin reduces eczema inflammation
Alternatives to Light Therapy
Both treatment options are only available to patients under a doctor’s care. But because UVB rays can be found in various other natural and artificial light sources, some patients suffering from psoriasis have looked for other ways to treat the condition without their doctors’ supervision. Whether for lack of time, lack of funds, or some other reason, some patients have turned to tanning beds for exposure to UVB rays as a skin care treatment.
Phototherapy and Tanning Beds
It’s not hard to see why some people forgo the recommended medical path, opting for therapy at the tanning salon instead of prescription skin care treatments. The tanning salon is affordable, convenient, and definitely exposes skin to UV rays. But unfortunately, there are a number of issues associated with self-treating psoriasis at the tanning salon, and many patients either aren’t aware of them or choose to ignore them.
The first problem is that most tanning beds only emit UVA rays, not the UVB rays that have shown to be an effective skin care treatment for psoriasis. The next problem is that even when using tanning beds that do emit UVB light, it’s very difficult for a patient to know how much light he or she is being exposed to. Physician-supervised treatments provide patients with the optimum amount of light to promote healthier skin, something tanning beds aren’t capable of doing. The third major problem is the increased risk of skin cancer associated with tanning bed use. Prescription light therapies minimize the risk of skin cancer by only targeting parts of the body that need to be treated, while the entire body is exposed to UVB rays in tanning beds.
Our dermatologists endorse the National Psoriasis Foundation’s opinion that tanning beds are not an adequate substitute for physician-supervised light therapy. In fact, we highly discourage patients from using artificial tanning beds for any reason, and we encourage all patients to use sunscreen with any exposure to UV rays. Patients suffering from psoriasis or other skin conditions should contact us to schedule an appointment with a dermatologist for a skin care consultation.
The Trouble with Tanning
When I was in my early 20s, I was working as a local pizza delivery guy. As much fun as it was to bring people their favorite dinner in a box (is anyone ever sad to see a pizza delivery person?), it wasn’t a job that offered health insurance or a living wage. My psoriasis was at its worst during this time, covering me nearly from head to toe. I used to joke (mostly to myself) that I had more crust than the pizza I was slinging.
So what does a guy with no insurance and little discretionary income do to control his out-of-control skin? Tanning beds. I went to a place called Brown-N-Serve in my hometown. A couple times a week I would strip down in a closet-sized room that had a bowl of palm tree and playboy bunny stickers next to the giant glowing clamshell bed. I will never forget the smell of the place. If you’ve been to a tanning establishment, you will know exactly what I am talking about. It’s kind of a combination of artificial coconut and burnt skin.
This thinned my plaques out enough that I wasn’t unintentionally sprinkling customer’s food with “parmesan cheese”, but it still never made my red spots completely go away. I did this for about 5-6 months (long enough to get results, but no too long that I ended up looking like Tara Reid) At that point a family member found out what I had been doing and bluntly told me I was..well..not very wise for tanning. My grandfather had died of melanoma. In fact, his death was one of the main triggers of my first flare up, but for some reason I didn’t think of the risk tanning was causing me.
Shining light on the facts
I started to do some research, initially to prove my family member wrong. I so desperately wanted to convince myself that the tanning was OK, because it was the most cost-effective way to keep my skin from piling up. Unfortunately, what I found was that it was not worth the money I was saving.
The first thing I unearthed all those years ago was the dangers of tanning beds being linked to skin cancer. I kind of knew this going in, but I thought because I lived in such a cloudy, cool area of the US, I wouldn’t be at any greater risk than those that lived in sunny places like Southern California or Arizona. Boy was I wrong! The light that comes from tanning beds is called UVA. These are the rays that penetrate deep into your skin. Because they permeate so deep, UVA rays are the ones most responsible for cancers and also for turning your skin to leather.
If looking like an old boot and risking cancer wasn’t enough for me to quit, what I found out next definitely was. The tanning beds weren’t really effective for my skin in the long run. In order to control my symptoms, both UVA and UVB rays are needed. UVA is usually only effective if used in conjunction with the drug psoralen. Furthermore, it’s a science to determine how much exposure is just enough without increasing the risks previously discussed. I realized a dermatologist was probably a much better at making this determination than the tanning salon receptionist. A doctor is also able to control where the rays are hitting. Granted, most of my body was covered with plaques, but there was still delicate skin in between that I wanted to preserve.
Reduce your risk
I was lucky enough find a couple foundations that would help cover the cost of treatments so I could stop tanning, but I realize that isn’t an option for everyone. What I would suggest is to always use your best judgement and think long-term. It’s really easy to get caught up in trying to find something that works for us quick, because this disease is so uncomfortable and burdensome! But trading out one horrible health problem for another isn’t a good solution.
If you don’t feel you have any other options, take some steps to protect yourself. This may include:
- Protect unaffected skin– use clothing or sunscreen to protect areas that do not have psoriasis.
- Wear goggles–protect your peepers by always wearing black-out tanning googles. You may look funny, but your eyes will thank you.
- Know your skin–take note of each mole or mark on your body and monitor them. If you notice any new or changing spots, see a dermatologist right away.
Can UV light benefit skin conditions?
The number of Consol customers using the facilities to successfully treat skin conditions are on the rise. Our customers report dramatic, confidence boosting and in some cases, life changing results through regular sessions on our beds and it’s fast becoming apparent that exposure to UV light has many more benefits that simply achieving a sun kissed look.
In search of some answers, we took to the internet to find out why. According to the ‘Life Science Daily’ news desk, patients suffering from psoriasis or other types of skin diseases could benefit from ultraviolet light emitted from commercial tanning beds, a low-cost and effective option to medical phototherapy, according to an expert on the treatment of psoriasis.
Psoriasis is a chronic condition that causes red and flaky skin. It is the most common autoimmune disease in the United States, affecting as many as 7.5 million Americans, according to the National Psoriasis Foundation. Psoriasis can be addressed with various topical treatments like corticosteroids, which reduce inflammation and relieve itching, biologic drugs that target specific parts of the immune system, or other types of oral or injected medications. Psoriasis also is commonly treated with artificial ultraviolet light, known as phototherapy, which may be expensive if performed in a doctor’s office and inconvenient for some patients. “We have some evidence that going to a tanning bed was the most common form of phototherapy that psoriasis patients use,” said Dr. Steven Feldman, a professor of dermatology, pathology and public health sciences at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina.
”Some patients choose a medical facility for treatment or opt to purchase phototherapy equipment for their home.” Feldman told Life Science Daily. “But if those aren’t reasonable options, just finding a tanning bed costs so much less than medical phototherapy,” he said.
Controlled exposure to ultraviolet A or UVB radiation can both effectively treat psoriasis, said Feldman, who is the director of the Psoriasis Treatment Center at Wake Forest Baptist and a former member of the National Psoriasis Foundation Medical Advisory Board. Feldman took part in a Wake Forest School of Medicine study in 2015 that reviewed the use of tanning beds as a dermatological treatment for different skin conditions.
“Selected use of commercial tanning beds in the treatment of dermatologic conditions may be another useful and effective treatment for those patients with an inability to access office-based or home-based phototherapy,” the study concluded.
The use of tanning facilities to treat other types of skin diseases with phototherapy also could help patients with atopic dermatitis, allergic dermatitis, vitiligo, alopeca and itchy skin, the study found. “While the use of tanning beds may not be right for every patient, in some patients the benefits of tanning beds as a source of UV therapy for their dermatological disease may be beneficial,” the study said.
Phototherapy may not be appropriate for every psoriasis patient. Patients with lighter skin who are more susceptible to sunburns should use caution and be carefully monitored by a professional.
When prescribed for patients with skin conditions, phototherapy may involve briefly exposing skin to UV rays for two or three times a week for several weeks. A combination of phototherapy and certain medications also may be prescribed.
Individuals with psoriasis may also see some improvement by exposing their skin to natural sunlight. Brief, daily exposure to small amounts of sun may improve psoriasis but it is still essential to take care not to over expose with any form of UV light.
Should You Treat Psoriasis in a Tanning Bed?
Phototherapy, or light therapy, is a psoriasis treatment your dermatologist might recommend as part of your psoriasis treatment plan when other strategies haven’t helped enough. Exposure to ultraviolet B (UVB) light can slow the growth of skin cells, essentially turning off your plaque-making mechanism — sometimes for up to a year — and clearing large areas of psoriasis.
A course of phototherapy usually involves a series of office visits (in some cases, nearly every day) over several weeks. There are many ways to deliver the light, including by laser, and the exact number of sessions that are needed depends on your doctor’s approach . For example, German doctors found that three sessions over nine days with a new type of excimer laser delivered safe and effective results.
But not every dermatology clinic has high-powered lasers. And for many people, just getting to the dermatologist as often as phototherapy requires can be a logistical nightmare. Given the financial and time commitment involved, you might wonder whether you can go the do-it-yourself route with a tanning bed.
The Appeal of Tanning Beds
“Many people can’t access clinic-based phototherapy because of cost, distance, or other inconvenience issues,” says Steve Feldman, MD, PhD, a dermatology professor at the Wake Forest School of Medicine in Winston-Salem, N.C. “While tanning beds aren’t entirely safe, the alternatives, such as systemic medications like methotrexate or cyclosporine, may be worse in certain cases.”
Tanning beds may be a good option if you can’t get to a dermatologist for phototherapy, but they’re not a risk-free alternative. So it’s important to weigh their advantages and disadvantages.
Safety Issues Surrounding Tanning Beds
In contrast to phototherapy in a medical setting, tanning beds may be more affordable and have more convenient hours. But the first question you need to answer is: What kind of UV light are they offering? Most tanning beds deliver only UVA light, which does not treat psoriasis, so you need a tanning bed that provides both UVB and UVA light.
The next issue is how much light you’re being exposed to. The main advantage of phototherapy under a dermatologist’s supervision is that the doctor can completely control how much light you are receiving, says dermatologist Marian Northington, MD, of the University of Alabama at Birmingham. The UVB light and the machines that provide it have been tested and calibrated to maximize treatment success, whereas tanning beds have not. “Clinic-based phototherapy also has considerable data to support its efficacy and safety,” emphasizes Dr. Feldman.
Moreover, skin cancer is a risk with any light therapy, but that risk is greater with a tanning bed than with lasers or UVB machines at a medical office. Unlike dermatologist-prescribed phototherapy, which is targeted to just areas with psoriasis, a tanning bed exposes your entire body to UV rays. This means your risks for skin cancer and cataracts are elevated, says Dr. Northington.
“Ultraviolet light does damage the skin,” Feldman says. “It makes the skin look old and leathery with excess exposure.” Because of that, you don’t want to bake in a tanning bed for a moment longer than necessary to control your psoriasis. However, that’s a judgment call that’s hard for you to make on your own. Without your dermatologist’s assistance, it could be easy to overdo the tanning bed experience.
“Psoriasis is a chronic, severe disease for some people,” says Northington. “You don’t want to get into a tanning bed forever.”
How to Use a Tanning Bed Safely
If a tanning bed is the only way you can get needed light therapy, ask your dermatologist for his or her insights on how best to use it. Also ask whether you’re taking any oral psoriasis treatment that’s making your skin more sensitive to light, which could result in a sunburn or other negative side effects, says Feldman.
Here are his other tips for using a tanning bed effectively and safely:
- Shop around for convenience. Choose a tanning establishment that is close to you, has an affordable package and hours that work for your daily schedule, and — of course — offers UVB beds. “A low cost for unlimited tanning would be ideal,” says Feldman.
- Create a strict routine. “Use the same bed at that establishment each time,” Feldman says. This will increase the chance that you get a similar dose with each exposure.
- Determine your starting dose. Your psoriasis will flare if you burn. “To be on the safe side, start with half of whatever the tanning bed operator suggests,” says Feldman. This is especially important if you are taking acitretin , a drug that makes the skin more sensitive to ultraviolet light. “Then try to go every day, increasing the amount of exposure with each visit,” Feldman suggests. (Don’t fret if you’re busy and have to skip one day.)
- Use mineral oil. “White scales on the surface of psoriasis reflects light,” Feldman points out. Mineral oil or prescription triamcinolone ointment can ease that effect. Make sure you use it every time.
- Protect tender parts. “Cover the face and, if you’re a man, the genital area when having tanning treatments,” says Feldman. Your face gets enough “phototherapy” every day just being out and about.
- Stop when psoriasis is under control. You’re not looking to bronze but to minimize the plaques.
- Do skin checks. Get in the habit of looking head to toe for any changes that could indicate skin cancer.
Better Than Beds: Other UVB Options
If you’re concerned about the potential hazards of tanning beds, one helpful alternative is a home UVB light machine. Your doctor may be able to recommend one and give you tips on how best to use it.
In a time and financial pinch? Short but regular doses of plain old sunlight over the course of several weeks may also help. The National Psoriasis Foundation suggests starting with just 5 to 10 minutes of sun exposure every day around noon, gradually increasing your exposure time by half a minute as long as you don’t burn. Still, check in first with your doctor to see whether any medications (oral or topical) could make you more susceptible to sunburn. Once you have your doctor’s go-ahead, protect any unaffected areas with a strong sunscreen before heading out in the noonday sun.
Phototherapy vs. Tanning: To UV Or Not To UV?
Posted on June 22, 2015 in Practice News, Eczema, Psoriasis, Dermatitis, Vitiligo, Rashes, Inflammation, Treatments, Itching, Light Therapy
“I often call it a medical tanning booth, because of how it looks,” says Dr. Adam Mamelak, board-certified dermatologist in Austin, Texas. “The truth is, it’s pretty far from it.”
Phototherapy is a treatment dermatologists have been using for decades to treat vitiligo, psoriasis, eczema, and other skin conditions. It involves exposing the skin to metered doses of ultraviolet light to suppress specific inflammatory reactions in the skin.
For a long time, natural light has been known to offer relief to those who suffer from certain skin conditions. Patients report that their psoriasis and eczema gets better in the summer, or when they go to the beach. These observations lead to the creation of phototherapy, a more strategic, targeted treatment for these conditions.
“Ultraviolet light can suppress our immune systems, particularly at a local level in the skin,” explains Dr. Mamelak. This, as well as its other damaging effects, is one of the main reasons excessive exposure to UV light is thought to be a significant risk factor for the development of skin cancers.
Phototherapy is different, however. It employs very specific wavelengths of UV light. Furthermore, these wavelengths are different from the ones used in tanning beds. As well, treatments are measured extremely carefully in order to keep exposures well below the threshold for any possible cancer development.
Narrow Band UVB Therapy is now the most common type of phototherapy available. Its predecessor, Broadband UVB therapy, utilized wavelengths ranging from 280-330 nano-meters (nm), while Narrow Band solely uses light with a 311 nm wavelength. In contrast, tanning beds use bulbs that typically emit 95% UVA (320-400 nm) and 5% UVB (290-320 nm) light.
Narrow Band UVB 311 nm light bulbs only emit a specific range of ultraviolet radiation, hence saving the skin for excess or more dangerous exposures. Narrow Band UVB light is also a more aggressive treatment, allowing for longer treatment times, which ultimately yields greater results with fewer treatment sessions.
A patient scheduled for Narrow Band UVB therapy will come to the office to have their skin assessed and to set up a treatment plan. The light booth is generally used for full body treatment, however can be augmented with your physician to only focus on certain areas. Patients are scheduled for phototherapy treatments 2-3 times a week. During the treatments, patients are asked to stand in the upright booth for a time ranging from 30 seconds to almost 10 minutes. The exact duration spent in the booth tends to increase with each session, until a therapeutic effect is reached. Patients skin is evaluated at each treatment sessions, and the time will be adjusted according to the response.
Patients will shield there eyes and sensitive skin areas during treatment. Treatments are well tolerated and no pain is usually experienced. Mild erythema or redness on the skin may be noted. It is possible to get a sunburn from phototherapy. If you feel you have experienced a burn, tell your physician immediately. Phototherapy is an ideal option for patients with widepread disease, or who have previously attempted topical or oral therapies with mediocre responses.
Narrow Band UVB phototherapy is now offered at Sanova Dermaology. Please contact us today to set up your consultation and see if you are a good candidate for this treatment.
Hi everyone 🙂
I have psoriases – guttate, plaque and PPP, and have since I was 9. I’ve been mostly controlled on and off by tanning for the past 30 years or so. I am 42. Yes, it’s hard to commit to tanning two to three times a week when you have a career and family, and there are times I may slack a few months or so and not go. I have had phototherapy as a kid, and it worked well when i lived in a cold climate and needed it, and before tanning beds were around. But, living in warm, humid Florida now, and using a tanning bed, has kept me reasonably clear for many years – except for flare ups when i’m sick or from certain triggers. Recently, i went to a new derm. He’s giving me phototherapy. And it’s the first week and i’m getting WORSE, not because of the phototherapy, but because i’m not able to TAN now in the tanning bed! Soooo, why am i doing this again? To spend $65 three times a week for my 2 minute sessions versus $40 a month for unlimited tanning? Is it supposed to be “better” for me? Because he told me it’s still considered carcinogenic. So, I’m just not sure here why I’m even trying this phototherapy? Any advice? Words of wisdom? Honestly, I’ve been tanning very responsibly for so many years I NEVER EVER burn, isn’t it good to have that kind of color, almost like having a natural sunscreen on? Not ONE of my derms have ever told me to stop tanning by the way. They have all told me its certainly safer than the risks of the biologics. I go to my skin doc for cancer checks very frequently at least annually, and have never had anything yet, (knock on wood) and that’s after 27 straight years of the tanning bed. As far as aging, i actually look OLDER when i DONT have my nice bronzy tan, and so far so good on the early aging. Will I have wrinkles in my 50’s? Probably. Will most people? Probably. I’m 42, I know they’re coming… whether I continue to tan or not! So, why do people choose phototherapy over tanning beds? Please, someone explain? I can’t believe I’m paying MORE $ right now to get WORSE…. just doesn’t feel right??? What do you think out there?
Debunking Psoriasis Myths: Does UVB Phototherapy Cause Skin Cancer?
Myth: UVB phototherapy causes skin cancer
Phototherapy is a common treatment modality for psoriasis patients that can be used in the physician’s office or psoriasis clinic or at home. Options include UVB phototherapy (broadband and narrowband), which slows the growth of affected skin cells; psoralen plus UVA (PUVA), which slows excessive skin cell growth; and excimer laser therapy, which targets select areas of the skin affected by mild to moderate psoriasis and is particularly useful for scalp psoriasis. Each of these therapies may be combined with other topical and/or systemic psoriasis treatments. The effects of UV light on the skin and the connection to skin cancer is widely known. Therefore, patient education on the risk for skin cancer with phototherapy is essential.
Evidence suggests that UVB phototherapy remains a safe treatment modality. In a 2005 analysis of prospective and retrospective studies on skin cancer risk from UVB phototherapy, 11 studies (10 concerning psoriasis patients) were reviewed and the researchers concluded that all studies eventually showed no increased skin cancer risk with UVB phototherapy. One of the PUVA cohort studies examined genital skin cancers and found an increased rate of genital tumors associated with UVB phototherapy.
Another analysis to define the long-term carcinogenic risk for narrowband UVB treatment found that there was no association between narrowband UVB exposure alone (without PUVA) and any skin cancer. For patients treated with narrowband UVB and PUVA, there was a small increase in basal cell carcinomas.
Dermatologists should monitor psoriasis patients for self-administered treatment with tanning beds. Based on a questionnaire sent to approximately 14,000 subscribers of National Psoriasis Foundation emails, 62% of 617 tanners started tanning to treat psoriasis; they were more likely to have received medical phototherapy and had more severe psoriasis. Approximately 30% of these patients indicated that they used tanning as a self-treatment for psoriasis because of the inconvenience and cost of UV light treatment in a physician’s office as well as treatment failure of other therapies prescribed by the physician. “Our results imply that tanning bed usage among psoriasis sufferers is widespread and linked with tanning addiction,” reported Felton et al. “Practitioners should be particularly vigilant to the possibility of tanning bed usage in at-risk patients.” These patients may be at increased risk for skin cancer. Problematic tanning behaviors may be seen in younger female patients diagnosed with psoriasis at an early age as well as patients with severe psoriasis who were previously prescribed phototherapy treatment.
Expert Commentary on next page
A Guide to Using Light Therapy for Psoriasis
Phototherapy is the original psoriasis treatment. For as long as people have had the disease, they’ve treated it with sunlight. Even today, with all the high-tech remedies available, light therapy continues to be one of the most effective treatments for psoriasis, an autoimmune disorder that causes skin cells to grow too rapidly, resulting in red, itchy lesions on the surface of the skin.
“When ultraviolet light hits skin, it does all kinds of things,” says Steven Feldman, MD, PhD, a professor of dermatology at the Wake Forest University School of Medicine in Winston-Salem, N.C. Ultraviolet light kills the immune cells in the skin that contribute to psoriasis, and research suggests that UV light may also disrupt the faulty signals between immune cells and skin cells that lead to psoriasis lesions.
With relatively few side effects, phototherapy is an effective—yet underused—treatment, experts say. “Phototherapy is a great treatment to start with,” says Kathy Kavlick, RN, community outreach nurse for the Murdough Family Center for Psoriasis in Cleveland. “Some people get really good results from it.”
Types of phototherapy
Phototherapy is usually administered on an outpatient basis in a dermatologists office two to three times a week, using a walk-in light booth that looks like a tanning bed stood on end. Light boxes for home use are also available.
There are two main types of phototherapy:
- Ultraviolet B light (UVB), one of the components of sunlight, is especially effective for treating psoriasis. During the treatment patients are exposed to the light for just a few seconds at first, and the exposure time is gradually increased to several minutes per treatment. UVB treatment is sometimes administered with topical treatments such as coal tar, anthralin, or just mineral oil. A form of UVB light known as narrow-band (NB-UVB) has been shown to be even more effective than UVB, and is increasingly being used by dermatologists.
- Although not as potent as UVB, ultraviolet A light (UVA) is also used to treat psoriasis. UVA treatment generally takes longer than UVB—exposure times can reach 15 to 20 minutes—but at these higher doses it is also effective in clearing lesions. UVA light is often combined with an oral medication known as psoralen (a treatment known as PUVA).
A newer variation of phototherapy uses excimer or pulsed-dye lasers to target individual plaques. Research suggests that laser therapy may require fewer treatments and produce longer remissions, but since this technique is so focused it is not very practical for people with widespread lesions. As Dr. Feldman notes, however, roughly eight out of 10 people with psoriasis have lesions only in small, isolated spots, and laser therapy may grow more popular as the technology becomes faster and more effective.
What works best
Patients generally require about 20 phototherapy sessions before they see an improvement in their skin. Although response rates vary, studies suggest that 65% of the patients who receive UVB treatment and 75% of the patients who receive NB-UVB will experience significant skin clearance. Although UVB treatments are more widely used, PUVA may actually be more effective.
In a 2006 study in the Archives of Dermatology that compared PUVA and NB-UVB therapy in patients with chronic plaque psoriasis, the patients who underwent PUVA therapy had a significantly higher clearance rate (84%) than those who received NB-UVB (65%). The former group also required fewer treatment sessions, and the effects lasted longer.
PUVA does have some potentially serious side effects, however. Nearly one-third of patients experience nausea after treatment—and, more important, PUVA carries a long-term risk of skin cancer, especially in patients with fair skin.
The psoralen molecule used in PUVA is believed to be largely responsible for the increased risk. Psoralen, which is ingested orally or applied topically, enters the bodys cells and, when activated by UV light, changes their DNA. This process kills off immune cells close to the skin and helps control psoriasis, but it also leads to collateral damage that can cause skin cancer in the long run.
Because of the risk of skin cancer, PUVA is typically reserved for the most severe and stubborn psoriasis cases. “PUVA is a very, very effective treatment,” says Dr. Feldman. “Its at least as effective as narrowband UVB, but it causes an increased risk of skin cancer, so we tend to avoid using it.”
UVB light is known to cause skin cancer as well, but studies have not shown any increased risk of skin cancer among psoriasis patients who have undergone UVB phototherapy.
If its so effective, why isn’t phototherapy used more?
Although phototherapy is considered a first-line treatment for psoriasis, patients and dermatologists alike report that it is often impractical.
Convenience is a factor, since patients need to visit their doctors office several times a week during business hours. But it can also be expensive; for each treatment, most insurance companies charge an office-visit co-pay, which tends to be higher than drug co-pays.
The National Psoriasis Foundation, the American Academy of Dermatology, the United States Department of Health and Human Services, and the World Health Organization all discourage the use of commercial tanning beds for treating psoriasis. “The spectra of light in tanning beds vary greatly and often include wavelengths of light that are carcinogenic and photo-damaging,” reads a 2013 statement from the National Psoriasis Foundation. “The ultraviolet radiation from these devices can damage the skin, cause premature aging and increase the risk of skin cancer.”
Good old sun
As people have known for thousands of years, natural sunlight is an effective treatment for psoriasis, although the effects may take several weeks to materialize. To avoid sunburn and overexposure, the National Psoriasis Foundation recommends only sunbathing after discussing it with your doctor. Your doc will likely prescribe multiple short sunbathing sessions. (Sunburns can actually exacerbate psoriasis.) Some doctors recommend going into the sun for a few minutes without sunscreen, and then applying at least SPF 15.
Does tanning help eczema?
For some of us, when summertime comes around we strip down and head for the beach, and if we haven’t achieved a golden glow within a month, then we have failed at life. At least that’s how it can be in Australia – the skin cancer capital of the world.
With all the safety/fear campaigns targeted at sun safety and the evils of UV rays, how is it that some people swear their eczema improves and even disappears when they get themselves a wicked tan? I mean, if we are to go by the hype, shouldn’t UV rays be doing us a disservice?
I do understand that for many people, the concept of ‘tanning’ sets off alarm bells and conjures images of spreading melanomas on the skin and half removed noses from skin cancer surgery.
Of course these are not imaginary fears and the link between the most dangerous skin cancer; melanoma, and sun exposure is very real.
The big question however still remains; is there a safe ‘sweet spot’ level of tanning and does tanning help eczema?
There is still debate raging among the medical community as to whether or not it is safe to have any UV exposure at all. Both sides of the argument have validity and I highly encourage you to do your research and use caution, but what I want to concentrate on here is the link between tanning and eczema.
VITAMIN D AND ECZEMA
I’ve already discussed the huge importance of Vitamin D when it comes to healing eczema and speeding up topical steroid withdrawal and this connection is very important.
In a nutshell, Vitamin D or more specifically, Vitamin D3 sulfate, is synthesized directly from sunlight and travels freely in the blood stream. It is needed for the health of almost every cell in your body and affects nearly 3000 genes including those responsible for the immune system, inflammation and skin health.
As wonderfully beneficial Vitamin D is for our skin, its advantages go much deeper and have even been found to significantly reduce the risks of developing other types of cancers in the body.
Low levels of Vitamin D are common in eczema sufferers with the cases of deficiency rising every year. For this reason, studies have revealed cases of dramatic improvement in eczema symptoms in those who were supplemented with Vitamin D or received the controlled use of UV light.
This is not going to be the case with everyone who has eczema as there are many factors which can potentially cause or trigger this condition which lie outside of simple vitamin deficiencies. If only it were that simple!
To boost ones intake of this coveted vitamin, you can take vitamin D3 supplements which are convenient, however lack the ‘sulfate’ component. This just means it requires ‘bad cholesterol’ as a mode of transporting itself around your body in order to have the same effect as vitamin D from sunlight.
The fact that you can get your Vitamin D3 from a supplement means you can also get it from your diet. However very few foods actually contain this nutrient and with the degradation of diet in today’s world, food sources are obviously not enough.
The other way you can source Vitamin D3 sulfate is directly from the UV rays themselves. These come in the form of sunbeds, specialized controlled UV applications usually found in dermatologist’s practices, or directly from the sun.
TANNING TO HELP ECZEMA
During my investigations, I found a deluge of anecdotal testimonies from people who have experience with tanning either in natural sunlight or from using sunbeds, who swear by this method as their seasonal sure-fire eczema cure.
These stories were extensive and went into detail about the history and severity of their eczema as well as the length of time it seemed to take before their symptoms would improve. I was actually blown away at the seeming efficacy of tanning in treating some of these apparent ‘untreatable’ cases.
I found it interesting that many of the aforementioned revelations were actually discovered by accident; noticing their eczema improving during summer after they would have spent time getting themselves tanned-up.
UV LIGHT FOR ECZEMA
Some of these people also talked about their use of specific UV controlled environments under the control of a practitioner, with the general treatment being UVB. Not everyone benefited positively, but those who did seemed to have great success in relieving their eczema for longer periods than sun tanning.
The link between tanning and reduced eczema symptoms appeared to be fairly consistent and potentially offers an explanation as to why eczema symptoms tend to worsen during the winter months.
I want to now take you through the methods of tanning which have brought relief to many eczema and topical steroid withdrawal sufferers. And no, I don’t mean fake tanning!! I mean sunlight, tanning beds and specifically designed phototherapy devices used by dermatologists.
TANNING BEDS FOR ECZEMA
Tanning beds use both UVA and UVB bulbs to mimic the effects of the sun. They are used for the sole purpose of providing a relatively controlled, aesthetically pleasing, and even tan and are usually on a timer so the user is under its effects for no longer than required.
Due to the fact that tanning beds synthetically resemble natural sunlight, the body will synthesize this light into the all-important Vitamin D3 sulfate, just like sunlight. This works towards improving the immune system and healing eczema symptoms, among many other health positives.
Having been used successfully by many eczema sufferers in their search for a glowing tan, some doctors and naturopaths are still recommending the use of tanning beds for patients to help their eczema. But none the less, this method is definitely taboo.
Tanning beds have come under fire in the last decade with a bone of contention from the medical community surrounding their use, with many professionals standing at opposite sides of the debate.
In many countries, the majority have even banned their use in a bid to tackle high cancer rates.
The positives for using tanning beds to help eczema is that the session costs are reasonable, you do achieve a ‘wicked’ tan, and they are available to use during periods when sunlight is scarce.
The downsides are that tanning beds aren’t designed for eczema so cannot control the specific UV output. There is also unfortunately an increased risk of developing skin cancer.
ECZEMA LIGHT THERAPY / PHOTOTHERAPY FOR ECZEMA
Much like tanning beds, phototherapy is time controlled and recommended by certain professionals as a way to help alleviate eczema. However unlike tanning beds, eczema light therapy is done under strict supervision by a dermatologist.
Though some tanning may occur after these treatments, it is not always the case and should not be used for this purpose.
Eczema light therapy, also known as phototherapy, most commonly utilize narrowband UVB for eczema issues as this is the most favourable portion of natural sunlight which penetrates deep into the skin. It brings with it beneficial Vitamin D production, anti-inflammation, antibacterial and immune boosting advantages as well as slowing the growth rate of affected skin cells.
There are other forms of eczema light therapy which use different UV types, but are used less frequently as UVB seems to be the most beneficial. UVA is the more damaging aspect of natural sunlight which is known to contribute in speeding up the ageing process of the skin and also skin cancers.
The application of controlled UV exposure starts off slowly, sometimes only allowing the skin to be exposed for a matter of seconds. This allows the body to adjust to the process and give a safe indication of whether any issues are likely to develop.
Those who would benefit from eczema light therapy are individuals who do not have the ability to get sunlight on their skin year-round, and those who are concerned about the damaging effects of sunlight and want a better guided and controlled method.
The downsides are that the overall treatment can take months before improvement is noticed, and treatments can be costly financially and on the person’s time.
DOES SUN TANNING HELP ECZEMA?
I live in Australia where the winter temperatures are a joke to us, and it is not uncommon to find people still working outside in shorts and tee-shirts. This could be the reason our Vitamin D deficiency is around only a third of the general population as opposed to some colder, rainier or more conservative countries whose rates soar to over 90%.
While not available to everyone year round, natural sun is said by many to be the best option for receiving their healing Vitamin D3 and eczema improving benefits.
During my investigations it was apparent that many people who gained improvement from their eczema were those who gravitated towards outdoor activities, including swimming and sunbathing. Though it was not obvious whether they were also using sunscreen to protect themselves, the common denominator in these cases was the development of a tan.
The effects of natural sunlight go further for the body than just its gift of Vitamin D. It can also boost serotonin (the happy hormone) to make you feel good while at the same time reducing melatonin which can increase fertility and improve sleep. It can also improve bone health as well as other skin and inflammatory conditions in the body.
There are many dermatologists and doctors who recommend getting around 15-20 minutes of sunlight per day with the safest times being morning and afternoon to avoid the harsh midday rays.
Care is also strongly recommended as there is a fine line between just enough and over-exposure. Pay attention to your body’s signals and if you are not feeling right, then it’s time to get into shade again.
As I see it, the benefits of using natural sunlight as opposed to other treatment forms is the convenience, it is free and comes with other health benefits. The downsides are that it is not exactly available to everyone year round and it also comes with harmful and potentially skin cancer causing risks.
THE IMPORTANT THINGS TO NOTE ABOUT TANNING FOR ECZEMA
Moderation! Tanning is essentially skin cells experiencing trauma, thus darkening to defend the body from the harmful effects of UV rays. The key is to not over-do it!
Tanning for too long not only places you at risk of skin cancers but can also dry out the skin, which is a big no-no for those with eczema. For this reason, it is wise to apply a natural and gentle moisturizer to your skin regularly to prevent this drying effect.
Photosensitive individuals with eczema would naturally react badly from tanning and should speak to a medical professional before attempting to use tanning as a way of helping their eczema. Those with fair complexions who burn easy also need to seek medical advice prior to trying these methods.
CONCLUSION: TANNING YOUR WAY TO HEALTHY SKIN
As with many eczema treatments today, there are unfortunately risks. We take risks every day from driving in our cars to eating that last piece of cake. The question we need to ask ourselves is when we have a condition that controls our lives, is it worth taking a risk to gain back the quality of life?
I can certainly speak from experience that there is almost nothing I wouldn’t do to find relief from the pain, itch and humiliation of eczema. Even if that meant spending time basking in the sun every day – which coincidentally is what many dermatologists recommend.
My personal experience with sunlight helping my skin condition happened when I was going through the worst part of topical steroid withdrawal. I naturally gravitated towards sunlight for many months and found that my symptoms were never quite as bad as when I spent days indoors with no exposure.
Whether it was the Vitamin D component or something else, I certainly felt that the improvements to my skin were not coincidental and my body seemed to really need it.
So does tanning actually help eczema?
As discussed, there is a whole bunch of anecdotal evidence to suggest a strong link between tanning and the relief of eczema symptoms.
Realistically, this would come down to the fact that through the increase of vitamin D and beneficial hormones synthesized from UV exposure, improved health and skin conditions such as this eczema is achieved. The tan is really just a fortunate by-product.
by Mel (Top Eczema Treatments) Mel is a health writer, blogger and founder of Top Eczema Treatments.
DEVOTEES of tanning aren’t the only ones who might be distressed over the recent reclassification by the International Agency for Research on Cancer of tanning beds as “carcinogenic.” Eczema sufferers who lack access to physician-administered light treatments have long used commercially available ultraviolet tanning beds to control their outbreaks.
Not that it’s a practice most doctors encourage. While exposure to certain kinds of UV rays under controlled conditions has proved effective for some eczema sufferers, experts warn that patients are putting themselves at risk by turning to tanning salons.
“The long and short of it is there is no data on whether outpatient UV therapy works because the tanning beds are incredibly heterogeneous, so the strength of what you’re getting is completely unknown,” said Dr. Lisa Beck of the University of Rochester Medical Center.
Not only is it difficult to know the strength of a commercial tanning bed, but such beds emit a different kind of rays UVA than those in a doctor’s office or hospital, which use shorter-wave ultraviolet B, or UVB, rays. Both rays are found in natural sunlight, and both help stunt the growth of T cells in the skin, which can contribute to the redness and scaling of eczema. And both types of rays are damaging to the skin, but UVA rays are believed to be more dangerous because they penetrate the skin more deeply.
Scientists uncover how sunlight on skin reduces eczema inflammation
In patients with eczema, the proportion of these regulatory T cells in their blood following light therapy directly correlated with disease improvement.
Researchers say their findings could lead to new therapies for eczema, which affects around one in five children and one in 20 adults in the UK.
Lead researcher Dr Anne Astier, from the MRC Centre for Inflammation Research at the University of Edinburgh, said:
“Our findings suggest that nitric oxide has powerful anti-inflammatory properties and could offer an alternative drug target for people with eczema. Activating regulatory T cells using this pathway may also provide a target for developing treatments for other conditions with overactive immune responses, including autoimmune diseases and rejection of transplants.”
Professor Richard Weller, a co-senior author on the study from the University of Edinburgh Medical School, said:
“It is clear that the health benefits of sunlight stretch far beyond vitamin D and we are starting to fill in these blank spaces.”
- Categories: Research
- Health categories: Skin
- Locations: Edinburgh
- Type: News article