What is UVB Therapy?

UVB therapy uses ultraviolet light to control different disease of the skin.
It can be effective in treating psoriasis, dermatitis, pruritus (itching) and
other skin diseases. UVB therapy is so named because treatment used Ultra
Violet light from the Beta range. UVB occurs naturally in sunlight and is
associated with suntans and sunburns.

Many people’s skin problems improve during the summer because they are
exposed to ultra violet beta light naturally from the sun. Therapy with
special UVB booths makes treatment possible all year round in a controlled
environment of dose and schedule to the skin in need of treatment.

At The Skin Clinic in Williamstown, we use a new form of phototherapy
called “Narrow Band UVB.” These wave-lengths are felt to be safer than
PUVA and more effective than the old broad band UVB light bulbs. Our
unit is manufactured by PhotoTherapeutix.

How often is the treatment given?

Treatment is usually two to three times per week with at least a day between
each treatment. The total number of treatments depends on your diagnosis.
Eventually, when symptoms are resolved, treatments will decrease until you
can either stop or go on a maintenance schedule to keep clear. An average of
20-30 treatments is normal to clear psoriasis lesions.

The treatment booth is the size of a telephone booth with tall special light
bulbs lining the inside, including the back of the door. The door has no
latch and opens easily from the inside or the outside.

Time of exposure to the light and the strength of the light produced by the
bulbs determine the treatment dose received. Treatment is started at a low level
which means a short exposure (as short as 15 seconds) to the light. The time i
gradually increased with each treatment and is adjusted to an individual’s skin type,
specific reaction to treatment and frequency of treatment.

For treatment all clothing covering areas in need of treatment is removed. Skin
that does not need treatment should be protected if it can conveniently
be covered with clothing or towels. The face which usually receives a great
deal of natural sun exposure should be protected if possible. Sensitive skin
areas (such as genitalia, breasts, etc.) may only tolerate a lower dose of
treatment with a slower pace of increased exposure. These areas should only
be exposed if skin disease is present. The male genitalia area is
particularly at increased risk, and exposure should be limited to needed
treatment only. We advise shielding the groin area if no skin disease is
present. We will help determine what shielding is appropriate. It is very important
that coverage during treatment inconsistent and that changes be on a gradual schedule,
agreed upon with the staff. This prevents over treatment of unconditioned areas.

Treatment involves standing in the center of the treatment booth for a
prescribed length of time. The light booth is on a timer that is set by the
the physician or his assistant. Positioning in the center
of the booth should be maintained during treatment, since getting closer to
the bulbs increases the strength of the treatment and the risk of over
treatment.

Protective eye wear must be work during treatment and is provided in clinic.
If a noticeable tan line around the eyes develops with treatment, a specific
schedule of removal of the glasses with eyes shut can be set up with the
nursing staff.

Other treatments can interact with or effect light therapy.

• Baths, moisturizers, creams and ointments can improve and speed up treatment response.
• Tar containing creams and ointments can improve treatment responses but can also cause an overreaction (burning). Use these only under the direction of the physician. Examples of tar containing creams are Mg 217, anthralin paste, LCD in Triamcinolone, crude coal tar, Ester gel. These tar containing products also sensitize your skin to natural sunlight.
• Oral medications taken can increase sensitivity to light treatment and natural sunlight. It is important that the physician and nursing staff be kept informed of all medications taken.
• Exposure to natural sunlight between treatments increases the dose of treatment that the skin receives. This can lead to over exposure which can interfere with the planned treatment schedule and the evaluation of reactions. Protection in the form of clothing, hats and sunscreen should be used to protect the skin from the sun. Under physician recommendations and with specific guidelines natural sun exposure can be used. Sun tanning booths should never be used.

Side Effects

Dry skin: Liberal use of moisturizers is recommended.

Itching: Frequently related to skin disease that is being treated or
dryness from the treatment. Moisturizers are helpful. Pills can be
prescribed by the physician to relieve itching. Itching can be an indication
that skin is not tolerating the treatment schedule and the time exposure
needs to be adjusted.

Skin burn: It is possible to get a burn (just like a sunburn) no matter how
carefully the treatments are done. Nursing staff will do evaluations of an
individual” reaction and response to treatment before each treatment and
adjust the dose accordingly. Any significant reaction between treatments
should be promptly reported to the nursing staff in order to get treatment
advice.

A slight reddening of the skin is expected, but a burn may need cooling ice
packs or soaks, anti-inflammatory medicines and a delay in the next scheduled
treatment with a dosage adjustment.

Pigment changes: Tanning and freckling may occur just as with exposure to
natural sunlight.

Folliculitis (inflammation of the hair follicles): Creams and ointments in
combination with warmth and perspiration during therapy can cause clogged and
irritated pores and hair follicles.

Non-spreading, treatable skin cancers: While PUVA is associated with a small
increased risk of melanoma and other skin cancers, this has not been shown to
occur with UVB.