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:
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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.
