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UVB Treatment
Why ultra violet light can be useful
Psoriasis sufferers may benefit from exposure to UVB light, one of the forms of ultra violet light that comes from the sun. There are 3 forms: UVA, UVB and UVC. Short wavelength UVC is absorbed by the ozone layer and does not reach the earth's surface. The UV light which does reach us is mainly long wave UVA, with some intermediate UVB and it is the UVB rays which are beneficial to those of us with psoriasis. UV light aids chemical reactions that affect the function of cells. In psoriasis this means that the cells do not multiply so rapidly and behave more like normal skin.
Too much UVB however is not a good thing because it burns. UVA is also not harmless and too much of both can prematurely age the skin and increase the risk of skin cancers. So you do need to take care even if you find that the sun helps your skin. The people at highest risk are those who have fair or red hair and those whose skin does not tan easily
What is UVB Treatment?
UVB contains a wide range of wavelengths and can be used to treat guttate or plaque psoriasis, which is proving resistant to "topical" treatments (i.e. creams and ointments). In the past few years a more refined form of UVB has been developed, known as "narrowband" and this is proving to be very effective. The aim is to clear the skin and this can take up to 30 treatments over a period of approx 6 weeks.
Compared with broadband UVB in the treatment of psoriasis:
- Exposure times are shorter but of higher intensity.
- The course of treatment is shorter.
- It is more likely to clear the psoriasis.
- Longer periods of remission can occur before the psoriasis reappears.
Side effects
Narrow-band UVB can result in burning, just like sunlight and broadband UVB. Frequent emollients should be applied to burned skin, and if recommended by the therapist, topical steroids. It sometimes provokes polymorphous light eruption. Long term exposure to ultraviolet radiation ultimately causes skin ageing and skin cancers. Although the risk from narrow-band UVB is unknown, research to date suggests it is no more risky than broadband UVB.
More generally all UV radiation can cause skin damage and treatments therefore have to be rationed. Doctors will not put patients at unnecessary risk. Care should be taken with the number of treatments over one year and indeed over a lifetime. This will vary from person to person depending on skin type and total dose administered.
What does the treatment involve?
The units used are similar to those used in hospitals and the whole body or just the infected areas can be exposed to the UVB. Usually the whole body is exposed to the UVB for a short time (seconds to minutes) and precautions must be taken to protect the eyes (use Goggles provided) and genital areas should be covered.
The amount of UV is carefully monitored. A number of protocols exist depending on the individual's skin type, age, skin condition and other factors. The skin may remain pale or turn slightly pink after each treatment. Let your therapist know if you experience any discomfort. Patches of psoriasis generally start to become thinner after five to ten treatments. Most patients with psoriasis need about 15-30 treatments to clear.
To UVB or not to UVB?
There are large numbers of studies showing the positive effect of UVB on Psoriasis patients. Generally 80% of patients will be cleared within 6 weeks, with 3 treatments per week. Patients who experience a reoccurrence within a short time after healing may use maintenance programs of treatment, once or twice per week.
Wrinkling of the skin (Actinic Elastosis) and skin malignancies are associated long-term side effects. However, in one study in a Swedish clinic of patients who had been on UVB treatment during a 20 year period, no increase of wrinkling of the skin or skin malignancies were found, when compared to an age and sex matched group from the same city.
Short-term side effects can be totally avoided by following the instructions with care. These are blistering with redness (erythema), which are uncomfortable but absolutely not dangerous. The risks involved with UVB are about the same as for an outdoor worker such as farmer or builder, who are exposed to sunlight on a daily basis. It is advised that anyone undertaking UVB Therapy visits a dermatologist once or twice a year for regular check up.
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