What Is Phototherapy?

Phototherapy is a treatment that uses controlled exposure to ultraviolet (UV) light to help manage skin conditions like eczema. It’s typically used for moderate to severe cases of eczema that haven’t responded well to standard treatments. There are a few different types of phototherapy, including:

• Narrowband UVB: The most common type used for eczema.
• Broadband UVB: An older form, used less often now.
• PUVA: Combines a light-sensitizing medication (psoralen) with UVA light; this option is typically reserved for more severe cases.

The difference between the types is the wavelength of the light and the intensity. Narrowband UVB light works at 311-312 nm, while broadband UVB light works at 270-350 nm. Narrowband UVB is more effective for eczema and tends to result in longer periods of remission.

How Does Phototherapy Work?

Phototherapy works by using ultraviolet light to directly affect the cells in your skin that play a key role in the immune response. When your skin is exposed to this controlled light, the energy from the UV rays penetrates the layers of your skin and interacts with immune cells such as T lymphocytes. These cells are responsible for producing the signals that lead to inflammation and irritation in eczema. The UV light causes subtle damage to the DNA in these overactive immune cells, which then triggers a process called apoptosis—a form of programmed cell death. This reduction in the number of active T cells helps lessen the intensity of the inflammatory response.

In addition to causing some immune cells to die off, phototherapy also alters the way your skin produces and responds to chemical signals known as cytokines. These cytokines are like messengers that tell your body how strongly to react. With phototherapy, the balance shifts, resulting in fewer inflammatory signals and more signals that promote healing and calm. Over time, this rebalancing of the immune response leads to reduced redness, itching, and swelling, allowing the skin to gradually improve.

What Should I Expect During Treatment?

During treatment, you can expect to begin with an initial consultation with your dermatologist, who will evaluate your eczema and determine whether phototherapy is an appropriate option for you. If you move forward, you will typically attend sessions in a clinic or dermatologist’s office where you are exposed to a controlled dose of ultraviolet light. The treatment starts with a low dose that gradually increases based on your skin’s response. Sessions are generally scheduled two to three times per week over a period of several weeks or months, depending on how your eczema responds. Throughout the process, safety measures are in place: you will receive special goggles to protect your eyes, and your skin will be regularly monitored for any signs of irritation or adverse reactions.

If your Eczema is localized, e.g., on your hands and arms, it's also possible to do phototherapy at home. Devices are available for purchase with a prescription. Make sure to always follow the instructions of your healthcare provider to not expose yourself to inadvertent skin damage.

Benefits of Phototherapy

Phototherapy offers several significant benefits for managing moderate-to-severe eczema. Many patients find that this treatment can be a game changer when conventional therapies haven’t provided sufficient relief. One of its major advantages is that it is non-invasive, meaning it doesn’t involve injections or oral medications. Over time, numerous individuals report long-term improvements in their skin condition, including fewer flare-ups and a reduction in overall symptoms. This combination of effective symptom control and a gentle treatment approach can lead to clearer, more comfortable skin and an enhanced quality of life.

Potential Side Effects

While phototherapy can be very effective, it does come with some risks:

• >Skin Redness or Irritation: Mild redness or a sunburn-like feeling can occur after treatment.
• Dry Skin: Some people experience dryness or peeling, so moisturizing is important.
• Increased Risk of Skin Aging: Long-term exposure to UV light may contribute to premature aging of the skin.
• Rare Risk of Skin Cancer: Although the risk is low when phototherapy is properly administered, long-term or excessive exposure to UV light can increase the risk.

It’s important to discuss these risks with your healthcare provider to weigh the benefits and potential side effects based on your individual situation.

In Summary

Phototherapy offers a promising treatment option for those with moderate-to-severe eczema who haven’t found sufficient relief from traditional therapies. By using controlled exposure to UV light, this treatment can reduce inflammation, soothe itchy skin, and help restore your skin’s natural barrier. While it does carry some risks—such as skin irritation and the potential for long-term effects—it is generally safe when administered under professional supervision.