UV Light Therapy
Knoxfield Medical Centre now has a Waldmann narrow-band UV light therapy unit, used by Dr. Igor Jakubowicz for the treatment of skin conditions that respond to light treatment. This is phototherapy using Narrow Band Ultraviolet B light (NBUVB) from an artificial source. The unit is particularly good for:
- Psoriasis which often worsens in winter - the most common condition
- Atopic dermatosis
- Pruritus (itch)
- Polymorphic photodermatosis
Narrowband" UVB has become the phototherapy treatment of choice for psoriasis, vitiligo, atopic dermatitis (eczema) and other photoresponsive skin disorders. Conventional "Broadband" UVB lamps emit light in a broad range over the UVB spectrum, including both the therapeutic wavelengths specific to the treatment of skin diseases, plus the shorter wavelengths responsible for sunburning (erythema). Sunburning has a negative therapeutic benefit, increases the risk of skin cancer, causes patient discomfort, and limits the amount of therapeutic UVB that can be taken.
"Narrowband" UVB lamps, on the other hand, emit light over a very short range of wavelengths concentrated in the therapeutic range, and minimally in the sunburning range. UVB Narrowband is therefore theoretically safer and more effective than UVB Broadband, but requires either longer treatment times or equipment with more bulbs to achieve the same dosage threshold. With the goal being to minimize the total cummulative dosage of erythemogenic ultraviolet light in a patient's lifetime, it follows that younger people should consider using UVB Narrowband.
Note that a typical course of treatment is 2-3 times per week for 30-50 treatments over 3-6 months in the clearance phase. Psoriasis may require DAILY treatments. There may be a maintenance phase with a treatment from 1-4 weekly. Individual responses vary so there is no fixed schedule. However, it is important to try to attend at the appropriate times otherwise the dosage schedule is interrupted and may need to be restarted. We will try not to keep you waiting - the nurse will take you through for your treatment sessions.
Phototherapy should not be applied if you have:
- Previous severe reaction to phototherapy
- Genetic disorders with increased photosensitivity or increased risk of skin cancer
- Convulsive disorder (epilepsy)
- Unavoidable taking of photosensitising drugs -
- Tetracyclines - doxycycline - Doryx, Doxsig, Doxylin, Minomycin, Vibramycin etc.
- Phenothiazines - Largactil, Avomine, Phenergan
- Sulphonamides - Bactrim, Septrim, Salazopyrin, Diamox
- Thiazides - Dithiazide, Hygroton, Hydrene, Moduretic
- Frusemide - Lasix, Urex, Uremide, Fusehexal, Frusid
- NSAID - Feldene, Voltaren etc.
- Amiodarone - Aratac, Cardinorm, Cordarone
- Malignant skin tumours in the affected area
- Generally increased photosensitivity
- Atypical (dysplastic) naevus
Possible Risks and Side Effects:
- Itching and / or sunburn-like reddening of the skin, rarely blisters - cool showers/baths/packs can help relieve some of the discomfort from heat and burning. Paracetamol can help ease discomfort. Moisturisers can prevent peeling. If blisters develop, a script for antibiotics or a cortisone cream may be required. Itchiness is related to dryness so we recommend patients increase their use of moisturisers during treatment.
- Pigmentation / tanning of the skin develops over the course of treatment and fades about 6 weeks after treatment ends.
- Severe inflammation of the eyes if safety goggles are not worn. An irreversible cataract occurs if the eyes are exposed long term to UV radiation - wear the safety goggles provided.
- Provocation of some dermatoses (e.g. polymorphic photodermatosis, photo-allergy). Folliculitis (inflammation of the hair follicles) may occur. This doesn’t cause discomfort but may require antibiotics.
- Skin aging
- UV lentiginosis (age spots) or freckling of the skin.
- Skin cancer. The skin must be examined regularly for any changes.
All treatments are bulk-billed with Medicare or Department of Veterans Affairs (DVA). Doctors’ visits are as per usual fee structure at commencement of treatment course.