What to Know Before Trying Phototherapy for Your Severe Eczema
Rachel Zohn | Sept 27, 2017
Reviewed by Michael Lehrer, MD on Dec 10, 2017
Phototherapy uses a special kind of light to treat the uncomfortable symptoms of moderate-to-severe eczema. Phototherapy can be effective for patients who haven’t found relief with topical treatments. Dr. Adam Friedman, associate professor of dermatology at The George Washington University of School of Medicine & Health Sciences, shares what you should know before you begin treatment.
Treatments for eczema
There are a number of ways to treat eczema, a condition that causes the skin to become inflamed, red and itchy. Treatments include moisturizers to keep skin from getting dry; anti-itch medication; antibiotics for skin infections; and reducing skin inflammation through topical steroids. Phototherapy, or light therapy, is another way to reduce inflammation and keep symptoms under control.
What is phototherapy?
Phototherapy uses ultraviolet light to treat eczema as well as other skin conditions such as psoriasis and vitiligo. There are several types of phototherapies available. One common type is ultraviolet B (UVB) light, which is considered the best part of natural sunlight for treating eczema. Narrow-band UVB phototherapy is a newer treatment for eczema and is considered to be safer and more effective.
How does it work?
The UV radiation from the light machines targets inflammatory cells on the skin. It suppresses overactive immune system cells on the skin which can cause eczema to flare. It can also increase vitamin D production and ramp up the skin’s ability to fight bacteria.
What to expect
Some phototherapy light units look similar to tanning beds but they emit a specific kind of ultraviolet light that helps your skin heal. Patients will undress down to their underwear and apply moisturizing oil to their skin. Eye protection must be worn when you are exposed to the light. Each session is short, usually just a few minutes.
Natural light vs. UV light
The light we get from the sun includes the same UV light waves you would get from a phototherapy unit, so some people say they see improvement when they’re outside a lot, e.g., during the summer. But phototherapy occurs under controlled settings, so patients receive a specific dosage of UV light during each session. The amount of light is slowly increased with each visit.
Effective therapy for difficult cases
Many patients find that phototherapy leaves skin looking and feeling symptom-free, without rash, redness or itchiness. The therapy may help those with cases of moderate to severe eczema who haven’t responded well to other treatments. Phototherapy is non-invasive and is considered safe and effective.
May help put eczema into “quiet” phase
Some people are thrilled to find that treatment puts their eczema into a quiet phase once treatment has ended. Once symptoms are under control, you may be able to reduce the frequency of your sessions. Response rates to light therapy are high: some dermatologist say up to 75 percent or more of patients see their symptoms reduced.
The biggest drawback is often the travel time back and forth to a doctor’s office. Most people must undergo treatment 2-3 times a week for it to be effective. And it will take a while before patients start to see results. A course of light therapy may take between 20 and 30 treatments.
Finding a dermatologist who does light therapy
Not all dermatologists offer light therapy. Depending on where you live, it may be difficult to find a dermatologist in your area who has a light unit. Phototherapy is more common among larger practices or those attached to hospitals or universities. You may need to research doctors in your area — and be prepared to travel longer distances.
The risk of phototherapy
Although the ultraviolet light used in phototherapy is carefully monitored, there is a risk of burns, developing age spots or increasing your risk of skin cancer over time. Some people have also complained the UV light causes headaches or nausea.
When to start
Light therapy should not be a first line of defense for a patient in the thralls of a severe eczema flare, according to Dr. Friedman of The George Washington University of School of Medicine & Health Sciences. Light therapy can take a while to be effective, so if possible, patients should try to calm their symptoms before beginning treatment.