Therapy
Psoriasis
Psoriasis is a chronic autoimmune condition characterised by inflammatory processes and accelerated skin renewal. Typical symptoms include red, scaly and itchy patches of skin, which frequently occur on the scalp, elbows, knees and buttocks. As the condition is incurable and usually progresses in flare-ups, treatment focuses on alleviating the symptoms.
A proven treatment option is UV phototherapy, particularly with narrow-band UV-B light. This inhibits inflammatory reactions and slows down the regeneration of skin cells, which can improve the appearance of the skin and the quality of life of those affected. After a course of treatment, usually comprising 20 to 30 sessions, many patients experience a significant reduction in symptoms.
Atopic dermatitis
Atopic dermatitis is a chronic inflammatory skin condition characterised by severe itching, a compromised skin barrier and immunological dysregulation. The condition occurs in flare-ups and manifests itself in different parts of the body depending on the patient’s age. Genetic factors and external triggers such as allergens and stress contribute to the development and worsening of symptoms.
UV phototherapy using the 311 nm narrow-band UV-B spectrum is an established treatment option, as ultraviolet radiation has an anti-inflammatory effect, modulates the overactive immune system and strengthens the skin barrier. Treatment is usually carried out three to five times a week over 25–30 sessions with an individually tailored dosage. During chronic phases of the condition, UV-B treatment is an effective and well-tolerated therapeutic option for relieving symptoms and improving the appearance of the skin in atopic dermatitis.
Vitiligo
Vitiligo is a chronic pigmentary disorder of the skin characterised by the loss or dysfunction of melanocytes. The depigmented areas of skin do not usually pose a direct health risk, but can cause considerable psychological distress due to the visible skin changes. One established treatment option is narrow-band UVB 311 nm phototherapy. This has an immunomodulatory effect by inhibiting the breakdown of melanocytes whilst simultaneously promoting the formation of pigment-producing cells. This can lead to repigmentation of the affected skin areas and slow the progression of the condition.
Treatment is usually administered three times a week over an extended period of up to nine months. Initial signs of improvement usually only become apparent after several weeks. Effectiveness varies from person to person and depends, amongst other things, on the patient’s age, the duration of the condition and the location of the skin lesions.
The basics of UV-B phototherapy
UV phototherapy is one of the established treatment methods for inflammatory skin conditions and is based on the therapeutic effects of sunlight, which have been recognised for centuries. In particular, the narrow-band UV-B spectrum at 311 nm has been shown by numerous clinical studies to be effective and associated with comparatively few side effects. Owing to its high efficacy, good tolerability and widespread availability, it is the preferred treatment recommended in national and international guidelines for conditions such as psoriasis, atopic dermatitis and vitiligo.
UV phototherapy can be used as monotherapy or in combination with other treatments, such as balneotherapy, PUVA or systemic medication. Combination therapies can increase efficacy, but are often associated with an increased risk of side effects and interactions and therefore require close medical supervision. Modern handheld UV devices also allow for flexible use at home and reduce the treatment burden on patients.
The application of UV-B phototherapy
Before each treatment, the eyes must be protected with suitable UV-protective goggles. Areas of skin not to be treated should be covered with clothing or sunscreen.
The UV dose administered is determined by the duration of exposure and the distance between the lamp and the skin. To maintain a consistent distance, the UV comb is always placed on the skin using the comb attachment. During the course of treatment, the exposure time – and thus the dose – is gradually adjusted. The duration of treatment depends on the individual’s sensitivity to UV light and is increased up to the so-called erythema threshold, which manifests as a slight, temporary reddening of the skin. As treatment progresses, the skin develops a higher tolerance to UV radiation, allowing for a further increase in dose. Individual sessions usually last between two and fifteen minutes.