Medically reviewed by Dr. Shani Saks, D.O. on Sept. 3, 2023
From ancient remedies to modern treatment plans, phototherapy remains a cornerstone of dermatology. If you or someone you know has vitiligo or other skin conditions, learning about the benefits of phototherapy could be enlightening.
- Phototherapy has deep historical roots and continues to be an effective treatment for many skin conditions.
- There are various mechanisms through which phototherapy works, each catering to different skin conditions.
- For those with vitiligo, narrowband UVB therapy might be the best option, and combining it with other treatments can further enhance its effects.
A Historical Perspective on Phototherapy
The use of light to treat diseases can be traced back to ancient civilizations. By the end of the 19th century, the invention of the electric light bulb and generator had shifted the focus from natural sunlight (heliotherapy) to artificial light sources for treatment, marking the birth of modern phototherapy. The work of pioneers like Niels Ryberg Finsen, who recognized the antibacterial effects of sunlight, helped to develop this field of study and ultimately earned him a Nobel Prize in Medicine in 1903 for his findings. Despite the introduction of advanced treatments over the years, phototherapy has remained a viable treatment in dermatology.
Mechanisms: How Phototherapy Works
Learning about the mechanics behind phototherapy may help you understand how it works for specific skin concerns. Six primary effects of phototherapy have been documented, including:
- Promoting normal cell turnover: This may be beneficial for conditions like psoriasis and atopic dermatitis.
- Immune system modulation: By directing the migration of immune cells and keeping the immune system in check, this action may help treat skin conditions like psoriasis, scleroderma, and some lymphomas.
- Pigmentation-promoting effects: This action may be helpful for treating vitiligo, a condition that causes loss of skin color.
- Anti-scarring mechanisms: These may be necessary to treat conditions like scleroderma.
- Anti-itching effects: These may be useful for those who have itchy skin due to conditions like psoriasis or atopic dermatitis.
- Pro- and prebiotic effects: This aspect deals with the skin’s natural bacteria and can be beneficial for atopic dermatitis and psoriasis.
The Use of Phototherapy for Vitiligo
If you’re struggling with vitiligo, especially on the head and neck, treatment options are available. Narrowband UVB therapy is particularly effective for treating vitiligo because it is more efficient and has fewer side effects than other methods. Here’s what you should know:
- Frequency: Typically, treatments are 2–3 times per week.
- Duration: If, after 3 months, there’s no significant repigmentation, it’s advised to evaluate the treatment. Ideally, it shouldn’t be continued for more than 12–24 months.
- Combination with topicals: The effects of narrowband UVB can be improved by combining it with topical treatments like glucocorticoids or tacrolimus ointment.
[Note: If using tacrolimus, it’s recommended to avoid direct sun exposure during the treatment period.]
Every individual’s response to treatment can vary. It’s always best to consult a dermatologist to find the right treatment plan for your needs.
Kurz, B., Berneburg, M., Bäumler, W., & Karrer, S. (2023). Phototherapy: Theory and practice. Journal Der Deutschen Dermatologischen Gesellschaft, 21(8), 882–897. https://doi.org/10.1111/ddg.15126