People have been using ultraviolet (UV) light in the form of sunlight to treat vitiligo, eczema, psoriasis, etc from centuries, and most patients still find that their symptoms improve during the sunnier months of the year. But now times have changed and specially designed UV lamps are used for this purpose.
Narrowband UVB is increasingly being used in hospitals for the treatment of vitiligo and various other skin disorders like eczema and psoriasis. It uses specific wavelength of ultraviolet (UV) radiation, 311 to 312 nm, which tends to be more effective than using standard UVB light that contains many different wavelengths.
PUVA is a type of photo chemotherapy (vitiligo treatment by means of drugs that react to ultraviolet radiations), which is often used to treat vitiligo. It is a combination of psoralen (a chemical that sensitizes the skin to light which is either taken orally or directly applied to the skin), and Ultra Violet (UVA) light type A.
All forms of UV therapies require a visit to a hospital several times a week. It is usually carried out in a day care dermatology clinic or physiotherapy departments. Initially the UV exposure time is kept short and is increased gradually. The amount of UV exposure received is carefully monitored and the total cumulative dose (expressed as Joules/cm2 skin surface) is recorded because large doses of UV time increases the risk of skin aging and skin cancer, the maximum safe limits for exposure to UV radiation at the hospital are not exceeded.
Most often patients buy a home vitiligo phototherapy system to get rid of the hassle of traveling to the hospital. These home phototherapy systems provides convenient and better results but screening and education of candidates for home phototherapy is important to ensure compliance with the treatment program.
Before starting any kind of phototherapy you must seek a dermatologist because not everyone’s vitiligo is suitable for narrow-band UVB or other phototherapies. If the area affected by vitiligo is small then it may be appropriate to try topical treatments such as steroid creams (Note: steroids can be harmful if used for long term) in the first place. In case of very extensive vitiligo, treating whole body with creams becomes difficult and in this case narrowband UVB becomes an appropriate option. Light therapy may not be possible for other reasons, such as whether to treat a small child or someone with claustrophobia, which may not tolerate standing in the UV cabinet. Similarly, people who have a skin disease aggravated by light, or a history of excessive sun exposure or skin cancer cases would not be suitable candidates for this form of treatment.
It is not possible to predict the course of vitiligo treatment, whether it will work, and if so, how well. Some areas, particularly the hands and feet are difficult to treat. Generally, treatment is continued for 2-3 months in the first place and if no repigmentation is found then it is discontinued.