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Phototherapy services

You may be prescribed a course of light therapy by your dermatologist or dermatology specialist nurse.

The team

Dr Giles Dunnill, consultant dermatologist is the phototherapy specialist consultant. A team of trained nurses provide the light therapy treatments. You will be required to attend a consent session with the nurses prior to commencing your prescribed course of light. 

What is phototherapy?

There are two types of phototherapy:

The most commonly used is Narrowband UVB (ultraviolet light B spectrum) also known as TLO1. 

The other is photochemotherapy, PUVA, using a combination of UVA (ultraviolet light A spectrum) with a form of psoralens given either orally, in a bath or topically. Psoralens is  pronounced with silent p. 

Narrowband UVB

Narrowband UVB uses a specific section of the spectrum , 309-311nm, that provides therapeutic benefits to many skin conditions.  Guttate psoriasis usually clears quickly with this form of treatment. Other conditions which may respond include eczema, prurigo and vitiligo.

It is considered that Narrowband UVB is safer than PUVA in the long term, regarding the risk of developing skin cancers. 

Treatment is given three times a week, on Mondays, Wednesdays and Fridays. The length of the course is variable depending on the response. A course of 6-8 weeks is often sufficient to produce significant benefit, but the course may need to go for longer in some cases.  It is important to have the 48 hour break between treatments to evaluate the skin's response to the light. Patients need to attend regularly and be able to commit to this regime.  The whole body is treated within a cabinet.

The aim of light therapy is to clear the skin as much as is possible within the time limitations, making treating of the skin manageable following light therapy. It is important to continue with other prescribed skin treatments during this course. 

PUVA

UVA penetrates to deeper layers of the skin than UVB due to its longer wavelength. A photochemical drug called Psoralens is used to sensitise the skin to the light. Psoralens is found naturally in plants such  as lemons, limes, celery and figs.

UVA may be prescribed to treat psoriasis that may not have responded well, or received a short remission following Narrowband UVB. Other conditions may include Graft versus host disease, polymorphic light eruption and mycosis fungoides.  Psoralens comes a several forms. You may be prescribed tablets or bath PUVA.  You will be advised on these preparations in your consultation with Dr Dunnill or his registrar, prior to your consent session with the nurses.

Treatment occurs twice weekly for six weeks, you will then be reviewed by Dr Dunnill in his clinic and you may continue further treatments, possibly another six weeks, according to the review. These treatments take place on Mondays and Thursdays or Tuesdays and Fridays. Again, regular attendance is required. 

Local PUVA

This treatment is often offered to treat hands and/or feet with either psoriasis or eczema. Using a psoralens solution, your hands and/or feet will be soaked for 15 minutes then only the hands and or feet will be treated using a smaller machine. These treatments are also provided twice weekly as full body PUVA. 

What are the risks?

UV can provide the sensation that you have been out in the sun and may induce a sunburn or prickly heat rash. These are short term risks and are taken seriously. Long term risks can be development of skin cancers and ageing of skin.

Mole checks will be carried out at the beginning of your course of light. Other forms of protection include wearing goggles during your treatment. Men are asked to protect gentalia with the use of a dark, thick sock to prevent burning. Ladies will not be expected to wear underwear in the cabinet.

Due to the risks, it is recommended that no more than 150-200 treatments are given in a lifetime. 

Appointments

PUVA Therapy: if you have been referred for PUVA treatment, you will be sent a letter with an appointment to see Dr Dunnill or his registrar so that the type of PUVA can be decided upon.

All light therapy: a letter will be sent out to you requesting you to book an appointment with the nurses for a consent session where you will receive all information relating to the treatment you have been prescribed. A skin assessment will be carried out to ensure we can provide the best individual treatment you require, and your course of light appointments will be booked. The consent session takes place for all light therapy types on Tuesdays and Thursdays.

Opening times:

Monday to Fridays, 8am to 12.30, 1.30pm to 3pm, 4pm to 4.45pm.

Children's clinic from 3.15pm to 4pm (the unit is closed to adults).

Contact details

0117 342 2780.