UVB Phototherapy


At Cahaba Dermatology, we offer NB-UVB for psoriasis and vitiligo treatment. Dr. Groysman is an expert at treating psoriasis and will help you get clear skin faster. We are one of the few treatment centers for psoriasis in Alabama and offer a therapeutic spectrum for psoriasis from UV light therapy, Xtrac excimer to oral, topical and injectable treatment.

We also offer Xtrac excimer laser for targeted treatment of psoriasis and vitiligo. Please refer to Xtrac tab for more information.

Before
Before UVB Phototherapy Treatment for Psoriasis and Vitiligo
After
After UVB Phototherapy Treatment for Psoriasis and Vitiligo

A UVB narrowband lamp emits safe light energy.

Narrowband UVB lights (NB-UVB) comprises a subset of the UVB spectrum centered at roughly 311 nm. This is less than 1% of total range of wavelengths from sunlight.

Studies have shown that:

  • Narrow band UVB light treatment uses the optimal part of the UVB light spectrum which slows growth of psoriasis lesions or re-pigmentation of one's natural skin coloring.
  • Exposure time of narrowband UVB lamps can be longer than with traditional broadband UVB yielding more effective results. Recent studies have shown 75% clearing (PASI 75) with narrowband UVB.
  • Erythemal response (similar to sunburn) is nearly eliminated with narrowband UVB light.
  • Risks and side effects of other treatments such as systemic drugs have not been found with narrowband UVB light therapy.

NB-UVB therapeutic advantages for your skin condition

Ultraviolet Light Box for Phototherapy
  • Psoriasis - Narrowband UVB light treatment provide faster clearing, less sun burning, and more complete disease resolution than traditional UVB and is much safer than biologics.
  • Vitiligo - Narrowband UVB lights are proving to be very useful in the treatment of Vitiligo. Narrowband UVB light treatment is replacing traditional PUVA phototherapy treatment. UVB narrowband lamps for vitiligo require no photo-sensitizing agents.

People have been using ultraviolet (UV) light in the form of sunlight to treat psoriasis for more than a century, and most psoriasis patients still find that their symptoms improve during the sunnier months of the year. But these days, light therapy, or phototherapy, for psoriasis can involve exposure to specially designed UV lamps in the setting of a dermatology clinic. At Cahaba Dermatology we offer both UVB, UVA and excimer phototherapy.  There are several types of artificial UV light therapy: broadband UVB (BB-UVB), narrowband UVB (NB-UVB), psoralen plus UVA (PUVA), and targeted therapies including the excimer laser. Each is quite effective at improving psoriasis.

Background on Types of Light

Light travels in waves, and different types of light can be distinguished from one another by the “width” of the waves (the distance from the peak of one wave to the peak of the next). This distance, called wavelength, is usually measured in nanometers (nm), or billionths of a meter. UV light used for phototherapy has wavelengths in the range of 280-400 nm, with BB-UVB (280-320 nm), NB-UVB (primarily 311-313 nm), and UVA (320-400 nm) covering different subsets of that range. The excimer laser and lamp deliver light at 308 nm, which is in the UVB range. For comparison, commercial sun tanning beds use primarily UVA light.

How does UVB work?

UVB inhibits DNA synthesis, which may, in turn, inhibit the overgrowth of skin cells seen in psoriasis plaques. UVB also promotes the self-destruction of T lymphocytes, the immune cells that gather in psoriasis plaques and trigger inflammation. Finally, UVB increases cellular production of several substances that reduce inflammation. Some combination of these mechanisms may explain how UVB exposure controls psoriasis.

What is Narrowband UVB (NB-UVB)

NB-UVB lamps emit light in a narrow band, primarily at 311-313 nm, the wavelengths that have been shown to treat psoriasis most effectively with the fewest side effects.

How are they administered?

Patients usually receive treatments three times a week for several months at a dermatologist’s office or clinic. Before beginning treatment, patients are generally evaluated to determine the maximum amount of light they can tolerate without developing erythema, or reddening of the skin (the Minimal Erythema Dose (MED)). Treatment begins at a lower exposure (50% MED, for example), and the exposure is gradually raised. To improve effectiveness, NB-UVB is sometimes used in combination with topical treatments such as vitamin D3 analogues (calcipotriene) or retinoids (tazarotene) or with systemic medications.

How well do they work?

NB-UVB is superior for treating plaque psoriasis. NB-UVB is works well even at doses significantly below the MED, so patients experience fewer side effects. One review of the available clinical trial data concluded that psoriasis clears completely for 63-80% of patients who use NB-UVB; another similar review found that 55% of patients experience a 75% reduction in psoriasis severity (PASI75) after 12 weeks of treatment.

When will my psoriasis clear?

Clearance can take a while—most patients need 15 to 20 treatments to see a 50% reduction in psoriasis severity, which corresponds to 5 – 7 weeks if following the typical three times per week treatment schedule.

What are the advantages of NB-UVB?

NB-UVB have a significant safety advantage over most other psoriasis therapies, because side effects are limited to the skin. This makes UVB a popular choice for pregnant women, for example. The most serious potential side effect—skin cancer—has not been clearly demonstrated. (PUVA, by contrast, has a well-documented link with skin cancer.)

What are the drawbacks of NB-UVB?

The possibility that UVB treatment increases the risk of skin cancer cannot be dismissed, although so far solid evidence is lacking. All patients receiving UVB should have annual skin cancer checks and keep their total UVB exposure as low as possible. Patients at high risk for skin cancer, including those with fair skin and those who have had skin cancer in the past, should be especially careful.

The most common side effect of UVB therapy is erythema, a sometimes painful reddening of the skin similar to sunburn. The dosage of UVB that causes erythema varies from patient to patient. Determination of an acceptable UVB dose on an individual basis helps to minimize this side effect.

If you have questions or concerns about caring for your skin, you should make an appointment with Dr. Groysman to discuss treatment. Call us at 205-214-SKIN.

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