Phototherapy

Phototherapy, also known as light therapy, is a treatment option for vitiligo, a chronic skin condition characterized by the loss of pigment in certain areas of the skin, resulting in white patches or depigmentation. Phototherapy involves exposing the affected skin to ultraviolet (UV) light in controlled doses to stimulate melanocyte activity and promote repigmentation of vitiligo patches.

There are two main types of phototherapy commonly used for vitiligo: narrowband ultraviolet B (NB-UVB) therapy and psoralen plus ultraviolet A (PUVA) therapy.

1. Narrowband Ultraviolet B (NB-UVB) Therapy:

○ The most widely utilized type of phototherapy for vitiligo is called NB-UVB therapy.

○ It entails applying a certain UVB light wavelength (311-312 nanometers) to the skin via a portable or specialty light box.

○ Usually, treatments are given at a phototherapy clinic or dermatologist’s office two or three times a week.

○ The intensity and length of the vitiligo, as well as each patient’s response, determine how long the therapy will take and how many sessions are needed.

○ It is believed that NB-UVB therapy causes gradual repigmentation by inducing melanocyte migration and production to depigmented areas of the skin.

2. Psoralen plus Ultraviolet A (PUVA) Therapy:

○ Psoralen, a photosensitizing drug, is used in conjunction with UVA light exposure to provide PUVA therapy.

○ Depending on the treatment plan, topical or oral administration of propranolol is possible.

○ Following the absorption of psoralen, UVA light—usually from a specialized UVA light box, booth, or laser—is applied to the skin.

○ PUVA therapy sessions typically last several minutes each and are given two to three times a week.

○ The length and frequency of PUVA treatments varies according to patient characteristics and response to treatment, just like NB-UVB therapy.

○ PUVA therapy stimulates the repigmentation of vitiligo patches by causing DNA damage in melanocytes.

It has been demonstrated that NB-UVB therapy and PUVA therapy are both useful in helping vitiligo patients regain their pigmentation, especially in cases when the disease is localized or segmented. However, the results of treatment can differ, and it might take more than one session to see a noticeable improvement. Furthermore, phototherapy has possible hazards and side effects, including sunburn, skin irritation, and an increased risk of skin cancer with continued use. For this reason, it is imperative that vitiligo patients receive treatment under the supervision of a dermatologist with experience handling this condition.