UVB phototherapyrefers to exposure of the affected area to Ultraviolet light (311-312 nmwavelength). 

Full BodyChamber 

The full bodychamber comprises of either 24 tubes or 48 tubes and looks like a small cubiclehaving a dosimeter to set the dose. There are many companies who manufacturethe unit, however, the source of light is the TL-01 tube from Philips.  

1.      This method is administered by a trained staffmember of the clinic/hospital.

2.      In this method the patient needs to completelyundress and stand in a specially designed chamber (cubicle) in the center ofunit, which has the UVB tubes.

3.      The patient is given protective eyewear to cover theeyes or he/she can simply close their eyes and stand.

4.      The initial dose (200 or 300 mili joules dependingon skin type) is set as per the doctor’s advice or as per protocol of the placewhere the treatment is being administered. Usually the treatment isadministered three or two times a week on alternate days (or as per doctors’advice). Twice or thrice a week treatment does not make any difference, thetotal number of sessions are more important. 

5.      Efficacy of once a week treatment is not studied andmay be ineffective. 

6.      Patients must note that the dose is graduallyincreased till the affected area starts turning pink (mild erythema).

7.      Once the pink color persists for 24 hours aftertreatment, then the dose has to be fixed. The same dose is continued till theaffected lesions stops turning pink (mild erythema) again as mentioned above. 

8.      If the pinkness does not persist for 24 hours posttreatment, then the dose is increased in a controlled fashion to achieve milderythema again. 

9.      At any stage the affected area should not turnbright red and the patient should not experience any itching or pain. Howeverthere can be occurrence of an uncomfortable sunburn type effect about 8 hoursafter treatment, but this fades away in few days and should be treated withfrequent and liberal amount of moisturizer (any moisturizer can be used). 

10.  In this case the treatment needs to be reduced and abreak from phototherapy is required till the lesions heal completely. 

11.  A total of 300 sessions can be taken at a go. Moresessions can be taken after a break of 6 months. 

12.  Frequency is 2 or 3 times a week, never onconsecutive days. Mon/Wed/Fri or Tues/Thurs/sat or Mon/Thurs, Tues/Fri,Wed/Sat.  

StandardProtocol – Face initial dose 50mJ,and body can be 100 to 300 mJ depending upon skin type. Dose is increased by50mJ or 10 to 20% every session until lesions turn pink at 24 hours aftertreatment. Dose is fixed when lesions turn pink. Maximum dose for face is 500mJbecause usually facial lesions repigment with 500mJ. However, this dose can beincreased beyond 500mJ. Maximum dose for body is 3000mJ. If one session ismissed, dose is reduced by 20%, 2 missed by 30%, 3 missed by 50%, and more than1 week, start with initial dose or refer to physician. For any adverse effectssuch as bright redness, blisters, it is advised to see physician. 

 Side Effects: 

1.      Sun burn like reaction

2.      Tanning of skin. 

3.      Thickening of the skin. 

4.      The effect of phototherapy is similar to Sunexposure and causes aging of skin. 

5.      Development of skin cancer: This is more theoreticalbecause there is no case report of skin cancer due to UV rays. All studies aredone in white Caucasian patients who are prone to develop UV related skincancer. In South Asian and Middle Eastern population UV related skin cancersare extremely rare. Vitiligo is known to protect people from skin cancers dueto up-regulation of p53 gene.  

Important Note:Inform physician in case of any adverse effects immediately and refrain fromover treating. All treatment should be taken under the guidance of a licensedDermatologist.