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What Is Phototherapy With Narrowband UVB?

Ultraviolet light is used to treat many different skin conditions, primarily psoriasis, eczema (dermatitis), lichen planus, vitiligo and itch with no rash. It works by damping down the immune response in the skin.

There are a number of forms of ultraviolet light used by dermatologists. The light used in this clinic is not the same as the ultraviolet light used in commercial solariums. The machine we use at Northside Dermatology is known as narrowband UVB. This is a new form of ultraviolet B light which has been ‘tuned’ to get the maximum effect with minimal side effects.

How Is Narrowband Phototherapy Done?

The treatment is delivered in a large metal cabinet. You will stand in the centre of the cabinet while special fluorescent light tubes emit the narrowband UVB light. You will need to undress before you get into the cabinet. Depending on where your skin rash is, you may need to remove your underwear as well. Most people need to cover the genital area and the face. Please bring a small towel to your appointment to cover your face during the treatment. Alternatively, you can use an item of your clothing, such as a t-shirt.

You will need to wear special goggles while in the cabinet to protect your eyes from the UV light. Our clinic will provide a pair of these goggles for your use and you will be asked to keep them and bring them in with you to each treatment.

If you have any “funny-looking moles”, we sometimes cover these with sunscreen or dot bandaids. The nipples may also need to be protected in this way.

For each treatment, try to wear the same style of clothing. If you wear boyleg underwear to one appointment and then next time wear a g-string, you may burn the previously-protected skin. The same rule applies to the type of bra you wear.

Before an appointment, we recommend applying moisturising cream to your skin, as this facilitates better absorption of the UVB rays. If you have recently applied sunscreen, please ensure that it is washed off prior to the treatment.

During your first session, you will only stay in the cabinet for a short time — just a few seconds. With each subsequent treatment, you will spend more time in the cabinet. We will increase the time gradually based on your skin type and sensitivity.

Your doctor may prescribe creams or ointments to apply to your skin in addition to the narrowband UVB treatment. Please apply these after you have the phototherapy treatment.

We are open Monday through to Friday, 9am – 5pm. It is possible to have two UV treatments 24 hours apart, but if you need to have a third treatment, then you will need to wait 48 hours.

Phototherapy treatments are generally given three times per week for 6 to 12 weeks. For the treatment to be effective, it is important that you endeavour to attend all of the treatments recommended for you. Please tell us if you have had a break in your treatment schedule, as it will affect your treatment dose.

How Much Does Phototherapy Treatment Cost?

The government pays for phototherapy treatments through the Medicare system. You do not owe anything if you have a Medicare card.

For overseas visitors, insurance companies will generally pay for the treatment if it is required. You will need to check with your insurer to be certain. The Medicare item number for phototherapy treatment is 14050.

What Are the Risks Associated With Phototherapy With Narrowband UVB?

The main possible side effects of this treatment are:

1. Burning of the skin (sunburn)

Some tablets make you more prone to developing a sunburn. There are many that do this, so please check with your doctor or our practice nurse before commencing treatment.

St John’s Wort, herbal medication and antibiotics can increase sun sensitivity. Certain foods such as celery, parsnip and some citrus fruits, if taken in very large quantities, can also increase your risk of sunburn.

Our doctors will adjust the treatment times according to your skin type (based on how easily you tan or burn). Your skin may feel a little sore after some treatments. If you get a burn (pain and redness) the evening of or the day after treatment, please make sure that you tell the staff before your next treatment.

Too much recent sun exposure may result in a narrowband UVB treatment causing a burn. Please avoid excessive recreational sun exposure, such as sunbathing and sports that require you to be outdoors for long periods of time. After treatments and at all other times, if you are outdoors, please cover up well with sensible clothing and sunscreen.

2. Darkening of the skin (suntan)

3. Increased chance of skin cancers in later life

One of the concerns in using ultraviolet light is its ability to cause skin cancers. It usually requires repeated exposure over many years to do this. The ‘narrowband’ of UVB is thought to be less likely to cause skin cancers. Currently, the skin cancer risk from all forms of UVB is considered to be low.

For patients with darker skin types, the risk of skin cancers is extremely low, if any at all.

People with a past history of skin cancer are usually not treated with phototherapy. Care is also taken with those who have a family history of skin cancer, abnormal mole patterns, a lot of sun exposure in their life, very fair skin and are on immune suppressant tablets.

You or your partner should regularly examine your skin during treatment and notify the doctor or our practice nurse of any odd-looking bumps or pigmented lesions.

If you have already had a lot of sun exposure over your life or a large number of ultraviolet or solarium exposures, it would be prudent to have annual skin checks.

4. Increased photoageing effects later in life (wrinkles, freckling and blotchy colour changes to the skin)

There is a risk that this treatment may worsen sun-induced ageing effects later in life. The sort of light available in solariums is more likely to cause these skin ageing side effects than narrowband UVB. The cumulative sun exposure you receive recreationally contributes to most of this risk.

What if I Miss Some of My Phototherapy Treatment?

It is best not to miss appointments to get the maximum benefit from the treatment, but missing one treatment here and there is ok. If you consistently miss treatments, the treatment will take longer and will not be as effective. Missing treatments also increases the risk of burning. In this situation, we usually reduce the treatment time and slowly increase it again. This also applies to treatments missed due to holidays.

When Do I Stop Phototherapy Treatment?

Regular checks by the doctor every eight weeks are required. Treatment will be stopped when your skin clears or shows significant improvement. For psoriasis or eczema, it is common for the rash to return after treatment ends. Recurrence can often be controlled with appropriate creams or ointment or a small amount of sun exposure. Phototherapy is not right for everyone. Some people have to stop because of side effects or because of difficulty maintaining a regular treatment schedule.

If you believe you have a condition that would benefit from phototherapy treatment, please contact Northside Dermatology on 03 8582 8688 to schedule an appointment with a consultant dermatologists.