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Phototherapy exposes a patient to ultraviolet (UV) light for a controlled amount of time and may be prescribed to treat moderate to severe:

Atopic dermatitis

Contact dermatitis

When prescribed, phototherapy is likely to be part of a total treatment plan.  Typically, a treatment plan includes lifestyle modifications to prevent flare-ups, topical (applied to the skin) treatment, and if needed, stronger therapy, such as medication that is swallowed or injected.

Two types of phototherapy are used to treat eczema:

UV light therapy

PUVA (also called chemophototherapy)

UV Light Therapy

This may be used alone or with a topical treatment, such as coal tar.  Ultraviolet A (UVA), ultraviolet B (UVB) or a combination of UVA and UVB therapy may be used.  During therapy, the patient's body, or just the affected skin, is exposed to the UV light.  Goggles are worn during treatment to protect the eyes.  Patients usually receive treatment in a dermatologist's office.

There are two types of UVB therapy:

Broadband (3-5 treatments per week)

Narrowband (2-3 treatments per week)

Broadband - This UVB therapy has been around for more than 80 years, and it is still highly effective. The biggest drawbacks are that the patient must travel between 3 and 5 times per week to a site that offers this therapy and that broadband light does not  effectively treat the scalp and areas where skin folds occur.

Narrowband - This newer form of UVB therapy is called ��narrowband�� because it emits a narrower band of UVB wavelengths. Narrowband UVB therapy is proving more effective than the traditional broadband therapy. However, it does have the potential to produce severe burning. Like broadband, it is still not known if narrowband UVB therapy poses a long-term risk for development of skin cancer.

PUVA

PUVA combines medication with light therapy and stands for "psoralen" + "UVA".  Psoralen is a prescription medication that makes the skin more sensitive to UVA rays.  Before UVA exposure, the patient swallows, bathes in, or applies psoralen to the skin.  After treatment, patients must wear UVA-blocking sunglasses for 1 or 2 days when exposed to sunlight because psoralen remains in the eyes for a while.

PUVA's effectiveness is limited to carefully selected patients whose condition is likely to respond to this therapy.  PUVA has a number of side effects, which may include nausea, headache, fatigue, burning skin, itching, and irregular skin pigmentation.  A series of treatments is usually needed, and a full course of treatment may take six months.  In several studies, patients have had substantial improvements when PUVA was combined with topical corticosteroids.

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