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Narrowband UVB phototherapy

Narrow-band UVB refers to a specific wavelength of ultraviolet (UV) radiation, 311 to 312 nm. This range has proved to be the most beneficial component of natural sunlight for psoriasis and looks promising in the treatment of some other skin conditions including atopic eczema and vitiligo, pruritus, lichen planus, polymorphous light eruption and early cutaneous T-cell lymphoma.

Compared with broadband UVB, in the treatment of psoriasis:

• Exposure times are shorter but of higher intensity.
• The course of treatment is shorter.
• It is more likely to clear the psoriasis.
• Longer periods of remission occur before the psoriasis reappears.

Side effects

Narrow-band UVB can result in burning, just like sunlight and broadband UVB. Frequent emollients should be applied to burned skin, and if recommended by the therapist, topical steroids. It sometimes provokes polymorphous light eruption.

Long term exposure to ultraviolet radiation ultimately causes skin ageing and skin cancers. Although the risk from narrow-band UVB is unknown, research to date suggests it is no more risky than broadband UVB and probably less risky than photochemotherapy (PUVA).

Blistering due to UVB

What does the treatment involve?

Patients attend two to five times weekly. The patient is placed in a specially designed cabinet containing fluorescent light tubes.

The patient stands in the centre of the cabinet, undressed except for underwear, and wears protective goggles. Usually the whole body is exposed to the UVB for a short time (seconds to minutes).

The amount of UV is carefully monitored. A number of protocols exist depending on the individual's skin type, age, skin condition and other factors.

The skin may remain pale or turn slightly pink (the Minimal Erythemal Dose) after each treatment. Let your therapist know if you experience any discomfort.

Patches of psoriasis generally start to become thinner after five to ten treatments. Most patients with psoriasis require 15 to 25 treatments to clear.