Q. How long does it take to see if treatments are effective?
A. Unfortunately, we do not know a specific number; we hope to see results within your first 12, 24 or 30 treatments that have been scheduled for you two to three times per week. Please keep in mind that each individual is unique, so we are unable to determine an individual’s response time.
Q. How long will I receive treatments? Will treatments ever stop?
A. The skin conditions we treat with phototherapy are chronic. That means they are long-lasting, possibly for your lifetime as in the case of psoriasis or atopic eczema. Our goal is to get your condition under control, and hopefully almost clear to the eye. When we see your condition is under control or clear to the eye, you will be placed on a maintenance treatment program, for example, once a week, once every other week, and so on. It is even possible to take break from treatment, and some diseases like psoriasis may stay well for several months.
Q. Do I need to do anything before or after treatment?
A. You do not need to do anything before or after treatment; however, if you are going to be doing outdoor activities such as playing golf or tennis, boating, or just going to the beach, please apply sunscreen to the exposed areas. We recommend a sunscreen containing titanium or zinc oxide, which will help prevent sunburn and reduce your risk of skin cancer.
Q. What should I expect after my treatment?
A. You may experience “sunburn” like feelings, that is, you may see your skin become pink or red in color, possibly tender, about 12 hours after a treatment in the UVB light box. This may not happen after the first few treatments but it may occur as we continue to increase your dose in order to clear your skin. If you are receiving hand or foot PUVA, XTRAC or Pharos laser treatments you may experience similar effects with blisters.
Q. Should I still receive treatment if I get burned?
A. Our motto is “pale pink is perfect.” Therefore, it is desirable for you to be pink the day after a treatment, but not red or sore. If you are just pink and have no discomfort, we would like you to come in for your next scheduled treatment. If you are unsure about your reaction, please call the phototherapy technician or discuss it during the next visit. We can adjust your dosage down if you are burning, or we can not give a treatment that day. You will not be charged if a treatment is cancelled.
Q. Can flares occur when receiving treatments?
A. Yes, flares may occur for other reasons such as stress, unrelated infections, or allergic reactions. If this happens to you, we would continue on the same treatment program or might increase the frequency of treatments to help the flare subside.
Q. Can I still use my current medications that Dr. Camisa or my other providers have prescribed for me?
A. Yes, please continue to use any medication that Dr. Camisa or your other providers have prescribed for you, unless you were instructed to do otherwise. For medicated creams and ointments, we recommend applying those after a light treatment, but you may apply oil or petroleum jelly to thicker plaques prior to UVB light box treatment.
* If you start taking a new medication after you start your phototherapy program, please inform the phototherapy technician.
Q. What internal medications can interact with the ultraviolet light treatments?
A. Some drugs interact with the long-wave ultraviolet light found in the bath-PUVA treatments which we give for palms and soles. These include common antibiotics such as Tetracyclines, Sulfa, Quinolones including Cipro, and common diuretics such as Hydrochlorothiazide and Lasix. Some less commonly used medications such as chlorpromazine (Thorazine) and Amiodarone may be affected by the narrow-band UVB light box.
* As stated above, the best policy is to let us know all of the medications you are taking before and after you start phototherapy.
Q. How long does each treatment take?
A. The treatment time in the UVB light box varies by your skin type, that is, how light or dark your natural skin color is. The first few treatment exposures will probably be 2 minutes or less. However, the time is increased at each visit as your skin becomes adapted to the light, so that your maximum time may reach between 4 and 8 minutes. These dosages will be carefully monitored by the technician and reviewed by your doctor or nurse. The hand and foot PUVA treatments take longer because the soak in the medicated solution takes about 15 minutes and the maximum light exposure is 4-5 minutes for a total of about 20 minutes.
Q. Will phototherapy give me a tan?
A. Phototherapy is a medical treatment for serious skin diseases. It should not be confused with cosmetic tanning salons. While some tanning may be noted after both UVB and PUVA treatments, it is considered a side reaction that actually gives little benefit to the skin condition under treatment.
Q. Can phototherapy cause skin cancer?
A. NBUVB light and Bath PUVA as they are used in treatment of psoriasis and other skin diseases has not increased the incidence of skin cancer. However, because excessive natural sunlight and tanning bed exposures are associated with skin cancer, we recommend prudent sun exposure with use of sunscreen and avoidance of tanning salons.
Q. What is the difference between UVA and UVB?
A. UVA and UVB refer to long and short wavelengths of light, respectively. The longer the wavelength, the higher the energy levels of the light, and the deeper the penetration into skin. We use UVA to treat diseases of the palms and soles which have thicker skin than the rest of the body. We use UVB to treat the entire body skin in a full body standing cabinet or with a focused laser beam for smaller resistant areas anywhere on the body including the scalp, palms and soles.