Eczema Treatment: Targeted UV Phototherapy
Targeted UV phototherapy only affects skin with eczema, sparing healthy skin, so it can be applied at higher dosages over fewer treatments.
“Targeted” refers to administration of UV light via excimer laser, elemental gas lamp or other light source such as LED, to a small area of eczema typically less than 4 cm². The light administered is typically in the UVB range (between 280nm and 320nm). The devices typically consist of a wand or other handheld device connected to a stationary base console. Due to the small treatment area size of the handheld, many dosages are administered to the eczema, each dosage lasting several seconds.
Before treatment, the patient's sensitivity to UV light is determined. The minimal amount of UV light required to cause slight reddening of the patient's skin is called Minimal Erythemic Dosage, or MED. Non-targeted UV phototherapy affects healthy and unhealthy skin alike, and is administered in dosages less than the patient's MED.
Because targeted UV phototherapy is only administered to the eczema, healthcare providers can administer intense UV dosages, up to several times as much as the MED. More UV light is administered to the affected eczema resulting in more pronounced effects, meaning less visits for treatment are required.
In one study, patients with acute eczema on the palms and backs of hands were given a total of 15 high dosage UVA irradiations over 3 weeks. After the first week, all but one patient reported greatly reduced itch, and after 15 treatments 10 of 12 patients reported significant clinical improvements1. In another study, high dosage (targeted) UVB was administered to 57 patients with localized, mild therapy-resistant atopic dermatitis. Complete remission occurred in 84% of patients (48/57), with a mean reduction in patient-reported pruritus (itching) as one hallmark after 3-4 treatments2.
While non-targeted phototherapy has been in use for decades, targeted phototherapy is a much more recent advancement in the treatment of eczema. It can only be administered by a healthcare provider and is not available for home use.
Many health insurance providers cover both targeted and non-targeted UV phototherapy. The patient should always make certain their healthcare provider is aware of how their disease is impacted by their Quality of Life (QoL).