Vitiligo Treatment: UV Phototherapy
UV phototherapy is capable of restoring pigment where stores of melanocytes still exist.
Ultraviolet (UV) light is a natural part of all sunlight.
UVA light (320 to 400nm) and UVB light (280 to 320nm) are the UV radiation wavelengths which reach the surface of the earth. It is generally known that exposure to too much sunlight, specifically too much UVA and UVB light, causes sunburn, aging of the skin, and in some cases, skin cancer. That is why sunblocks try to keep UVA and UVB light from reaching the skin they are applied to. Vitiliginous skin is especially susceptible to excess sunlight. It is less generally known that sunlight strongly affects the skin in beneficial ways for patients with psoriasis, eczema, vitiligo, and various other skin conditions.
In general, UV light is thought to stimulate activation and migration of melanocytes to the site of exposure. UV light is thought to stimultate keratinocytes (skin cells) to release cytokines and inflammatory mediators which activate and promote melanocyte migration to the sites of exposure. The major source of “naïve” melanocytes is the follicular reserve, the body of melanocytes which are present in the hair follicles of skin. It is rare for skin with amelanotic hairs, or hairs with no pigment (white hairs), to repigment from UV light exposure.
UV light also acts to suppress the immune system. UV light exposure can slow or stop the spread of vitiligo and allow and promote repigmentation. In patients with no follicular melanocyte reserve who undergo skin graft or melanocyte transplant, repigmentation is often improved through simultaneous use of UV phototherapy.
UV Phototherapy comes in two forms: Non-Targeted and Targeted.
There are several types of UV phototherapy devices. Treatment is issued in one of two ways: non-targeted and targeted. Non-targeted refers to delivering lower dosage UV light to healthy and unhealthy skin alike, two to three times per week, over several months. Targeted phototherapy refers to delivering higher dosages of UV light to only vitiligo skin, sparing healthy skin, two to three times per week for several weeks. Targeted UV phototherapy has been shown to offer potentially more rapid response due to typically higher intensity dosages.
The patient should always make certain their healthcare provider is aware of how their disease is impacted by their Quality of Life (QoL) before beginning on any treatment regimen. Patient progress should be monitored closely, including changes to QoL.