Safer than sunbathing, as long as you choose a good UV lamp and use it properly
Following on from last week's blog post, I'd like to add some information about #home-phototherapy safety because it is a serious medical treatment and needs to be approached with care and common sense.
Thinking about this whole subject of taking our vitiligo (or psoriasis) treatment into our own hands, it seems to me that staying safe boils down to 3 key considerations:
Am I a good candidate for home phototherapy?
UV therapy has one of the best track records of all treatments for #vitiligo and #psoriasis, so if you have been diagnosed with either condition there is a good chance that phototherapy could be of significant benefit to you. In particular, narrowband UVB is known to stimulate the formation of pigment in vitiligo and to produce faster and longer-lasting improvements in psoriasis than any other UV bandwidth. This is because it uses wavelengths of 311 - 312 nanometres only (the most beneficial component of natural light), meaning it eliminates unnecessary and potentially harmful UV exposure. I don't know enough about how or why it is so successful in treating psoriasis but, in the case of vitiligo, its effectiveness is largely due to the fact that this narrow bandwidth allows new pigment to form in less time than it takes for the skin to burn. In this sense, it is much safer than sunbathing - which is how I obtained my UV exposure when I first started to repigment - because it is carefully targeted and scientifically administered in a way that sunlight can never be, enjoyable though basking in the sunshine undoubtedly is.
In my opinion, the safest way to approach phototherapy, if you are thinking about it for the first time, is to consult with your doctor to make sure it is appropriate for your particular case. Unfortunately, not all general practitioners and dermatologists fully appreciate the massive difference it can make to a person to have new hope and to see even partial improvement in their skin condition. Some are reluctant to refer for outpatient UV treatment and even more unlikely to prescribe home therapy. So don't be afraid to ask for a second, or third, opinion if you feel your request is not being taken seriously.
Ideally, phototherapy should take place in a hospital or clinic environment under full medical supervision, at least to begin with, because this ensures nothing is left to chance and enables the individual to ask questions and learn about how the treatment works, what results to expect and how to avoid any potential pitfalls. However, it isn't always feasible to have this kind of outpatient treatment, which is why new and improved home phototherapy devices have been developed which allow us the flexibility to treat ourselves at home with equal success and equivalent safeguards.
This well-researched article - A Practical Approach to Home UVB Phototherapy for the Treatment of Generalized Psoriasis - which is just as relevant to vitiligo, puts the subject into perspective and I would highly recommend reading it if you are considering home treatment for the first time. It offers important advice, covers some crucial safety issues and points to the fact that many doctors are unjustly suspicious of home phototherapy. The article ultimately concludes that:
"Home phototherapy is convenient, cost-effective, and associated with better quality of life compared to outpatient phototherapy […] However, few dermatologists have embraced home phototherapy. When asked why not, they cite inferior efficacy and higher risk, despite the lack of evidence to support these assumptions."
Is my chosen UV device appropriate?
Given that safety and effectiveness should be top priorities in any medical treatment, it makes sense to select a home device very carefully to ensure that it is the right type of product for your needs and that it is good quality. If you were to have this kind of treatment as an outpatient you would quite rightly assume that the hospital has the best equipment for the job. Admittedly, we are likely, as individuals, to have a much more limited budget for our purchase than a hospital but we would be very foolish to compromise standards of quality and safety in favour of the lowest price on the internet. If a UV device is on sale at an amazingly low price, you have to ask yourself why.
If you live in the USA you will need to get a doctor's prescription before buying a home phototherapy unit in any case, so you will probably be able to get advice from your doctor as to what is and isn't suitable.
But for the rest of us here are some quick tips on making an informed choice:
Am I willing to use it responsibly?
This is the factor over which, in theory, we have the greatest control but which, ironically, can carry the most risk. So I think it is important to be really honest with yourself. If you are the sort of person who has difficulty being disciplined, paying attention to detail and sticking to routines, I don't recommend you attempt UV treatment at home, unless you can get medical supervision to back you up. You will be better off as an outpatient or simply getting moderate sun exposure. But, if you are highly motivated to improve your condition and willing to follow the safety instructions that come with your device to the letter a home phototherapy unit could be the perfect way to benefit from UV treatment without the inconvenience of having to visit the hospital three times a week (usually during working hours).
If you have never had phototherapy before it is important to understand a bit about how it works and why the dosage is very gradually and precisely increased at each session. It also helps to know what effects to look out for (e.g. your skin should look slightly pink, following a treatment, but should not feel sore). And you should understand what to do if you miss a treatment by more than a couple of days (i.e. reduce the time/dosage of your next treatment accordingly so as to avoid burning.) All of this information will be available if you obtain your product from a reputable source. And the final word on this is, if you are in any doubt about any aspect of using your device, ask the manufacturer and/or your doctor for advice.
The home phototherapy devices currently available from Vitiligo Store to residents of the UK and Europe can be found here. Hand-held and small panel devices are also available for residents of the USA and Canada by using the contact form on the site. Prices and insurance arrangements can be accessed on request.
My name is Caroline.