When is the combination of UVA and UVB an option?

Combined UVA and UVB irradiation has proven itself for atopic dermatitis and for certain forms of itching. Whether it is suitable for you, or whether another procedure is a better fit, is decided after a medical examination.

How does the combination differ from PUVA?

In PUVA the skin is pretreated with a photosensitising agent (psoralen) before the UVA irradiation, as a bath or as a cream. In the UVA/UVB combination this is not needed; there is therefore also no light sensitivity lasting several hours afterwards caused by the agent. The general precautions of any phototherapy still apply.

And the difference from pure UVB therapy?

UVB therapy uses only the short-wave component and is frequently used for psoriasis. The combination adds the UVA component and has proven itself for atopic dermatitis and certain forms of itching. Which procedure suits you is decided on the basis of the findings.

Which medicines do I have to report?

Everything you are taking, including herbal preparations such as St John's wort. We pay close attention to photosensitising, and especially phototoxic, preparations because they increase the skin's sensitivity to light. Please also tell us before you start a new medication.

How long does the improvement last?

The long-term effect of this form of treatment appears to be favourable; how long an improvement lasts, however, differs from person to person. We cannot give an assurance. Once the course is complete, we recommend regular dermatological check-ups.

UVA/UVB combination therapy

For atopic dermatitis and certain forms of itching we use combined UVA and UVB irradiation. A photosensitising agent as in PUVA is not needed for this.

Overview

In UVA/UVB combination therapy the skin is irradiated with both components of ultraviolet light: the short-wave UVB and the longer-wave UVA. This form of phototherapy has proven itself for atopic dermatitis (neurodermatitis) and for certain forms of itching (pruritus). One advantage is that the two UV spectra can be dosed independently of each other.

The combination differs from pure UVB therapy by the added UVA component, and from PUVA in that no photosensitising agent is needed. There is therefore no bath or cream before the irradiation, and none of the several hours of increased light sensitivity afterwards that is typical of PUVA.

The long-term effect of this form of treatment appears to be favourable; how long an improvement lasts, however, differs from person to person and cannot be promised. As with any phototherapy, before we begin we pay attention to photosensitising and in particular phototoxic medication. Whether the combination is an option for you is decided after a medical examination.

Areas of application

Atopic dermatitis (neurodermatitis)
Certain forms of itching (pruritus)

Procedure

Medical examination and review of your medication
First we assess whether the combination therapy is suitable for your condition and whether anything speaks against it, such as a light-sensitive disease or a very fair, UV-sensitive skin type. Particular attention goes to your medication: as with any phototherapy, we look out for photosensitising and in particular phototoxic preparations, because they increase the skin's sensitivity to light. Please therefore bring a list of everything you are taking.
Setting and increasing the dose
The irradiation dose is set by the doctor and increased at regular intervals in the course of the treatment; the yardstick for this is how your skin reacts.
Irradiation
Depending on the findings, irradiation is given as whole-body or as partial-body irradiation. No pretreatment with an agent is required. During every irradiation you wear UV-protective goggles; in the whole-body cabin the genitals are covered in men.
Monitoring the course
At regular intervals we assess the skin findings and the tolerability and adjust the dose. Once the therapy is complete, we recommend regular long-term dermatological check-ups.

What to expect

The irradiation dose is set by the doctor and increased step by step.
How often per week and over what period treatment is given depends on the findings and the course. [PLATZHALTER: Übliche Behandlungsfrequenz und Gesamtdauer der UVA/UVB-Kombination in der Praxis angeben.]
There is no pretreatment with a bath or cream; the appointment consists of the irradiation itself.
During every irradiation you wear UV-protective goggles.
The aim is an improvement that lasts as long as possible; how long it lasts differs from person to person and cannot be promised.
Once the course is complete, we recommend regular long-term dermatological check-ups.

Risks & notes

Certain medicines increase sensitivity to light, for example some antibiotics, blood pressure or sedative medication and St John's wort. As with any phototherapy, we pay attention to photosensitising and in particular phototoxic medication before we begin. Please tell us about everything you are taking, and before you start any new medication.
The most common acute side effect is a sunburn-like reddening; if the dose is too high, stronger reactions are possible.
UV therapies can increase the risk of skin cancer in the long term and make the skin age prematurely. The dose is therefore controlled and limited by the doctor.
Not suitable for everyone: with certain light-sensitive conditions (e.g. lupus erythematosus, porphyria), an increased risk of skin cancer or a very fair, UV-sensitive skin type, we assess suitability before the treatment begins.
Before the treatment, do not apply any sun-protection products or perfumed cosmetics (perfume, soap, aftershave) to the skin.
The outcome of the treatment differs from person to person and cannot be guaranteed. We discuss the risks relevant to you in person beforehand.

How UVB, UVA/UVB and PUVA relate to each other

The three procedures of our light therapy differ in the spectrum used and in whether a photosensitising agent is needed:

UVB therapy: uses only the short-wave component between 280 and 320 nm, as narrowband UVB limited to a range around 311 nm. It is frequently used for psoriasis.
UVA/UVB combination: irradiates with both components of UV light. It has proven itself for atopic dermatitis and certain forms of itching. No agent is needed.
PUVA (photochemotherapy): pretreatment with a psoralen as a bath or cream, followed by UVA irradiation. As a result, light sensitivity is increased for at least four hours afterwards, with corresponding rules of conduct.

Frequently asked questions

When is the combination of UVA and UVB an option?: Combined UVA and UVB irradiation has proven itself for atopic dermatitis and for certain forms of itching. Whether it is suitable for you, or whether another procedure is a better fit, is decided after a medical examination.
How does the combination differ from PUVA?: In PUVA the skin is pretreated with a photosensitising agent (psoralen) before the UVA irradiation, as a bath or as a cream. In the UVA/UVB combination this is not needed; there is therefore also no light sensitivity lasting several hours afterwards caused by the agent. The general precautions of any phototherapy still apply.
And the difference from pure UVB therapy?: UVB therapy uses only the short-wave component and is frequently used for psoriasis. The combination adds the UVA component and has proven itself for atopic dermatitis and certain forms of itching. Which procedure suits you is decided on the basis of the findings.
Which medicines do I have to report?: Everything you are taking, including herbal preparations such as St John's wort. We pay close attention to photosensitising, and especially phototoxic, preparations because they increase the skin's sensitivity to light. Please also tell us before you start a new medication.
How long does the improvement last?: The long-term effect of this form of treatment appears to be favourable; how long an improvement lasts, however, differs from person to person. We cannot give an assurance. Once the course is complete, we recommend regular dermatological check-ups.