What is the difference between narrowband UVB therapy and selective phototherapy?

Both work in the UVB range between 280 and 320 nm. In selective phototherapy the maxima of the light lie at 305 and 320 nm; narrowband therapy uses a more narrowly confined section, usually around 311 nm. For psoriasis it is one of the established treatments. Which method fits you is decided after the examination.

How often and for how long do I have to come for irradiation?

Usually on three or five days per week. How many irradiations are needed depends on the findings and on how the treatment progresses. A single session is short.

Why is the irradiation combined with topical active substances or brine baths?

The combination is meant to support the effect of the irradiation. Active substances such as dithranol and calcipotriol are applied topically to the lesions; the brine bath precedes the irradiation. Whether and which combination makes sense for you is something we discuss with you; the brine baths (balneophototherapy) are carried out in our bathing department.

Does UVB therapy increase the risk of skin cancer?

UV therapies can increase the risk of skin cancer in the long term. The dose is therefore controlled and limited by the doctor, in men the genitals are covered in the cabin, and once the course is complete we recommend regular dermatological check-ups. With an increased risk of skin cancer or a very fair skin type, we assess suitability beforehand.

Is UVB therapy also an option for vitiligo?

Circumscribed vitiligo areas are treated with the excimer laser, whose light (308 nm) also lies in the UVB range and hits only the depigmented spots. You will find more about this on the vitiligo page.

What do I need to be mindful of before and during the treatment?

Wear the UV-protective goggles in the cabin and do not apply sun-protection products or perfumed cosmetics before the irradiation. Let us know before you start taking any new medication, and avoid additional sunbathing and tanning beds during the course of treatment.

UVB therapy (partial- or whole-body irradiation)

UVB irradiation is one of the established light therapies for psoriasis. We irradiate the whole body or only the hands and feet; where useful, the treatment is combined with topically applied active substances or with brine baths.

Overview

UVB is the part of ultraviolet light with shorter wavelengths than UVA. For the treatment of skin conditions the spectrum between 280 and 320 nm is used, as irradiation of the whole body or of individual regions. Irradiation with maxima at 305 and 320 nm is referred to as selective phototherapy. Narrowband UVB therapy uses a more narrowly confined section of this range (usually around 311 nm); for psoriasis it is one of the established treatments.

In our practice we have whole-body irradiation units and devices for irradiating the hands and feet. Treatment is usually given on three or five days per week. The dose is set by the doctor and increased from session to session, adjusted to how your skin reacts. During the irradiation you wear UV-protective goggles.

UVB phototherapy can be combined with other treatments to support the effect of the irradiation. Options are topically applied active substances such as dithranol and calcipotriol, as well as brine baths. The brine baths are carried out as balneophototherapy in our bathing department; whether a topical accompanying treatment makes sense for you is something we discuss with you. You will find more about the bathing department and about cost reimbursement on the light therapy page.

Areas of application

Psoriasis, especially with extensive involvement or many lesions
Atopic dermatitis (neurodermatitis), depending on the findings also as a UVA/UVB combination
Chronic hand and foot eczema, using devices for irradiating the hands and feet
Sun allergies (e.g. polymorphic light eruption)
Certain forms of persistent itching (pruritus)
Further inflammatory skin conditions after medical assessment

Procedure

Examination and indication assessment
First we assess whether UVB therapy is suitable for your condition or whether another form of light therapy is a better fit. We ask about previous illnesses, your skin type and all the medicines you take, because some preparations increase sensitivity to light.
Setting the starting dose
The first irradiation dose is set by the doctor, among other things according to your skin type. From session to session the dose is increased step by step; the yardstick is how your skin reacts.
The irradiation
Depending on the findings, we irradiate the whole body in the cabin or only the hands and feet with a device intended for that purpose. During the irradiation you wear UV-protective goggles; in the whole-body cabin the genitals are covered in men. Treatment is usually given on three or five days per week.
Combination and course
Where useful, we add a topical treatment to the irradiation, for example with dithranol or calcipotriol, or a brine bath followed by the irradiation. Over the course we check the skin reaction and adjust the dose. Once it is complete, we recommend regular long-term dermatological check-ups.

What to expect

Treatment is usually given on three or five days per week; the dose is set by the doctor and increased step by step.
A single session is short; the treatment takes place on an outpatient basis in our practice.
During every irradiation you wear UV-protective goggles.
Psoriasis is a constitutional (genetically determined) condition and cannot be cured by the irradiation; the existing lesions are treated. A particular outcome cannot be guaranteed.
Once the course is complete, we recommend regular long-term dermatological check-ups.

Risks & notes

The most common acute side effect is a sunburn-like reddening. If the dose is too high, stronger reactions up to blistering are possible.
The skin can become drier and itch during the course of treatment; a lipid-replenishing skin care is then advisable. In the irradiated areas a temporary tan usually develops, which fades after the end of therapy.
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; we discuss your individual risk with you.
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.
Certain medicines (e.g. some antibiotics, blood pressure or sedative medication, St John's wort) increase sensitivity to light. Please tell us about every preparation you take, including newly prescribed ones.
Before the irradiation, do not apply any sun-protection products or perfumed cosmetics (perfume, soap, aftershave) to the skin.
When combined with topical active substances, skin irritation is possible. We discuss with you how to use the preparations.

Combination treatments

UVB phototherapy can be combined with further treatments to support the effect of the irradiation. The options are:

Dithranol: a topically applied active substance that is put on the lesions in psoriasis.
Calcipotriol: a topically applied active substance that is likewise put on the lesions in psoriasis.
Brine baths (balneophototherapy): a bath in salt solution followed by the irradiation, which we carry out in our bathing department. You will find details on cost reimbursement on the light therapy page.

Irradiation cabin or excimer laser?

For the UVB treatment of diseased skin, two routes are open in our practice. Which one fits is decided after the examination:

Whole-body or partial-body irradiation in the cabin or with the hand and foot devices: with extensive involvement, many lesions or chronic hand and foot eczema.
Excimer laser (308 nm): with single, small psoriasis lesions, with circumscribed vitiligo areas and in regions that whole-body irradiation hardly reaches, such as the scalp, armpits or groin. The light hits only the diseased skin; the healthy surroundings are spared.

Frequently asked questions

What is the difference between narrowband UVB therapy and selective phototherapy?: Both work in the UVB range between 280 and 320 nm. In selective phototherapy the maxima of the light lie at 305 and 320 nm; narrowband therapy uses a more narrowly confined section, usually around 311 nm. For psoriasis it is one of the established treatments. Which method fits you is decided after the examination.
How often and for how long do I have to come for irradiation?: Usually on three or five days per week. How many irradiations are needed depends on the findings and on how the treatment progresses. A single session is short.
Why is the irradiation combined with topical active substances or brine baths?: The combination is meant to support the effect of the irradiation. Active substances such as dithranol and calcipotriol are applied topically to the lesions; the brine bath precedes the irradiation. Whether and which combination makes sense for you is something we discuss with you; the brine baths (balneophototherapy) are carried out in our bathing department.
Does UVB therapy increase the risk of skin cancer?: UV therapies can increase the risk of skin cancer in the long term. The dose is therefore controlled and limited by the doctor, in men the genitals are covered in the cabin, and once the course is complete we recommend regular dermatological check-ups. With an increased risk of skin cancer or a very fair skin type, we assess suitability beforehand.
Is UVB therapy also an option for vitiligo?: Circumscribed vitiligo areas are treated with the excimer laser, whose light (308 nm) also lies in the UVB range and hits only the depigmented spots. You will find more about this on the vitiligo page.
What do I need to be mindful of before and during the treatment?: Wear the UV-protective goggles in the cabin and do not apply sun-protection products or perfumed cosmetics before the irradiation. Let us know before you start taking any new medication, and avoid additional sunbathing and tanning beds during the course of treatment.