The MedDerm Phototherapy Center is the only one of its kind in Southern California. Various light therapies are available at MedDerm to treat a wide variety of medical disorders of the skin.

Narrowband UVB (NB-UVB) therapy is 311nm wavelength light that suppresses abnormal lymphocyte function in the skin. NB-UVB is thought to be superior to Broad Band UVB light exposure because narrowband light eliminates the most dangerous shortwave UVB rays. Those short rays are most highly associated with the induction of skin cancer.

Ultraviolet A-1 spectrum (UVA-1) is 340-440nm wavelength light (peak output is 370-390nm). UVA-1 is long-wave radiation that suppresses the function of the peripheral (skin) T and B lymphocytes. These are important immune cells, however, in many skin diseases they lead to dysfunctional immune reactions. Like the shortened UVB exposure of NB-UVB, UVA-1 also provides an effective therapeutic spectrum without the dangers of short wave exposure.

The following skin disorders can be treated with ultraviolet phototherapy. Approximate treatment times and number of sessions required are listed. Treatments are usually given 2 to 3 times per week. These vary depending on the degree of skin involvement and with the skin disease.

Psoralen and Ultraviolet A Phototherapy (PUVA) combines the administration of psoralen (OxsoralenTM) with UVA light exposure 2 to 3 days per week. Oxsoralen (which can be applied topically or taken orally) makes the skin more sensitive to UVA. Compared with Broad Band UVB treatment, PUVA clears psoriasis more consistently and in fewer treatments. However, it is associated with nausea, headache, fatigue, burning, and itching. Sunlight must be avoided after ingesting or applying Oxsoralen to avoid sunburn, and eye protection must be worn for 24 hours after taking Oxsoralen by mouth. Long-term treatment has been associated an elevated risk of non-melanoma skin cancers and melanoma.

Photodynamic Therapy (PDT) is effective for the treatment of actinic keratoses (precancers of the skin) and thin non-melanoma skin cancers (superficial basal cell carcinoma and superficial squamous cell carcinoma). PDT can also be used to improve acne vulgaris, sebaceous gland enlargement and large pore size. PDT is a two-step procedure that is done on an outpatient basis.

First, a photosensitizing medication called aminolevulinic acid (ALA or Levulan) is applied to the affected skin. It is selectively absorbed by precancerous and cancerous skin cells, as well as sebaceous glands. It is allowed to “incubate” on the skin for 45 to 120 minutes prior to exposure to therapeutic light. The skin cells that have absorbed the ALA photosensitizer are then “activated” by a blue or red light (or by both types of light depending on the patient’s needs) to selectively destroy the cells that absorb ALA and undergo the photochemical reaction.

PDT is relatively pain free. The major side effect is temporary inflammation of the skin that appears as red, tight skin initially and then red, peeling skin which can take up to 3 days to heal. It may take 7-10 days to heal if the treated individual is exposed to sun during the 48 hours following treatment. After PDT is performed, it is important to avoid exposure to bright light and/or direct sunlight to prevent excessive redness and swelling. Normal indoor lighting, television and computer exposure are fine. In some cases, two treatments may be needed to clear all precancerous lesions; most clear in one treatment. The results are often maintained for many years if careful sun protection is followed thereafter.