Phototherapy for eczema: Narrow-band ultraviolet B, broad-band ultraviolet A, and visible light – which is the best?
- zeemfindsout
- Feb 18
- 2 min read
Updated: Mar 11
The big idea:
In eczema, phototherapy is the use of controlled doses of medical-grade ultraviolet (UV) light to reduce inflammation, itching, and improve skin clearance. There are three types of phototherapy used in the treatment of atopic eczema – broadband UVB, narrowband UVB, and UVA.
What the study asked:
This study aimed to compare the three different forms of phototherapy, specifically narrow-band UVB, UVA, and visible light therapy, as second-line, adjunctive treatments in adult patients with moderate to severe atopic eczema.
Explanation of key terms:
Ultraviolet A (UVA) phototherapy
Uses longwave UVA light in conjunction with a photosensitising medicine called psoralen, a combination known as PUVA.
PUVA treatment is administered to the whole body in a stand up cabin, or can be given to localised areas such as the hands and feet with smaller, compact machines.
Narrowband Ultraviolet B (UVB) phototherapy
With narrow-band UVB, the light tubes produce a narrow part of the UVB spectrum. Two wavelengths – between 311 and 313 nm – penetrate more effectively into the skin than the old broadband sources.
The dose of UV given at each treatment is also higher compared to the broadband dose, because many of the unwanted wavelengths that cause the skin to burn are excluded.
Adjunctive treatment
Supplementary treatment used together with the primary treatment
What the study did:
Over a period of 12 weeks, a group of 73 patients was split randomly into receiving either UVA, UVB or visible fluorescent light phototherapy treatments twice a week.
The type of UVA fluorescent lamp used was typical of lamps available in most sunbeds in the UK, and is widely used for psolaren photochemotherapy.
What was used as the primary measurements of each treatment’s success was the change in total disease activity and the change of the extent of disease compared to each patient’s starting condition.
What the study found:
More patients in the narrow-band UVB group than in the visible light and UVA groups had lower disease activity (36% [7 to 65] and 36% [8 to 64], respectively).
More patients in the narrow-band UVB group showed a moderate or greater improvement 12 weeks after the end of the treatment than those in the visible light group (32% [1 to 63]) and in the UVA group (35% [5 to 65]).
What this means for eczema:
Narrow-band UVB is an effective adjunctive treatment for moderate to severe atopic eczema, and the treatment is well tolerated by most patients, although the long-term safety of narrow-band UVB phototherapy in patients with eczema will need to be monitored.
Especially for those whose eczema may not respond well to regular treatments, or creams and moisturisers alone, phototherapy could present a promising sidealong treatment option that they could consider!
Links and references:
Study:
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