Vitiligo is a skin disorder characterized by the appearance of white skin patches on different parts of the body. The white patches appear because of damage caused to melanocytes i.e. cells that manufacture pigment. In addition to affecting visible parts of the body, vitiligo can also affect the eyes and the tissue inside the nose and mouth.
Light therapy is one of the most commonly used treatment options for vitiligo. Other treatments include topical creams, systemic steroids, depigmentation methods, surgery, oral corticosteroids, excimer laser, and antioxidants among others.
Read on to find out about light therapy for vitiligo.
What Causes Vitiligo?
The cause of vitiligo is still unknown but doctors believe that it could be an autoimmune disorder.
In people with vitiligo, it is possible that the immune system actively destroys pigment-producing cells. Genes may also increase a person’s risk for vitiligo.
Some studies have posited that the immune system does not destroy the pigment-producing cells. Instead, the cells destroy themselves.
Light Therapy For Vitiligo
In the recent past, the combination of Ultraviolet A light and psoralen was used for treatment of vitiligo. Psoralen is a type of medication that can be taken orally or topically to treat a number of skin conditions including vitiligo.
In the PUVA method (Psoralen plus UVA), a UVA light therapy box is typically used. This treatment method is administered three times a week only under the guidance of a doctor.
PUVA for vitiligo is no longer a popular treatment alternative due to the method’s side effects, which include:
To minimize the risk of cataracts, patients usually wear sunglasses to protect the eyes against UVA during treatment for a period of 12-24 hours after applying or ingesting psoralen.
Due to the risk of side effects, PUVA is used less for treatment of vitiligo in children.
Narrow Band Ultra Violet B Light Therapy
Narrow Band Ultra Violet B Light (NB-UVB) is a recent treatment for vitiligo. It has become the most preferred treatment for vitiligo covering more than 20% of the body. NB-UVB treatment kits minimize over-exposure to ultraviolet light.
In particular, NB-UVB light boxes limit exposure to harmful UV radiation while increasing exposure to Ultraviolet B light. This minimizes the risk of side effects posed by the PUVA method while allowing patients to benefit from phototherapy treatments. This method also has fewer side effects as it does not require the use of supplemental drugs.
NB-UVB light therapy is safe to conduct at home using cabinets and light-panels. While cabinets get the job done, doctors recommend using light panels, which are more effective at treating localized vitiligo.
For best results, place the NB-UVB light panel 7 inches away from the part of the body you are treating. While this treatment can be administered at home, consult with your dermatologist about the duration of exposure, as this will largely depend on your skin tone and how long you have been treating your skin.
How NB-UVB For Vitiligo Works
While conventional light therapy lamps produce wavelengths in the range of 280-330 nm, NB-UVB light panels emit wavelengths in the range of 311-312nm.
According to clinical studies, UVB delivers optimal therapeutic effectiveness when wavelengths are delivered in the 295-313 nm range. Wavelengths lower than 300nm increase the risk of burning and skin cancer. Those in the 311-312nm range are the safest.
The 311-312 nm range of UVB light spectrum helps to encourage the production of pigment cells. Light therapy enables melanocytes to be produced faster than it takes the light to burn the skin. Light therapy benefits the immune system and can help prevent new white skin patches from forming.
NB-UVB can be done using a full-body cabinet in a doctor’s office or from home using a handheld device or a full-length light panel. Handheld devices are convenient for treating small areas affected by vitiligo.
While NB-UVB can be used with other treatments, many patients have found it to be effective on its own. Children who are old enough to stay still and keep sunglasses on can benefit from NB-UVB.
Side Effects of NB-UVB
While NB-UVB is the gold standard for treating UVB, some patients may experience side effects including:
Nonetheless, exposure to NB-UVB is safe as long as the patient keeps their eyes closed during light therapy sessions and takes a yearly eye exam.
How Long Does It Take To See Results
Clinical studies show that there are two types of vitiligo patients—those who react quickly to NB UVB treatment (about two-thirds) and those who require incremental doses of treatment to realize significant results.
Presently, there are no specific traits to differentiate patients in either group. Exposure to 200mj with increments of 50mj will deliver results for all vitiligo patients.
However, two-thirds of patients will experience slower results and greater aggregate exposure to UVB radiation. At the same time increasing the 200mj dose with 15% increments will be effective for most patients but will increase the risk of at least one bout of erythema for one-third of vitiligo patients.
The patient’s preference and doctor’s judgment will determine the dose and increments that will deliver the best results.
Patients on an aggressive treatment protocol, i.e. those whose are exposed to 15% dose increments of NB-UVB light 3 times a week will see significant repigmentation within 20 treatments. If you respond well to NB-UVB you will still likely have to continue with treatment for years.
Patients who do not experience repigmentation within 30-60 treatments are likely not suitable candidates for NB-UVB light therapy.
Factors That Affect Vitiligo Treatment Results
The extent of repigmentation you will experience following treatment with NB-UVB will depend on several factors.
First, a greater duration of treatment will deliver greater repigmentation results.
Second, combining light therapy with topical treatments can improve the rate of repigmentation.
Third, the distribution of vitiligo, the percentage of the body affected, and the duration of time you have had the condition will impact treatment results.
Overall, it takes 3 to 6 months to begin to see results but consistent treatment for 2 to 6 years will deliver significant results.
The frequency of light therapy treatment will gradually reduce as you begin to achieve maximum repigmentation. Treatment may be discontinued if new lesions do not occur.
It is common for vitiligo to return if the immune system is triggered by events such as trauma, stress or illness. If the condition reoccurs, you may need to resume treatment.
Areas that respond the best to treatment include the face, upper arms and legs, chest, back, and buttocks. The hands, wrists, and feet repigment slowly.
Vitiligo Light Therapy Equipment
Portable, handheld devices offer the greatest convenience for treating localized vitiligo from the comfort of your house. We picked out one of the best light therapy kits for vitiligo and reviewed it for you.
Summary
Light therapy for vitiligo can be an effective long-term treatment. For most patients, results can be seen within 3 to 6 months. Whether you opt for a handheld device, a panel or a full-body cabinet, correct and consistent use of treatment will deliver the fastest repigmentation results.Before starting light therapy, consult your doctor.