At Colorado Springs Dermatology Clinic, P.C., we have the specialists who are highly trained and experienced with laser & light therapy technologies such as PUVA Therapy, or photochemotherapy, to treat some of the most severe skin diseases with optimal results.
PUVA, also called photochemotherapy, is a form of ultraviolet radiation treatment used for serious skin diseases. The P stands for psoralen, a type of chemical found in certain plants, and the UVA stands for ultraviolet A, a long wave ultraviolet radiation. The oral administration of the psoralens is followed by UVA light exposure, which activates the psoralens, causing them to interact with the body’s DNA, thus inhibiting the cell multiplication of certain skin diseases.
Who is a Candidate for This Treatment?
Originally developed for treatment of psoriasis, PUVA treatment is also used on patients with other chronic skin diseases including graft versus host disease, cutaneous T cell lymphoma and vitiglio. These diseases are characterized by rapidly multiplying cells and the goal of PUVA therapy is to arrest the multiplication. Because of its serious side effects, the therapy is not generally recommended for children. Care should be taken with patients who have had melanoma or multiple skin cancers, are pregnant or nursing, or who have skin types that tend to burn easily.
What Is the Treatment Process?
PUVA combines an oral drug with ultraviolet light exposure. In the most common form of PUVA therapy, the patient is administered Oxsoralen-Ultra® (8-methoxypsoralen) by mouth. The dosage of the drug is determined by the weight of the patient. About 45 to 60 minutes later, skin is exposed to the long wave ultraviolet radiation for a length of time determined by the patient’s skin pigmentation. The darker your skin is, the longer the light exposure will be.
During treatment, you will remove clothing from the affected body areas and stand in a seven foot high light box. Lights will be turned on for a length of time between one and 10 minutes. During this time, you will wear groin protection (underwear or a towel) as well as protective goggles to shield eyes from the ultraviolet light. The male genitals are particularly susceptible to the cancer-causing effects of UV light therapy. If the affected areas are not on the face, some patients may wear a bag over their heads to prevent photo-aging of facial skin. UVA-absorbing wrap-around sunglasses must be worn for 24 hours after treatment and sunlight should be avoided for at least 24 hours afterwards.
How Many Treatments Will I Need?
PUVA must be administered in a physician’s office and requires treatment two to three times a week for 12 to 15 weeks for significant improvement. In psoriasis cases, therapy may be required indefinitely as PUVA does not cure the disease. Treatments must be administered at least 48 hours apart as the burn caused by PUVA can be delayed for up to two days. The amount of light applied is increased at each visit with adjustments made for pigmentation. If 30 treatments are administered with no significant improvement, the therapy will be discontinued. However, if significant improvement is noted, frequency of treatments may be decreased to maintain improvement.
What is the Advantage of PUVA?
PUVA is able to activate only at the site of the disease, on the skin, making it less toxic than similar therapies that require systemic administration and have effects on other parts of the body.
Are There Side Effects?
A number of side effects are associate with PUVA, including:
- headache and dizziness
- nausea
- itching and redness
- skin burn and blistering
- tanning or darkening of the skin
The oral medication should be taken with food as it may cause nausea. Ginger capsules or prescription drugs such as Reglan® may help fight the nausea.
PUVA treatment also has potentially serious side effects. It has potential to cause a variety of skin cancers, particularly squamous cell skin cancer, with risk directly related to the amount of energy administered during the procedures. It also unavoidably causes photo-aging and, if improperly monitored, can cause serious ultraviolet lights burns. PUVA patients may also develop white and brown spots to appear on the skin.
What Can I Expect After Treatment?
After treatment, skin should be checked by a physician at least once or twice a year for skin cancer or signs of other damage.