What is phototherapy
Phototherapy is a technique that involves the regular use of light radiations, emitted by artificial devices to treat certain medical conditions. The treatment is based on the biological effects produced by exposure to light. Phototherapy is an effective and safe solution as an adjuvant in the treatment of dermatological disorders, alterations in the biological rhythm of sleep-wake and some psychiatric illnesses.
Preparation
Before starting phototherapy it is necessary to undergo a medical examination to ascertain that this treatment is appropriate for your case, and to learn the precautions to be taken. In addition, the doctor can advise and prescribe specific "light boxes".
Before proceeding with the purchase of the phototherapy device, it is necessary to know the "light box" models available and the relative functions, in order to choose the most suitable for your needs. In selecting the device there are three fundamental factors to consider:
- Clinical efficacy
- Eye safety
- Visual comfort
To consider: if you decide to undergo self-treatment with phototherapy, it would still be advisable to be followed by your doctor, who can provide advice on how to get the maximum benefit from the cycle of sessions and inform on how to minimize the occurrence of any side effects.
During phototherapy treatment it is necessary to avoid:
- drugs that increase photosensitivity;
- excessive sun exposure and the use of tanning beds;
- perfumed products;
- moisturizing creams, ointments and lotions (unless expressly indicated by the doctor).
Fundamental elements for an effective treatment
Phototherapy is more effective when the correct combination of light intensity, duration and exposure times is obtained.- Duration: at the beginning of the therapy, the doctor can advise you to undergo sessions with short exposure intervals (for example: 15 minutes); with the continuation of the therapy, the patient can gradually prolong the exposures. Phototherapy generally involves daily sessions that vary from 30 minutes to two hours and depend on the intensity of the light undergoing.
- Time / exposure times: for most patients, phototherapy is more effective if it occurs in the early hours of the morning and is contraindicated during the late evening or night, as it can cause sleep disorders.
- Light intensity: it is determined in lux (unit of measurement of the International Lighting system), which provide an indication of the amount of light received by the subject at a certain distance from the light source. The phototherapy devices generally produce between 2, 500 and 10, 000 lux. The intensity of the light varies depending on the duration of the exposure and on the distance to which it stands compared to the "light box". The 10, 000 lux phototherapy devices require approximately 30-minute sessions, while the 2, 500 lux ones can take two hours.
Note. Phototherapy requires time and perseverance. The patient may be tempted to skip a session or suspend the treatment plan. To avoid the feeling of boredom you can set the device on a table or desk, at home or in the office, so that you can carry out activities (such as reading, using the computer, writing, watching television, talking on the phone or eating ) simultaneously with the phototherapy session.
Side effects
Phototherapy is generally a safe treatment, however mild and transient side effects may occur, including:
- headache
- nausea
- rashes
- eye strain
- irritability, states of agitation
- hyperactivity, euphoria
- dry mouth
- sleep disorders
The side effects of phototherapy generally arise in the initial phase of the treatment cycle and can be resolved within a few days without the need for intervention. These adverse reactions can be managed by reducing the times of the sessions, adjusting the distance of the device, taking breaks during extended sessions or changing the daily exposure time to the "light box".
In the event that the side effects were worse or not resolved, it is necessary to contact your doctor for advice and additional information.
Phototherapy could potentially induce, with low incidence, even more serious side effects, such as premature aging of the skin or, in extreme cases, skin cancer. It is necessary to specify that these consequences are reached following the combination of various factors ranging from photosensitivity to genetic susceptibility.
Warning!
P-UVA therapy, which involves the association of UV-A radiation and Psoralen tablets:
- it can cause phenomena of nausea, consequent to taking the drug;
- it cannot be used if the patient is suffering from severe liver or kidney disease;
- is contraindicated during pregnancy.
Some conditions require particular caution:
- pathologies that make the skin particularly photosensitive, such as systemic lupus erythematosus (SLE);
- taking medications that increase sensitivity to sunlight, such as some antibiotics, anti-inflammatories and dietary supplements containing St. John's wort;
- particular eye diseases that make the eyes vulnerable to light damage;
- skin cancer;
- some cases of bipolar disorder and severe depressive states need to take precautions attentive to the possible development of negative and manic states of mind.
Note. Tanning beds are not an alternative to phototherapy: there is no evidence that light radiations released by these tanning devices produce a therapeutic effect comparable to that of phototherapy.
Results
Phototherapy has proven to be a valid adjuvant treatment for conventional medical treatments: it helps to alleviate symptoms, increases energy levels and improves mood.
The effects of the treatment can be found within a short time: the results are generally obtained in a few days, but the therapeutic plan may include the use of phototherapy even for two or more weeks. Therapy success may vary subjectively (in some patients it may be more or less effective).
In order to obtain the maximum therapeutic effect, it is useful to follow some indications:
- Respect the daily treatment plan: it is essential to demonstrate consistency in daily phototherapy, as indicated by the doctor, in order to obtain and maintain the effects of the treatment. Therefore, it is advisable not to skip a daily session or not to suspend therapy, unless otherwise indicated.
- Select the most suitable device for your needs: before buying the "light box" for phototherapy it is useful to do some research and contact your doctor to get advice. The purpose is to identify the features and functions of the device, as well as check whether important elements such as safety, convenience of use and the right degree of brightness are respected.
- Use other treatments: if there is no significant improvement in the effect of phototherapy, it may be necessary to implement an alternative treatment plan that can help to achieve results and which includes, for example, psychotherapy sessions or medication antidepressants.
Final considerations
Phototherapy has been shown to be particularly effective for some dermatological diseases, in addition to particular conditions that share pathogenetic mechanisms that subvert natural chronobiological rhythms.
The fields for future clinical applications are numerous, but need further investigation. Of particular interest will be to confirm the efficacy and safety of phototherapy applied to anxiety disorders, problems of dietary behavior and possible uses in involutive pathologies (example: Parkinson's disease).
