UVA1 Phototherapy
What is UVA1?
The term phototherapy or light therapy applies to exposure of the skin to specific wavelengths of light or electromagnetic radiation. There are three ranges of radiation that are applied in phototherapy: infrared (800-3000 nm), visible light (400-800 nm), and ultraviolet radiation (100-400 nm). Treatment of skin disorders most often involves ultraviolet radiation (UVR). UVA1 is the name given to the waveband of electromagnetic radiation ranging from 340-400nm. UVA1 phototherapy filters out lower wavelengths. It is effective in clearing or controlling a variety of skin diseases.
At Central Dermatology Clinic we are one off very few Dermatology practices in Australia offering this specialised form of phototherapy.
How does UVA1 help skin diseases?
UVA1 is proven to be effective in treating skin disease by suppressing components of cell-mediated immune function.
UVA1 penetrates deep into the reticular layer of the dermis, acting on fibroblasts, dendritic cells and inflammatory cells, particularly T-cell lymphocytes, as well as mast cells and granulocytes.
UVA1 radiation induces apoptosis (cell death) in the presence of active oxygen molecules, such as singlet oxygen, hydrogen peroxide, or superoxide radicals. It activates programmed (induced) and non-programmed (natural) cell death.
The success of UVA1 in atopic dermatitis was found to result from UVA radiation-induced apoptosis in skin-infiltrating T-helper cells, leading to the loss of T cells from eczematous skin. The effect of UVA1 in inducing T lymphocyte apoptosis may also help treat cutaneous lymphoma (CTCL).
UVA1 also activates fibroblasts to produce matrix metalloproteinases, which break down excess collagen in the extracellular matrix. This is why it is useful in sclerosing (scar-like) skin conditions.
What are the indications for UVA1?
- Atopic dermatitis
- Scleroderma (various forms) and Scleredema (adultorum Buschke)
- Cutaneous T-cell lymphoma
- Urticaria pigmentosa
- Lupus erythematosus
- Extragenital lichen sclerosus
- Granuloma annulare.
Continued improvement may occur for up to several months after a treatment course.
What are the adverse effects of UVA1?
Adverse effects with UVA1 phototherapy have been classified as acute (short-term) or chronic (long-term).
- Pigmentation/tanning
- Redness
- Dryness
- Itch
- Herpes simplex (cold sore) virus reactivation
- Polymorphous light eruption.
- Photoageing
- There is no scientific evidence to date that UVA1 phototherapy contributes to skin cancer risk.
Conclusion
UVA1 is a form of phototherapy that appears particularly useful for treating atopic dermatitis and sclerotic skin diseases (scleroderma).
Overall, the side-effects are well tolerated and treatment is easily accessible at Central Dermatology Clinic. Treatment is fully subsidised by Medicare and should be attended three times weekly for usually a treatment course of 6 weeks.
