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Posts Tagged ‘vitiligo’

Tanning Systems, Phototherapy and You

Thursday, November 19th, 2009

 

It is all too common for dermatologists to suggest that patients with psoriasis or vitiligo go to tanning salons to see if it helps improve their condition. While this used to be a marginally viable treatment option, very few people see any results today. Unfortunately, their doctors often use the lack of a positive skin response as confirmation that phototherapy is simply ineffective for those patients… which generally leads to the next step; TNF Inhibitors (AKA: "Biologicals" & "Systemics" like Enbrel, Raptiva or Humira). While these truly can be miracle drugs for those with no better option, and whose condition is severe enough to justify the risk for serious adverse side effects, a large percentage who are taking now them would likely see positive results if they were able to use a real phototherapy system.

The reason for this misconception about tanning systems and any therapeutic benefits for treating skin conditions is simple; it used to be somewhat accurate. When tanning salons first became popular, the quality of the lamps used were relatively poor in that they emitted a lot of UVB light with the UVA that’s needed to tan. For this reason, it was not uncommon for users to get burned with tanning systems that had the older lamps. This undesirable side effect for tanning customers was precisely what was beneficial for medical patients. 

Today’s higher quality lamps have reduced the amount of UVB produced by tanning systems to virtually nothing – an amount that is almost always far below what’s needed for the desired therapeutic response. The quality of medical UVB lamps has also improved greatly. Today’s Narrowband UVB lamps, in particular, are incredibly precise; they only emit light in the color range that has proved to be the most effective within a few nanometers.

This means the old-school advice for patients to seek medical benefits from commercial tanning systems is flawed. Most dermatologists are probably not aware of this, because most are against tanning at all – whether through commercial tanning systems or simply spending time outside in the Sun.

True phototherapy, like that obtained with medical UVB lighting systems from UVBioTek, is simply too effective for too many people to be so casually written off as "ineffective" before it has even been tried. Patients need to be clear with their doctors about this if they wish to avoid the risks and costs associated with even proper use of TNF Inhibitors. Again, such medications are absolutely critical for many people, but a large number of them could be seeing results from phototherapy that are as good, if not better, than the improvements those drugs have provided.

So, if you have a condition that’s UVB phototherapy-treatable, the only effect you should expect to get from a tanning system is your skin getting darker. If you want your skin to get better, make sure you and your doctor both understand the difference. Remember that your doctor’s interest is always in helping you to get better, they may simply be unaware that it is no longer effective.

While UVB phototherapy will not be the best solution for everybody, it has to be a better solution for a vast number of patients. Make sure both you and your doctor know this before concluding that phototherapy is not effective for your condition… because it usually is.

Narrowband Excimer Lasers versus UVBioTek nbUVB

Thursday, September 10th, 2009

A relatively new treatment being adopted by many doctors is the 308nm excimer laser; there are several makers, but they all emit the same kind of coherent light. These treatments are seeing a lot of success with vitiligo patients in particular. As with all other medically accepted therapies for such conditions, this is yet another treatment option. It is not a cure, nor is it necessarily the best treatment option for your condition; just another option that will work for some and do little for others. 

The 308nm excimer laser is essentially the same sort of device as the lasers used for treating varicose veins, for removing tattoos and hair removal except these emit a much higher frequency light. Treatments must be administered by trained therapists with a handheld ‘gun’. Eye protection and sheilding is a must for both the patient and the operator for the duration of all treatments.

With UVBioTek nbUVB treatments, a therapist usually operates the system for the patient, but there is none of the "hands-on" treatment required when using the excimer laser. The patient simply disrobes and stands within the light for a few minutes every few days. Eye protection is usually only required of the patient.

The treatment process is roughly the same as with hair & tattoo removal. The laser blasts an area of skin about the size of a quarter, depositing a large amount of energy (millijoules) into the skin. Affected areas are treated one quarter-sized spot at a time, usually overlapping them to make sure the entire area is treated.

The laser emission (blast, zap, flash, take your pick) can definitely be felt; it is described as anywhere from barely perceptible (usually by laser manufacturers) to having a rubber band snapped against the skin (often by therapists) to something akin to getting a tattoo (by many patients). Some laser systems even puff some coolant onto the skin just before the light hits to numb the sensation. Since pain can only be measured by the individual, you have to assume that it’s going to feel somewhere in between the extremes, but you also have to assume that you will be feeling it.

UVBioTek narrowband UVB systems are completely pain-free as long as they are used properly; in this case, "properly" really just means "without burning the skin". UVBioTek treatments feel just like standing close to bright flourescent lights for a few minutes every other day (ideally). It is not hot; most people don’t even work up a sweat. The whole body is treated at once.

A round of treatments usually consist of 10 laser sessions covering the entire affected areas, after which patients are told to expect to remain clear anywhere from 4 to 10 months. How long someone remains "clear" is also a relative concept; it really means how long most patients are willing to put up with the progession of their condition before deciding it’s time to pay for and put up with more laser treatments. On average, most people seem to end up needing a round of treatments about once a year… each and every year.

The amount of time required for a patient to get clear in a UVBioTek phototherapy system depends on the severity of their condition, the frequency of the treatments, and the patient’s opinion of what "clear" is. Most patients get 2-3 sessions per week, and it usually takes a few months to start clearing. Once clear, patients usually need two to four sessions per month to maintain it.

While it generally takes less time to get clear using a laser than with a full-body nbUVB system, treatments will be required in perpetuity. Laser treatments are generally more costly than traditional nbUVB sessions. This is primarily because of the amount of time a technician is needed per patient, but also because the equipment itself is much more expensive. For these reasons, there are no home excimer lasers.

Since conditions like psoriasis and vitiligo are chronic and treatments will be needed for the life of the patient, the most cost-effective way to get clear and stay that way is by using a home nbUVB system. Instead of paying for laser treatments each and every year, a UVBioTek home system is a one-time purchase that generally provides effective treatments for the life of the patient.

Most will agree that it’s a lot easier to use their home system for a few minutes every other morning just before hopping in the shower than it is to get up, get dressed, get to the doctor’s office, wait to be called, get undressed, wait for the technician to get started, wait for them to get finished, get dressed again, pay for the privilege, and then drive on your way. When you consider the cost of all the copayments, the time spent, the cost of transportation, and the hassle of it all, the cost and convenience of a home UVBioTek system is worth its weight in gold.

Fortunately, they aren’t nearly that expensive.

Be aware that it is okay to be persistent with your doctor. Many are simply unaware of phototherapy. Others are downright opposed to it out of misconceptions and misunderstandings. Narrowband phototherapy is non-invasive, doesn’t require additional medications, has virtually no side-effects, is effective for roughly 80% of all patients with nbUVB-treatable conditions, and has an impressive safety record; after almost a century of medically therapeutic phototherapy usage, no link has ever been established between proper use and an increase in the risk for skin cancer. 

Whichever therapy you and your doctor decide is best for you, the sooner you can start, the sooner you will get clear. A home UVBioTek system of your own will cost less than just a few rounds of laser treatments, and probably a lot less than you think. Give us a call at 800-UVBIOTEK (800-882-4683) and find out how we can help you deal with your life-long condition… for life.

The true cost of ‘Biological’ medications…

Thursday, September 3rd, 2009

 

The use of ‘biological’ medications such as Enbrel, Humira, Raptiva and others have been used to treat psoriasis at a phenomenal rate . In 2008, the entire psoriasis market represented ~$2.5 billion. 55%, or $1.4 billion was spent on biological meds alone.

Aside from the known risks these medications present for cancer and other serious side effects, a large percentage of those patients would likely see better results with phototherapy and without increasing the hazards associated with biological medications. Many patients find that they can get and stay clear with phototherapy alone, without using the expensive and potentially risky biological medications. Sadly, too many dermatologists are prescribing biologicals without ever seeing if phototherapy would be effective first.

The cost of a home narrowband (nbUVB) system is often less than a single month’s worth of biological meds, yet it will provide a time-tested, virtually side-effect free therapy for decades with no additional costs to the patient OR the insurers. Instead, more than half of all the money spent in treating psoriasis is going to the pharmaceutical companies on a regular, routine schedule. This ensures a steady revenue stream, but at the expense of the patient’s best interests.

If just half of the patients who used biological meds in 2008 had instead purchased home nbUVB systems, it could have reduced the overall amount of money spent on psoriasis by a billion dollars annually… while providing more patients with more satisfying, trouble-free results.

(reference: http://www.researchandmarkets.com/research/b8d445/commercial_insight)

 

Vitiligo & nbUVB for East Indian patients

Friday, August 7th, 2009

Phototherapy dosage is based on the skin’s response. The darker the skin, the longer the dosage required. Many people have expressed concern that nbUVB would be less effective for them, because they have particularly dark skin. A study that was released on 08/07/2009 by the Indian Journal of Dermatology, Venereology and Leprology (IJDVL) offers proof to the contrary.

Out of the 150 patients who were treated twice weekly for a year (every other day is considered the optimal regimen), 99 patients saw repigmentation of 25% or more. The remaining 51 patients did see repigmentation, but less than 25% of their affected areas. As with all other studies conducted to this date, nbUVB was found to be both safe and effective with good to excellent results, and virtually no negative side effects.

The article can be read here: Evaluation of narrow-band UVB phototherapy in 150 patients with vitiligo

Had the subjects been treated at the more medically therapeutic rate of once every two days, the results would likely have been even more positive. It is worth noting that vitiligo is a particularly stigmatizing condition amongst the Indian population. Even worse, there is a higher than average incidence of vitiligo throughout the country. It is often called "white leprosy" and those who have it are treated like ‘lepers’; often prevented from marrying.

Kumar YH, Rao GR, Gopal K, Shanti G, Rao KV. Evaluation of narrow-band UVB phototherapy in 150 patients with vitiligo. Indian J Dermatol Venereol Leprol [serial online] 2009 [cited 2009 Aug 7];75:162-6. Available from: http://www.ijdvl.com/text.asp?2009/75/2/162/48662

What is phototherapy? What is ‘Narrowband’? What’s it used for?

Tuesday, August 4th, 2009

Phototherapy refers to medically therapeutic exposure to light, or using light to treat medical problem. Ultraviolet (UV) light is most frequently used, and it is broken down into three band-ranges. the A range (the "colors" that generate suntans; ~320-400 nm), the B range (the "colors" that can cause sunburns; ~290-320 nm), and the C range (the "colors" that are lethal to most living things; ~100-250 nm); these bands are also known as UVA, UVB and UVC.

While UVC lights are used in a variety of air & water purification and sterilization systems, there are currently no therapeutic uses for UVC light; it is simply too intense.

UVA lamps are most commonly used in tanning systems, but they are also used medicinally for what’s called "PUVA" therapy. For decades, PUVA was the only effective treatment for many people.

Too much UVB light and you’ll quickly get a sunburn, but when carefully administered it can be the solution for millions of people suffering with psoriasis, along with a long list of other conditions.

Within the UVB range, there is a very specific frequency range that appears to be what most skin problems are thirsty for; this is called "Narrowband UVB" (nbUVB; 311-313 nm) and it is effective for roughly 80% of all applicable patients. Its only side effects are sunburns (if you over-do it) and cataracts (if you don’t shield your eyes). While a history of moderate to severe sunburns has been linked to an increased risk for certain skin cancers, the proper use of UVB light has never been shown to increase the risk for skin cancer; and that’s with almost a century of medical use.

Phototherapy, specifically nbUVB, is most often used to treat conditions like psoriasis, vitiligo and eczema. Less common problems that respond well to nbUVB are certain types of dermatitis, prurigo, porphyria, pruritis, a form of cancer usually called CTCL (Cutaneous T-Cell Lymphoma). And phototherapy is safe enough to be used with pregnant women and children.

The basic goal behind nbUVB therapy is determining how much light exposure causes your skin to burn by slowly increasing your exposure amounts untill your skin begins to burn. You take treatments that are just below that amount every other day (at most) until you are clear again following the basic protocol developed by the National Psoriasis Foundation. 

*UVBioTek™ Phototherapy Equipment is safe when used properly.

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