PUVA Therapy
Date issued: October 2023
Review date: October 2025
Ref: B-450/VM/Dermatology/PUVA Therapy v4
PDF: PUVA Therapy final October 2023 v4.pdf [pdf] 128KB
What is PUVA Therapy?
Ultraviolet light therapy or phototherapy involves exposing the skin to ultraviolet light on a regular basis and under nursing supervision.
You will be receiving a form of Ultraviolet A (UVA).
Present in natural sunlight, UVA is an effective treatment for psoriasis, eczema, and other skin conditions.
Your dermatologist would have decided which treatment is best for you.
What does the procedure involve?
A trained phototherapy nurse will administer your UVA treatment at the hospital. The ultraviolet light is produced by fluorescent tubes in specially designed walk-in cabinets or in a portable unit.
Phototherapy treatment will involve exposing affected skin to the UVA light.
Prior to treatment with UVA, a medication called psoralen is given either topically (soak or bath) or orally (tablet). Psoralen makes the skin more light sensitive allowing the UVA wavelength to reach the dermis.
You will need to attend the phototherapy unit three times a fortnight. Depending on your condition, you will receive between 24 and 40 treatments.
We ask that you always be on time for your treatments. You must attend regularly for this treatment to be successful.
Pre-Assessment
You will be asked to attend an appointment for a pre assessment with the phototherapy nurses once you have been referred.
This appointment will involve a discussion with the nurses about your skin condition and what phototherapy will involve, organising appointments.
After this consultation treatment may start the following week.
Systemic/oral PUVA
The tablets need to be taken 2 hours before exposure to UVA with a light meal (as taken on an empty stomach may cause nausea and vomiting).
Once you have taken the oral psoralen, you must wear UV protective eyewear for 24 hours after ingestion. This is because the psoralen sensitises your eyes to UVA, and not wearing protective eye wear could cause long term damage.
The glasses will be provided by the department.
You need to inform medical/nursing staff of any medication you are taking as some medications may make you more sensitive to UVA light or be contraindicated with psoralen.
Bath PUVA for the whole body
Psoralen can be diluted in the bath. It is used as a soak to sensitise the skin prior to UVA. Patients are asked to bring a dressing gown and slippers or flip flops to wear after they have had their bath.
You soak in the bath solution for 10 minutes, and then you will have your UVA therapy.
With both systemic/bath PUVA most patients enter the box naked in order to expose all areas of affected skin. Your privacy and dignity will be always protected.
You will also be asked to wear eye protection/ goggles, and for some, a visor or face shield will be worn. For men the genitalia will be covered during treatment.
Topical psoralen
Psoralen can be applied directly onto areas of affected skin. This is known as topical PUVA. It will be applied as a 15-minute soak (usually for hands and/or feet).
Short Term Side Effects
Redness
The aim of each treatment is to give you an amount of UVA which is very close to one which will result in a “sunburn” reaction. Sometimes this type of reaction does occur despite our best efforts to avoid this side effect. This may occur 3-4 days post treatment. If you have any form of redness following your treatment, you need to inform staff immediately.
Itch
Some patients may experience localised itching from the psoralen. If this does occur, it is not normally enough to stop treatment, however on rare occasions we may need to.
Long term effects
It is known that exposure to natural UV light can lead to skin aging, photo aging (freckling, dryness, and wrinkling) and some forms of skin cancer; particularly in people who have been exposed to high levels of UV throughout life (such as outdoor workers). Patients who have received many courses of PUVA also have a slightly higher risk of developing some form of skin cancer.
Do I need to avoid/do anything whilst having Phototherapy?
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Medicines that make you more sensitive to ultraviolet light. You should inform the phototherapy staff of any medicines that you take prescribed or purchased, including herbal preparations.
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Perfumed products.
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Long hair should be tied back at each visit. Severe haircuts should be avoided during the course ofs treatment as this will uncover previously unexposed skin, which may then get a sunburn like reaction.
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Do not sunbathe during treatment and DO NOT use sun beds at all.
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Inform staff if you are or think you may be pregnant or breast feeding.
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Use suitable sun protection, including lip block especially for 24 hours after taking oral psoralen.
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Wash your hands after PUVA soaks to remove any residual psoralen. Use your emollients regularly. You can use your emollients before treatment.
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Avoid sitting next to windows when inside or in the car as UVA can penetrate through glass.
To book your assessment appointment please contact
Tel: 01752 439712 and wait to speak to a staff member.
Phototherapy Tel: 01752 439660
e-mail: plh-tr.dermatologyuv@nhs.net
Rowan House
Derriford Hospital
PL6 8BQ
