PUVA therapy is a very effective treatment used for numerous skin
conditions including ezcema and psoriasis. It involves taking an
unlicenced medication called Psoralen (P) either by mouth as a
tablet, applied to the skin as a lotion, or by soaking in the solution in
water. The skin is then exposed to special wavelengths of light called
UVA (PUVA). The Psoralen makes the skin more sensitive to the
light rays.
PUVA therapy must be carried out in hospital under medical
supervision; it will be necessary for you to attend twice weekly
during the course of treatment. The length of the course of treatment
will vary from one patient to another but an average for the treatment
would be between six to ten weeks.
Light exposure takes place in a specially designed cubicle containing
fluorescent tubes around the walls of the cabinet, unless you need
treatment only of areas such as the hands and feet from a small
portable unit.
PUVA with Tablets
Psoralen TABLETS make both the skin and eyes sensitive to
light for some hours. It is therefore most important that you wear
the protective goggles and visor, which are provided, during each
treatment. Protective UV 400 sunglasses MUST be worn for 12
hours after you take your tablets when outdoors, or indoors if near
fluorescent lamps.
Throughout the course of treatment you must not sunbathe or use
a sunbed at any time. On the days of treatment you should avoid
unnecessary exposure of the skin to direct sunlight (even through
window glass).
Topical PUVA
This is used to treat small areas of skin, for example, the hands and
feet. A lotion is applied to the affected areas or you may be asked to
soak in bowls of water with the solution added for 20 minutes before
UVA treatment. Protective glasses are not required to be worn if you
are receiving topical PUVA. Towels will be provided.
Bath PUVA
The doctor may decide to give you Bath PUVA. This involves
soaking in a bath for 20 minutes in a water solution of Psoralen prior
to UVA light. Towels and gowns will be provided on each attendance.
General Information
You should inform the supervising doctor about any other medication
being taken for other reasons.
You should avoid putting cosmetics, perfumed substances or
aftershave lotion on your skin before UVA treatment, as these may
make your skin more sensitive to the ultraviolet light.
You should avoid planning pregnancy during your PUVA treatment.
While no problems have been reported, it is a good rule to avoid
PUVA when you are pregnant. However, if pregnancy does occur,
you should tell the supervising Doctor.
Occasional side-effects are possible and these include:
• A sunburn-like reaction (particularly in patients with a fair
complexion).
• Very rarely a prickling sensation of the skin, occasionally bad
enough to necessitate stopping treatment.
• Queasiness aftertaking the Psoralen tablets (which can be
improved by changing the Psoralen dose).
• Skin dryness (this can easily be helped with moisturising
creams).
• Premature ageing changes in the skin (e.g. dryness, freckling
and wrinkling) may occur in patients who have had multiple
courses of PUVA therapy for many years and such they may
have a slightly increased risk of developing skin cancer in later
life.
• Your doctor will have assessed your skin type already and
discussed this as part of your consent process. Safe lifetime
doses are monitored in the department.
• The importance of wearing protective UV spectacles for the rest
of the day after taking the tablets cannot be underestimated as
there is a risk of cataract damage to the lens in the eyes.
Practical Points
Please take the prescribed number of tablets 2 hours before
attending the Unit for treatment. These should NOT be taken on an
empty stomach, but with a small amount of food.
Protective UV 400 sunglasses must be worn for 12 hours after
you have taken your tablets if outdoors or inside near any flourescent
lighting.
Throughout the course of your treatment, you should not sunbathe
or use a sun bed at any time. It is important that clothing is not worn
whilst undergoing treatment in the light cubicle (except male patients,
who will need to wear a protective covering to the genital area).
If you should develop excessive discomfort or redness of the skin
following treatment, please contact the nursing staff.
For treatment to be effective, it is important to attend the hospital
regularly. If you are unable to attend for treatment, yourself or a
relative should telephone the nursing staff, giving an acceptable
reason for cancelling. If you fail to attend for more than three/four
treatments without telephoning, then your treatment time will be
given to another patient.
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Author Dermatology Department
Approved by Dermatology Business Meeting
Date of Publication 03/09/2024
Reference No PL/119 (v7)
Review Date 01/09/2027
