Narrowband UVB (NB-UVB) phototherapy is considered a cornerstone for the treatment of vitiligo. For many people, the option to do this treatment at home offers both comfort and flexibility. But is home phototherapy as effective as in-office treatment? What should people know before investing in a device?

MyVitiligoTeam spoke with dermatologist Dr. John Harris, founding director of the Vitiligo Clinic and Research Center and professor and chair in the department of dermatology at UMass Chan Medical School. He shared insights on the pros and cons of home light therapy treatment, including how to make it work for your needs and what to watch out for when choosing a device.

A Trusted Option for Treating Vitiligo at Home

Dr. Harris has had extensive experience helping people use at-home light therapy to manage their vitiligo. “I have hundreds of patients that I’ve prescribed home phototherapy for treatment, and it works great,” he said.

UVB phototherapy involves exposing affected areas of skin to narrowband ultraviolet B light several times a week. This form of UV light calms the immune system’s attack on melanocytes (pigment-producing cells) and encourages repigmentation — helping restore color to depigmented patches over time.

“I have hundreds of patients that I’ve prescribed home phototherapy for treatment, and it works great.”

— Dr. John Harris

Although in-office phototherapy machines are stronger, Dr. Harris explained that treatment success depends just as much on how consistently it’s used. “At home, people are much more willing and able to keep up with the treatments,” he said — a benefit that outweighs the lower strength of the machine. “People do great.”

Key Benefits: Flexibility and Long-Term Use

Home phototherapy can be especially useful for:

• People with busy schedules
• Those who live far from a dermatologist’s office
• Those managing long-term skin conditions like vitiligo

Instead of traveling multiple times per week for treatment, people can use a home unit on their own time — a significant benefit for families, caregivers, and people with mobility challenges.

Dr. Harris pointed out another advantage: “It’s a one-time purchase, because then you can use it for the rest of your life,” he said. He added, “After extensive use, the bulbs may need to be exchanged for new ones, but that’s a much lower cost than the purchase itself.”

Because vitiligo is a chronic condition, many people benefit from repeated rounds of phototherapy throughout their lives. Owning a unit can make long-term maintenance easier and more cost-effective over time — especially for those whose vitiligo remains active.

The Cost Hurdle: Insurance Coverage Is Rare

While home phototherapy offers convenience, it comes with a major drawback: Insurance companies often won’t cover it.

“The challenge is getting it covered,” Dr. Harris said. “So a lot of insurance won’t cover a home unit — but will cover getting it at a dermatologist’s office.”

That means many people who want to pursue home treatment must often pay for the device out of pocket. “If someone’s going to get it at home, a lot of times they have to put up the money up front, and it can be expensive,” Dr. Harris said.

”A lot of insurance won’t cover a home unit — but will cover getting it at a dermatologist’s office.”

— Dr. John Harris

The most commonly recommended home unit — a full-length, 7-foot panel — typically costs between $5,000 and $6,000. This setup includes multiple bulbs and allows people to treat large areas of skin at once.

Tips for Choosing a Home Phototherapy Device

There are many aspects to consider when choosing a home phototherapy device. Dr. Harris recommended keeping the following in mind.

Size and Strength

Not all home phototherapy devices are created equal. Dr. Harris emphasized the importance of selecting the right type of device based on your treatment needs and skin area involved.

“There are less expensive things that you can buy, including a little handheld unit,” he said. “Those are so weak, though, that they take a very long time to get a full dose.”

Body Surface Area

He added that people often underestimate how difficult it can be to treat multiple areas of the body with a small device. “Usually what I recommend is if you’re going to make the investment, get the full, larger panel, because you don’t know how much you’re going to end up treating over the long term,” he said. “It’s easier to treat the front and back than to take a handheld or a small panel and try to move around a lot.”

“If you’re going to make the investment, get the full, larger panel.”

— Dr. John Harris

He said that in his experience, full-size units allow for more consistent treatment and better long-term results — especially when treating widespread or evolving vitiligo. While smaller devices may seem appealing due to lower cost, Dr. Harris emphasized that the convenience of full-size panels makes them a better choice for many people.

Manufacturer

In the past, Dr. Harris has often recommended two leading manufacturers for home phototherapy: National Biological and Daavlin. These companies recently merged under the brand Phothera, so available devices may have updated names or designs — but the quality remains. Each brand offers a range of options.

Safety and Setup: Ongoing Dermatologist Support

Phototherapy — whether at home or in-office — should always be guided by a dermatologist. With home-based devices, units can be programmed with safe dosage settings, with adjustments made over time based on treatment response and side effects.

As Dr. Harris explained, “As long as you keep seeing the dermatologist, the treatments can be loaded into it, and you can continue to use it.”

In addition to dermatologist oversight, proper training is crucial. Most device manufacturers offer instructions or guides, and some dermatology clinics provide step-by-step coaching to help you use the unit safely. Protective eyewear, accurate timing, and regular skin checks are all essential.

Downsides To Consider

While home phototherapy offers many advantages, there are limitations to keep in mind:

• Cost — Devices range from several hundred to several thousand dollars, with limited insurance coverage.
• Initial learning curve — Using the device correctly takes training and follow-up.
• Lower strength — Home units may be less powerful than office equipment, meaning longer sessions or slower results.
• Space needs — Larger units require room in your home for setup and use.

And, as with any UV-based treatment, side effects can include dry skin, discoloration, or sunburnlike irritation. Monitoring and adjusting dosages can help reduce risks.

‘A Fantastic Option’

Despite the challenges, Dr. Harris believes home phototherapy offers real hope for people living with vitiligo. It empowers people to take control of their treatment and provides a sustainable option for long-term skin care.

“I think at-home phototherapy is a fantastic option,” he said. “People do really well.”

For those unable to access regular in-office phototherapy, or for anyone looking to build a more flexible routine, home phototherapy may prove an effective treatment option to help with the management of vitiligo.

Read more about how to navigate old and newer therapies for vitiligo.

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