Psoralen + UVA (PUVA) phototherapy for Vitiligo

Overview
Psoralen + UVA (PUVA) phototherapy is a treatment for widespread vitiligo that helps repigment skin. It combines topical or oral psoralen, a medication that makes skin more sensitive to light, with UVA exposure from sunlight or a light booth.¹

Studies show that oral PUVA is 50 to 75 percent effective in restoring pigment to face, trunk, upper arms and upper legs. It’s not as effective on hands, feet and lips.² Topical PUVA has fewer side effects, but is less effective.³

How do I take it?
Oral psoralen medications (sold under the brand names Methoxsalen and Oxsoralen) are taken two hours prior to light therapy, which is performed twice weekly. UVA exposure generally starts at three to five minutes and is increased as treatment progresses.⁴ Groin areas, eyes, and face must be shielded during treatment.⁴

PUVA is administered under a doctor’s supervision and requires a time commitment of up to one year.²

Side effects
Side effects include phototoxicity, nausea, skin dryness, sunburn, hyperpigmentation (skin darkening), itching, and increased risk of skin cancer.⁴ PUVA therapy is not considered safe for children and pregnant women due to systemic use of the chemical psoralen.³

Research has shown that NB-UVB provides better response and fewer side effects than PUVA, and has become the preferred treatment for vitiligo. PUVA is generally used only in severe cases, such as rapidly spreading vitiligo.⁵

External Resources

References

1. Vitiligo Treatments – UMass Medical Vitiligo Research Center & Clinic. (2014, June 4). Retrieved December 2, 2019, from https://www.umassmed.edu/vitiligo/vitiligo-treatment/.


2. Vitiligo: Diagnosis and Treatment. (n.d.). Retrieved December 2, 2019, from https://www.aad.org/diseases/a-z/vitiligo-treatment
   


3. Matin R. (2011). Vitiligo in adults and children. BMJ clinical evidence, 2011, 1717.


4. Phototherapy: PUVA. (n.d.). Retrieved December 4, 2019, from https://www.aocd.org/page/PhototherapyPUVA.


5. Bae, J. M., Jung, H. M., Hong, B. Y., Lee, J. H., Choi, W. J., Lee, J. H., & Kim, G. M. (2017). Phototherapy for Vitiligo. JAMA Dermatology, 153(7), 666. doi: 10.1001/jamadermatol.2017.0002