UVA-1 technology is a promising technology for treating acute atopic dermatitis, scleroderma and morphea. It has also been shown to help systemic signs of SLE. We are happy to provide Chicago with the first UVA-1 device.
What is ultraviolet A1 (UVA1)?
This is a relatively new for of ultraviolet ray treatment. There are different types of ultraviolet A1 treatment units, designed to give different does, and to treat either whole body or localised areas. Ultraviolet A (UVA) rays are the longer rays in the ultraviolet spectrum (that is included in sunlight), and UVA1 rays are the very long rays. UVA1 is used less often than the other ultraviolet therapies, ultraviolet B and PUVA (psoralen + broad band ultraviolet A), but appears particularly promising for some conditions that we do not have other good treatments for.
What conditions are treated with UVA1?
UVA1 was first used in Germany over 20 years ago, and most of the studies initially reported its use for atopic dermatitis (eczema). Although for most people with eczema there are other better treatments we recommend it occasionally when other approaches are not enough. UVA1 has not been studied carefully for most conditions it is used for, and should be regarded as still an experimental treatment for many conditions, but seems to help in:
- Conditions where there is a scarring type process in the skin, including morphoea/scleroderma, lichen sclerosis, and overgrowths of scar tissue (particularly keloid scars)
- Conditions where there are collections of cells in the deeper layer of the skin (the dermis) that should not be there, including mastocytosis (a not cancerous build-up of mast cells in the skin) and mycosis fungoides (a T lymhocte, type of white cell, accumulation).
- Possibly, some forms of eczema where the inflammation is particularly deep (and not so easy to reach with other sorts of ultraviolet therapy), such as hand and foot pompholyx (a blistering eczema).
Why have I been referred for UVA1?
The dermatologists looking after you think it will help. You will be told if there is good study evidence that it works in your condition, or whether we are suggesting using UVA1 because we think it ought to work. If there is not much published evidence that it works in your condition you will be told this, and why we are recommending it. If you are to take part in any experimental study of UVA1 you will be told about this in detail, and will be given a separate study information sheet and will be clearly asked whether you want to take part or not (and have a study consent for to sin before you start).
Where do I have UVA1?
Dr. Memar is currently the only physician in Chicago who administers UVA1 treatment.
What happens when I get there?
First a member of nursing staff will go through the nursing documents that must be completed before you start treatment. They will show you around the unit and will explain all the procedures. Before you begin treatment you will receive a test dose, called and MED (Minimal Erythema Dose). A number of doses of UVA1 will be shone on your back (which usually takes 30 to 60 minutes), and the result will be read the next day before your first full treatment. This MED helps us to decide what dose of UVA1 it is safe to start with.
Some medications might make you more sensitive to UVA1, so please bring a list of your medications (prescribed and over-the-counter, including any herbal therapies) for this first visit.
How long will I have UVA1 treatment?
This varies from person to person, and depends on various factors, particularly the specific condition we are giving you treatment for. Usually, we will advise an initial 15 treatments and after a review then to assess how you are doing a longer course (often 30 treatments in total) may be recommended. For most conditions treated with UVA1 the ideal treatment frequency has not yet been worked out, and we usually treat between 2 and 5-times weekly.
What about my creams/ointments?
Please continue to use regular moisturisers during your treatment, but check that they are suitable (some creams contain fragrances that might react with UVA1, and others contain sunblocks) with the nursing staff at your first visit. Also, check whether or not you should still be using any other creams or ointments.
Things to avoid
On the days of treatment try to keep any sunlight exposure as small as possible in case this, when added to your treatment dose, causes a sunburn type reaction. Avoid fragrances and sunblocks before treatment, unless you have specifically been told otherwise.
The most common side effects are 1) sunburn-like reactions, with a redness of exposed skin, and 2) polymorphic light eruption, a usually itchy spotty reaction that appears a few hours to a day after treatment which (when caused by natural sunlight) is often confused with prickly heat. For both these effects use plenty of moisturiser, but contact us if you have a painful reactions, are very uncomfortable or you are worried.
UVA1 is a relatively new treatment so we don not know if there are any long-term side effects that might appear many years after treatment. It is however likely that if you have enough UVA1 treatment this could, just like natural sunlight, increase your risk of skin cancers. All treatments carry a risk of side effects (any treatment that never causes side effects is unlikely to work) and you, and the doctors advising you, have to weigh up the risks and expected benefits. The long-term risks of one, or few, courses of UVA1 are probably minimal, but if you need multiple courses the risk is likely to be greater and we will discuss this with you.