This leaflet provides information on treatment with PUVA (Psoralen tablets and Ultraviolet A light) which is used to treat a number of skin conditions. You will have received further information about your specific condition. It covers the actual treatment, the risks involved and advice on what you should and shouldn’t do before and after treatment. If you have any further questions, please ask a member of staff.
What is PUVA?
Ultraviolet radiation from artificial light sources have been used by dermatologists for over 100 years and is widely used and effective for treating a number of skin conditions. Choice of PUVA over other forms of light treatment depends on a wide range of factors including age, disease, skin type, previous therapy and current medication. Psoralen tablets are taken 2 hours prior to treatment and sensitise the skin to UV, allowing lower doses of UVA (longer ultraviolet wavelengths) to be effective in clearing your skin disease. PUVA can be more effective than UVB, but will make your whole body sensitive to ultraviolet light so more precautions need to be taken (see below).
What is the aim of treatment?
The aim of the treatment is to clear your skin, although it will not be effective in everybody. It is difficult to know how long your skin will remain clear for after treatment, but it is likely that you will require further treatment in the future. Your doctor can discuss this with you. Most patients are not routinely followed up after successful treatment, but you can ask your GP to refer you back in the future if you require more treatment.
Are there any risks?
The most common side effects of this treatment are erythema/redness/sunburn-like reactions to exposed skin. Redness can take 2-3 days to appear and can last for more than a week. Please inform the phototherapy team nurse prior to your treatment if you experience any side effects
Other potential short term side effects include:
- Dry/ itchy skin.
- Worsening of skin disease.
- Tanning – increased pigmentation to the treated area.
- Blistering.
Longer-term side effects of repeated courses of PUVA include; skin ageing, an increase in freckling and potential skin cancer to treated areas. Skin cancer risk is related to total lifetime exposure to ultraviolet light, as well as other factors such skin type.
There is an increased risk of skin cancer with increasing numbers of courses, and we therefore try to keep courses of treatment as short as possible and widely spaced. You will typically be limited to no more than 5 courses of PUVA over your life time. The skin on the palms of the hands and soles of the feet are less at risk of skin cancer, and more than 5 courses are sometimes given for this.
Dos and Don’ts
- Dry flaky skin will deflect the light, rendering UV therapy ineffective.
- Please moisturise your skin at least 3 times per day.
- You can moisturise your skin up to 2 hours before your exposure to light
- Please avoid using moisturiser and make up that contains SPF unless directed otherwise by the phototherapy team.
- Please use your prescribed steroid ointment/other topical treatment every evening as necessary.
- Avoid fragrances and sunblock before treatment unless you have been told otherwise.
- Always remember to inform the doctor or nurse if you are taking, or about to start any new medications including herbal medications (prescribed or otherwise) or cream while having UV therapy.
- Never use a sunbed and keep sunlight exposure to a minimum during your course of treatment as this may cause erythema (sunburnt).
- On bright days, protect treated areas from the sunlight, by wearing long sleeves, a hat etc. Sun block (SPF 30) can be used after treatment or on non-treatment days.
- Jewellery e.g. rings; if worn at the start of treatment should be worn at every treatment thereafter, as areas covered at the start will cause a sunburnt reaction if subsequently exposed.
- In order to maximise the benefits of UV regular and punctual attendance is essential.
Your Treatment
Please do not turn up outside of your scheduled appointment days/times without discussing first with the phototherapy nurses. The unit is open Monday to Friday between 7.30am and 4.45pm. Following your consultation with the doctor in the phototherapy clinic, your named nurse will discuss your appointment and treatment procedure with you.
On your first visit an arm test will be carried out. This is to assess your sensitivity to the ultraviolet light that we will be using to treat your skin condition. On the same day, after your arm test, you will receive your first treatment. Your sunglasses will also be tested to make sure that they block out the ultraviolet light that the sun naturally produces.
On treatment days only:
- Take your prescribed Psoralen tablets with a small amount of food two hours before your appointment.
- From the time you take the Psoralen tablets until the evening of the same day you must wear sunglasses when in natural light.
- Wear appropriate clothing- long trousers and a long sleeved top will protect your arms and legs from ultraviolet light exposure whilst travelling to and from the department and during your treatment course.
- You must wear protective sunglasses and face visor during treatment.
- Tubigrip must be worn to protect unaffected areas while on treatment (we will supply this).
- You will have treatment on a special unit which is given in J/cm2. We aim to give incremental increases throughout your treatment.
- Treatment is given either twice a week on a Monday and Thursday or Tuesday and Friday. Appointments are given on a block booking basis.
- A course of treatment will last up to 12 weeks (24 sessions).
- You must not have PUVA treatment if you are pregnant or breastfeeding.
- You should avoid getting pregnant during the treatment course.
Ideally you will develop mild skin redness/pinkness with no discomfort after each treatment. You must inform the phototherapy nurse prior to your treatment if your skin becomes sore or uncomfortable.
Please be advised that you will be discharged if you miss 3 appointments without notifying our department.
In case of any queries please contact the Phototherapy department via email on nuth.phototherapy@nhs.net or by telephone on 0191 282 0871 or 0191 282 0872 between the hours of 7.30am – 4.45pm. For urgent advice about this treatment out of hours please ring Ward 5 on 0191 282 5599.
Useful websites
If you would like further information about skin conditions and treatment options, you may wish to have a look at:
If you have any concerns during your treatment please discuss this with the Phototherapy team.
The Patient Advice and Liaison Service (PALS) can offer on-the-spot advice and information about the NHS. You can contact them on Freephone 0800 032 02 02 or e-mail northoftynepals@nhct.nhs.uk
