Are there home Narrowband Ultraviolet B (NBUVB) phototherapy options?

Home Narrowband Ultraviolet B (NBUVB) Phototherapy Options

Yes, home NBUVB phototherapy units are available and can be an effective alternative to office-based treatments for patients who cannot regularly visit a phototherapy center. 1

Home Phototherapy Availability and Efficacy

Home NBUVB phototherapy offers several advantages:

• Eliminates the need for frequent travel to a phototherapy center (typically 2-3 visits per week)
• Provides comparable clinical outcomes to office-based treatment
• Increases patient satisfaction and decreases treatment burden
• Allows for maintenance therapy after initial clearance is achieved

The PLUTO study demonstrated that patients using home NBUVB units experienced:

• Similar treatment efficacy compared to office-based therapy
• Comparable cumulative doses
• Similar incidence of short-term side effects
• Increased satisfaction and decreased treatment burden 1

Appropriate Candidates for Home Phototherapy

Home phototherapy is most appropriate for:

• Patients who have difficulty accessing office-based phototherapy
• Those who have demonstrated good compliance with medical treatments
• Patients who understand proper usage and safety protocols
• Those with conditions known to respond well to NBUVB (psoriasis, atopic dermatitis, vitiligo, mycosis fungoides) 2

Implementation and Safety Considerations

For safe and effective home phototherapy:

1. Medical supervision is essential:

   • Home phototherapy should always be conducted under physician direction
   • Regular follow-up appointments are necessary to monitor progress and adjust protocols

2. Patient education requirements:

   • Proper positioning in the unit to ensure even exposure
   • Recognition and reporting of side effects
   • Understanding of dosing schedules and increments
   • Importance of eye protection and shielding sensitive areas

3. Safety protocols:

   • Men should shield genitals with athletic supporters or socks
   • Women should protect nipples with sunscreen (SPF 50) or zinc oxide
   • Recent skin cancer sites or surgical scars should be shielded
   • Facial protection may be appropriate if no facial lesions are present 1

Potential Side Effects

Common side effects include:

• Short-term skin redness and discomfort
• Heat intolerance in the unit
• Tanning/pigmentation changes
• Skin dryness

Long-term considerations:

• Increased risk of non-melanoma skin cancers with prolonged use
• Accelerated skin aging with long-term exposure 1

Contraindications

Home phototherapy should be avoided in patients with:

• History of lupus erythematosus or xeroderma pigmentosum
• Skin types I and II who burn easily
• History of arsenic intake or previous ionizing radiation therapy
• History of melanoma or multiple non-melanoma skin cancers
• Medical conditions that prevent tolerating heat or standing for treatment duration 1

Practical Considerations

When implementing home phototherapy:

• Initial treatments may begin in-office to establish tolerance and appropriate dosing
• Maintenance therapy at home can follow after initial clearance
• Regular follow-up with a dermatologist is essential for monitoring
• Annual skin examinations are recommended for early detection of skin cancers 1

Home NBUVB therapy represents an important treatment option that can improve access to phototherapy while maintaining comparable efficacy to office-based treatment. However, proper medical supervision and patient education remain critical components for safe and effective outcomes.