Light therapy, also called phototherapy or bright light therapy, is the exposure to direct sunlight or artificial light at controlled wavelengths in order to treat a variety of medical disorders, including seasonal affective disorder (SAD), circadian rhythm sleep-wake disorders, cancers, neonatal jaundice, and skin wound infections. Treating skin conditions such as neurodermatitis, psoriasis, acne vulgaris, and eczema with ultraviolet light is called ultraviolet light therapy.
Medical uses
Nutrient deficiency
Vitamin D deficiency Exposure to UV-B light at wavelengths of 290-300 nanometers enables the body to produce vitamin D3 to treat vitamin D3 deficiency.
Skin conditions
Light therapy treatments for the skin usually involve exposure to ultraviolet light. The exposures can be to a small area of the skin or over the whole body surface, as in a tanning bed. The most common treatment is with narrowband UVB, which has a wavelength of approximately 311–313 nanometers. Full body phototherapy can be delivered at a doctor's office or at home using a large high-power UVB booth. Tanning beds, however, generate mostly UVA light, and only 4% to 10% of tanning-bed light is in the UVB spectrum.
Acne vulgaris As of 2012, evidence for light therapy and lasers in the treatment of acne vulgaris was not sufficient to recommend them. There is moderate evidence for the efficacy of blue and blue-red light therapies in treating mild acne, but most studies are of low quality. While light therapy appears to provide short-term benefit, there is a lack of long-term outcome data in those with severe acne.
Atopic dermatitis Light therapy is considered one of the best monotherapy treatments for atopic dermatitis (AD) when applied to patients who have not responded to traditional topical treatments. The therapy offers a wide range of options: UVA1 for acute AD, NB-UVB for chronic AD, and balneophototherapy have proven their efficacy. Patients tolerate the therapy safely but, as in any therapy, there are potential adverse effects and care must be taken in its application, particularly to children. According to a study involving 21 adults with severe atopic dermatitis, narrowband UVB phototherapy administered three times per week for 12 weeks reduced atopic dermatitis severity scores by 68%. In this open study, 15 patients still experienced long-term benefits six months later.
Cancer According to the American Cancer Society, there is some evidence that ultraviolet light therapy may be effective in helping treat certain kinds of skin cancer, and ultraviolet blood irradiation therapy is established for this application. However, alternative uses of light for cancer treatment – light box therapy and colored light therapy – are not supported by evidence. Photodynamic therapy (often with red light) is used to treat certain superficial non-melanoma skin cancers.
Psoriasis
For psoriasis, UVB phototherapy has been shown to be effective. A feature of psoriasis is localized inflammation mediated by the immune system. Ultraviolet radiation is known to suppress the immune system and reduce inflammatory responses. Light therapy for skin conditions like psoriasis usually use 313 nanometer UVB though it may use UVA (315–400 nm wavelength) or a broader spectrum UVB (280–315 nm wavelength). UVA combined with psoralen, a drug taken orally, is known as PUVA treatment. In UVB phototherapy the exposure time is very short, seconds to minutes depending on intensity of lamps and the person's skin pigment and sensitivity.
Vitiligo About 1% of the human population has vitiligo which causes painless distinct light-colored patches of the skin on the face, hands, and legs. Phototherapy is an effective treatment because it forces skin cells to manufacture melanin to protect the body from UV damage. Prescribed treatment is generally 3 times a week in a clinic or daily at home. About 1 month usually results in re-pigmentation in the face and neck, and 2–4 months in the hands and legs. Narrowband UVB is more suitable to the face and neck and PUVA is more effective at the hands and legs.
Other skin conditions Some types of phototherapy may be effective in the treatment of polymorphous light eruption, cutaneous T-cell lymphoma and lichen planus. Narrowband UVB between 311 and 313 nanometers is the most common treatment.
Retinal conditions There is preliminary evidence that light therapy is an effective treatment for diabetic retinopathy and diabetic macular oedema.
Mood and sleep related
Seasonal affective disorder
The effectiveness of light therapy for treating seasonal affective disorder (SAD) may be linked to reduced sunlight exposure in the winter months. Light resets the body's internal clock. Studies show that light therapy helps reduce the debilitating depressive symptoms of SAD, such as excessive sleepiness and fatigue, with results lasting for at least 1 month. Light therapy is preferred over antidepressants in the treatment of SAD because it is a relatively safe and easy therapy with minimal side effects. Two methods of light therapy, bright light and dawn simulation, have similar success rates in the treatment of SAD. It is possible that response to light therapy for SAD could be season dependent. Morning therapy has provided the best results because light in the early morning aids in regulating the circadian rhythm. People affected by SAD often have low energy, tend to eat more carbohydrates and sleep longer, but symptoms can vary between people. A Cochrane review conducted in 2019 states the evidence that light therapy's effectiveness as a treatment for the prevention of seasonal affective disorder is limited, although the risk of adverse effects are minimal. Therefore, the decision to use light therapy should be based on a person's preference of treatment.
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