A Typical Narrowband UVB Treatment Regime
Varieties of procedures (protocols) for UVB phototherapy have been developed and are tailored to fit different skin conditions. Protocols vary according to dermatologist preferences and patient’s skin conditions.
A typical protocol for narrowband UVB treatment of psoriasis consists of three sessions per week. Treatment sessions every other day are the most effective. Full remission is usually achieved in a period of 6 to 10 weeks.
The first treatment will be a small initial dose. The size of this dose is dependent on your sensitivity to UVB. Doses in subsequent treatments will then increase as your skin becomes more tolerant to UVB.
When narrowband UVB treatment is administered at home, the most practical and convenient way to determine the initial dose is to make an estimation of your skin sensitivity based on skin type (see table below). The size of this initial dose is small enough to be considered safe for your skin type.
Always burns, never tans; sensitive ("Celtic")
Burns easily, tans rarely
Burns moderately, tans gradually to light brown
Burns minimally, always tans well to moderately brown (Olive Skin)
Rarely burns, tans profusely to dark (Brown Skin)
Never burns, deeply pigmented; not sensitive (Black Skin)
The exposure time for the initial dose will vary according to skin type and the equipment being used. See equipment instructions or obtain advice from your dermatologist.
Warning! - Narrowband UVB lamps produce high levels of UVB. The initial dose will be measured in seconds rather than minutes. It is important to test a small area of skin by exposing it to the proposed initial dose, prior to whole body exposure. The area should be inspected 24 hours later. If erythema (reddening of the skin) is present then test a different area of skin by exposing it to a lower dose or consult your dermatologist.
Following the initial dose, subsequent increases in treatment time are based on your response to the most recent treatment.
If erythema (pinkness of the skin) did not result from the most recent treatment, then increase the next treatment time by 20%.
If erythema did result from the most recent treatment, then treatment is based on the level of erythema
Treatment based on Erythema
Level of erythema
Just perceptible erythema (pinkness of the skin)
Repeat previous dose and then reduce subsequent increments (e.g. instead of 20% increments use 5% or 10% increments)
Well defined marked erythema which is causing minimal discomfort
Omit treatment until settled, then repeat previous dose and reduce subsequent increments (e.g. instead of 20% increments use 5% or 10% increments)
Sore erythema without oedema (swelling or puffiness of the skin)
No treatment until erythema has settled, then resume treatment at half previous dose and reduce subsequent increments (e.g. instead of 20% increments use 5% or 10% increments)
Fiery sore erythema with oedema
No treatment until erythema has settled and patient has been reviewed by a doctor. Topical steroids, emollients and analgesia may help
Severe fiery erythema with oedema and/or blistering
No treatment. Review by doctor for treatment and plans for alternative treatment when erythema has subsided.
Don not exceed the maximum exposure time stated in the equipment instructions or as advised by you dermatologist.
Phototherapy sessions are continued until remission is achieved or no further improvement can be attained, and for a maximum of 30 treatments, unless medical advice is given to the contrary.
Your dermatologist may advise a maintenance program to help prevent your condition flaring up again.
You should see your dermatologist at least every 6 months to discuss your skin condition, and the need for continued treatment.