The Role of Phototherapy in Patients With Vitiligo
An expert discusses how phototherapy requires 2 to 3 sessions per week in specialized light booths or home units, is particularly useful for vitiligo covering more than 10% body surface area, and can be targeted to specific areas using 308-nm lasers for smaller lesions.
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Phototherapy represents a highly effective, safe treatment modality requiring 2 to 3 sessions weekly in narrow-band UVB-emitting booths for several minutes per session. Traditional phototherapy occurs at specialized dermatology centers, though home units offer increased convenience and accessibility. Insurance coverage for home phototherapy units varies significantly, potentially creating access barriers, but successful coverage can dramatically improve treatment adherence by eliminating frequent office visits.
Phototherapy proves particularly valuable for extensive vitiligo affecting more than 10% of the body surface area, where whole body exposure to narrow-band UVB provides comprehensive treatment coverage. The ability to treat large surface areas simultaneously represents a significant advantage over topical therapies alone. For smaller, localized areas, targeted laser therapy using similar 308-nm wavelengths can stimulate repigmentation in specific locations, offering an alternative approach to whole body phototherapy exposure.
The combination of phototherapy with topical treatments, particularly the newer JAK inhibitors, has shown enhanced efficacy in clinical practice. This multimodal approach allows practitioners to optimize treatment outcomes by leveraging both systemic light exposure and targeted topical interventions. The flexibility of phototherapy protocols, whether delivered in clinical settings or through home units, makes this treatment modality adaptable to various patient needs and clinical scenarios.
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