Atopic dermatitis is a persistent skin condition that can make the skin red, dry, and very itchy. People and children with moderate to severe atopic dermatitis that covers a large body area or does not respond to certain treatments may consider trying ultraviolet (UV) light therapy.

UV light therapy, also known as phototherapy, involves exposing the skin to ultraviolet light to help reduce itching and inflammation. While treatment can be effective, it can also result in potential adverse effects such as sunburn and tender skin.

In this article, we will discuss the effectiveness of UV light therapy in treating atopic dermatitis, how it works, its side effects, costs, and other treatment options for people with eczema to consider.

A person receiving UV light therapy to treat their atopic dermatitis.Share on Pinterest
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Atopic dermatitis (AD) — also known as atopic eczema or, more commonly, eczema — is the most common type of eczema, affecting roughly 15-20% of children and 1-3% of adults globally.

AD is a chronic skin condition that comes and goes. It tends to run in families. While researchers are still unsure, evidence suggests that it occurs due to an overactive immune system that reacts to environmental triggers such as tobacco smoke, skin products, and air pollutants.

Its presentation varies from person to person and can range from mild to severe. There is currently no cure for AD, however, proper self-care measures and treatments can help to clear the skin and prevent flareups.

UV light refers to a type of radiation that is invisible to the human eye, with sunlight being the most common type of UV light. Experts can further classify UV light into three bands based on their wavelengths — UVA, UVB, and UVC.

UV light therapy, or phototherapy, is a treatment that uses UVA, UVB, or a combination of both (UVAB) to treat skin conditions such as eczema and psoriasis. For UVB treatments, people can receive either narrowband (NB-UVB) or broadband UVB (BB-UVB), which vary in how much of the UVB spectrum they use to treat skin conditions.

Dermatologists may recommend trying UV light therapy after using topicals without success but before trying systemic medications.

Phototherapy is generally effective in treating AD. While many dermatologists may consider biologics to be the most effective treatment, evidence highlights the efficacy and safety of NB-UVB for treating both psoriasis and AD.

A 2021 study found that phototherapy led to clinical improvements of AD symptoms and reduced the need for topical and oral corticosteroids and antihistamines, which are the first lines of treatment for AD. A 2020 study states that NB-UVB is a safe, effective, and well-tolerated treatment for children and for all Fitzpatrick skin types, including those with skin phototypes greater than type III.

UV light therapy works by exposing the skin to carefully calculated doses of UV light. UVA rays go deeply into the skin and are responsible for the skin tanning. UVB rays do not penetrate as deeply. However, they can cause delayed tanning and burns.

UV light can help treat eczema due to its anti-inflammatory properties. This is because UV light has an immunosuppressive effect, meaning it can reduce an overactive immune response in the skin.

Before prescribing light therapy, a doctor will first examine if phototherapy is safe for an individual. Aside from doing a thorough skin exam, they will ask about the individual’s family history, reaction to sunlight, medications they are taking, and if they are pregnant or nursing.

A person can have phototherapy in their healthcare professional’s office or a clinic. People who only need treatment for certain parts of the body need to cover all other areas using sunscreen or clothing to avoid getting a burn.

However, individuals who require treatment for their entire body may need to apply moisturizing oil to their skin and stand undressed (except for their underwear) in a booth that emits UV light. They also need to wear goggles to protect their eyes.

Dermatologists determine the type of therapy and treatment dosage that will benefit the individual while avoiding adverse reactions. The length of UV treatment and the course of the treatment will depend on the person’s skin condition and their response to the treatment.

Individuals may need to undergo 2-3 sessions in a week for a few months to see improvements in their symptoms. Once skin lesions clear up, doctors may only require individuals one treatment per week or month to prevent future flareups.

Phototherapy is generally safe. However, people can expect mild redness 24 hours after the treatment as well as dryness. Individuals must moisturize their skin after treatment to help alleviate skin dryness. Other side-effects may include:

  • itchy skin
  • tender skin
  • sunburn
  • photosensitive skin eruptions
  • skin tanning
  • cataracts from UVA treatment

As with prolonged exposure to sunlight, people exposed to high amounts of UV due to long-term light therapy treatment are at risk for accelerated skin aging, including developing age spots and wrinkles.

Some people may also experience an eczema flareup at the start of treatment. There is also a potential risk for skin cancer. A doctor will often suggest that people attend their local clinic for regular skin cancer screenings once they receive a substantial amount of UV treatments.

A 2020 study notes that the cost of both in-clinic and home UV treatments can vary depending on the skin condition and amount of treatments necessary. Anecdotal sources suggest that annual costs for in-clinic phototherapy average at roughly $5,700, while the price of home phototherapy devices can range from about $900-5,000.

A survey by the National Eczema Association given to its members worldwide found that the median annual out-of-pocket cost of AD for people with AD or their caregivers ranges from $600 to beyond $1,000. However, 8.5% of the survey participants reported spending over $5,000.

Despite the huge cost, phototherapy and at-home phototherapy devices can be more cost-effective than other AD treatments, such as biologics. At the same time, a person may be able to get coverage, at least in part, from insurance. Medicare may cover UV therapy if it is medically necessary. They may also cover at-home devices as durable medical equipment.

Home UVB phototherapy is an alternative option where individuals use a phototherapy device at home to treat their AD. Similar to clinic treatments, individuals using home UV phototherapy need to comply with a consistent treatment schedule.

Usually, people get treatment at a facility before transitioning to home phototherapy. It is also vital that individuals carefully follow their practitioners’ instructions and regular checkups and follow-ups. Aside from this, common at-home management for AD includes applying moisturizers such as ointments and creams, proper bathing, and wet wraps.

Individuals can also buy over-the-counter medications for AD without prescription, such as topical hydrocortisone.

Click here to learn more about natural remedies for eczema.

Practitioners may suggest phototherapy as a second line of treatment after unsuccessful topical treatments. If these options are still unsuccessful, health practitioners may consider other prescription medications, such as biologics and immunosuppressants.

Biologics are medications that target specific proteins called interleukins to help stop a person’s immune system from overreacting. Immunosuppressants are medications that help to suppress the immune system. They include traditional systemic drugs such as cyclosporine, and systemic steroids.

While side-effects such as redness and skin tenderness are common after phototherapy, individuals may want to consider seeing their doctor if they present with the following:

  • redness of treatment area beyond 24 hours
  • any open areas on the skin, including blisters, burns, and cuts
  • worsening of eczema
  • blisters, rashes, or drainage
  • presence of new lesions on the site treated
  • fever and chills
  • flu-like symptoms, including headache, fatigue, or nausea

Atopic dermatitis, or eczema, is a fairly common skin condition that results in itchy, red, scaly patches on the body. A number of treatment options are available, including phototherapy, which uses UV light to reduce the symptoms of eczema.

Phototherapy may be a viable and cost-effective option for individuals who have moderate to severe AD, especially when they do not respond to other treatment options.