Ultraviolet Therapy: Difference between revisions

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UV - C      100 - 280 nm        Germicidal region
UV - C      100 - 280 nm        Germicidal region


Ultraviolet radiation obeys the law that governs all the radiations, they may reflect, scatter and are absorbed by molecular chromophores. The degree of absorption is generally greater for shorter wavelengths, shorter wavelengths penetrate less deeply. Absorption depends on the thickness of the epidermis and any pigmentation of the skin. Skin thickening due to lesions will result in increased scattering and absorption and thus reduced penetration. <ref>Kitchen SS, Partridge CJ. A review of ultraviolet radiation therapy. physiotherapy. 1991 Jun 10;77(6):423-32.</ref>  
Ultraviolet radiation obeys the law that governs all the radiations, they may reflect, scatter and are absorbed by molecular chromophores. The degree of absorption is generally greater for shorter wavelengths, shorter wavelengths penetrate less deeply. Absorption depends on the thickness of the epidermis and any pigmentation of the skin. Skin thickening due to lesions will result in increased scattering and absorption and thus reduced penetration. <ref>Kitchen SS, Partridge CJ. A review of ultraviolet radiation therapy. physiotherapy. 1991 Jun 10;77(6):423-32.</ref>
 
== '''Physiological effects of ultraviolet radiation''' ==
 
# Erythema because of dilation of the capillaries and arterioles.
# Pigmentation or tanning of the skin
# Desquamation or Increased skin growth
# UVB can convert sterols in the skin   to vitamin D, therefore increasing the production of vitamin D in the body.
# Prophylactic effect starts in the body as the resistance of the body to infection is increased because of the stimulation of reticuloendothelial system.
# Ultraviolet radiation destroys Langerhan’s cell and stimulates the proliferation of suppressor T cells, these immunosuppressive effects may contribute to the development of skin cancer.
# Strong dose of UVB and C radiation to the eyes can lead to conjunctivitis and photokeratitis which in turn results in Irritation of the eye, a feeling of grit in the eye, watering of the eye and aversion to light. (photophobia). A strong dose of UVA may also lead to the formation of cataracts.
# Prolonged exposure of UVR lead to, premature ageing of the skin, this is especially so in the light -skinned people. It also decreases function of sebaceous and sweat glands. The skin becomes wrinkled, dry and leathery.
# Cancer: Carcinogenesis is a danger, as these rays may influence the DNA and thus effect cell replication. Squamous cell carcinomas are a serious side effect. Hence, Shorter ultraviolet waves should be avoided, and course of treatment should not exceed four weeks.


== Indication ==
== Indication ==

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Introduction[edit | edit source]

Ultraviolet  therapy  is a form of treatment commonly used to treat certain skin disorders. It consists of irradiation of the patient with the UVA band of ultraviolet light. The therapeutic application of ultraviolet (UV) portion of the electromagnetic spectrum (or UV therapy) has been used for decades, although the recognition of the therapeutic effect of sunlight, dates back to ancient times, artificial UV radiation that allows precise dosing has only been available since last century with UV-A in 1974, narrowband UV-B in 1984, UV-AB in 1985, and UV-A1 in 1992.

Ultraviolet therapy has been reported to be very effective in destroying bacteria and promoting wound healing and therefore a promising adjunctive therapy for chronic wounds infected with resistant bacteria.

Ultraviolet therapy is commonly used to treat conditions like, psoriasis, atopic dermatitis, vitiligo, mycosis fungoides, and hand/feet eczema.

Though there is evidence present for effectiveness of Ultraviolet therapy in the management of wounds and other skin conditions and the significant role physiotherapists play in its application, anecdotal evidence suggests that this modality is not routinely applied for treatment in regular clinical practice. [1][2]

Description[edit | edit source]

UVR is a non-ionizing radiation that lies between soft x-rays and visible light in the electromagnetic spectrum. It has a wavelength of 10 nm 300/480 nm. The therapeutic part of ultraviolet spectrum are classified by International Commission on Radiation (CIE).[3][1]

On the basis of dominant biological effects displayed by each region as :

UV - A 315 - 400 nm Encourage wound healing

UV - B 280 - 315 nm Skin erythematous region

UV - C 100 - 280 nm Germicidal region

Ultraviolet radiation obeys the law that governs all the radiations, they may reflect, scatter and are absorbed by molecular chromophores. The degree of absorption is generally greater for shorter wavelengths, shorter wavelengths penetrate less deeply. Absorption depends on the thickness of the epidermis and any pigmentation of the skin. Skin thickening due to lesions will result in increased scattering and absorption and thus reduced penetration. [4]

Physiological effects of ultraviolet radiation[edit | edit source]

  1. Erythema because of dilation of the capillaries and arterioles.
  2. Pigmentation or tanning of the skin
  3. Desquamation or Increased skin growth
  4. UVB can convert sterols in the skin   to vitamin D, therefore increasing the production of vitamin D in the body.
  5. Prophylactic effect starts in the body as the resistance of the body to infection is increased because of the stimulation of reticuloendothelial system.
  6. Ultraviolet radiation destroys Langerhan’s cell and stimulates the proliferation of suppressor T cells, these immunosuppressive effects may contribute to the development of skin cancer.
  7. Strong dose of UVB and C radiation to the eyes can lead to conjunctivitis and photokeratitis which in turn results in Irritation of the eye, a feeling of grit in the eye, watering of the eye and aversion to light. (photophobia). A strong dose of UVA may also lead to the formation of cataracts.
  8. Prolonged exposure of UVR lead to, premature ageing of the skin, this is especially so in the light -skinned people. It also decreases function of sebaceous and sweat glands. The skin becomes wrinkled, dry and leathery.
  9. Cancer: Carcinogenesis is a danger, as these rays may influence the DNA and thus effect cell replication. Squamous cell carcinomas are a serious side effect. Hence, Shorter ultraviolet waves should be avoided, and course of treatment should not exceed four weeks.

Indication[edit | edit source]

1. Acne: Acne is skin condition which presents pustules, papules and comedones blocking the hair follicles and sebaceous glands on the face, back and chest.

Ultraviolet radiation may be given with the following aims :

  • An erythema will bring more blood to the skin and improve the condition of the skin.
  • Desquamation will remove comedones and allow free drainage of sebum, thus reducing number of lesions.
  • The UVR will have a sterilizing effect on skin.[5]

Modest improvement was observed with sunburn rays (UV-B) and slightly more with the combination of long ultraviolet radiation (UV-A) and UV-B.[6]

2. Psoriasis: It is a skin condition which presents localized plaques in which the rste of cell turnover from the basal layer through to the superficial layer is too rapid.

Treatment can be given using the Leeds regimen or PUVA

Leeds regimen In the Leeds regimen the sensitivity of the patient's skin to UVR is increased by the local application of coal - tar, added to a bath prior to treatment

Clinical Presentation[edit | edit source]

add text here relating to the clinical presentation of the condition, including pre- and post- intervention assessment measures. 

Resources[edit | edit source]

add appropriate resources here, including text links or content demonstrating the intervention or technique

References[edit | edit source]

  1. ↑ 1.0 1.1 Ultraviolet radiation (UVR) in Physiotherapy. PHYSIOGRIP. April 24, 2020. Available from: https://sarvanshikhalora.in/ultraviolet-radiation-uvr-in-physiotherapy/
  2. ↑ Nuhu JM, Mohammed J, Muhammad M. UV therapy: Physiotherapists' perception of therapeutic efficacy and barriers to usage. Hong Kong Physiotherapy Journal. 2014 Jun 1;32(1):44-8.
  3. ↑ CIE V. Commission Internationale de l’Eclairage (International Commission on Illumination). International lighting vocabulary. 1987.
  4. ↑ Kitchen SS, Partridge CJ. A review of ultraviolet radiation therapy. physiotherapy. 1991 Jun 10;77(6):423-32.
  5. ↑ John M. Angela FORSTER “Clayton's Electrotherapy Theory and Practice” 9th Edition. British Journal of Sports Medicine. 1982 Dec;16(6):188.
  6. ↑ Mills OH, Kligman AM. Ultraviolet phototherapy and photochemotherapy of acne vulgaris. Archives of dermatology. 1978 Feb 1;114(2):221-3.
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