The part of the sun’s spectrum that we concern ourselves with is the Ultraviolet portion which is by definition 200 nM to 400 nM (nM is nano meter or a billionth of a meter). The UV Spectrum is broken up (by definition) into three bands, UVA, UVB and UVC. Science has arbitrarily defined these as

• UVA – Long Wavelength             320 to 400 nm
• UVB – Medium Wavelength       290 to 320 nm
• UVC – Short Wavelength            200 to 290 nm (Sometimes called ‘Germicidal Light’)

UVB Narrow Band is a small slice of the UVB Spectrum at 311 nM and is identified as that part of the UV Spectrum that seems to provide the optimal therapeutic effect with the lowest risks including lower risk of cancer, lower risk of sunburn and very low risk of contributing to premature skin aging.

OK I’m rambling a bit. People ask, how does UVB NB equate to sunlight? This is an impossible question to answer.

This question is impossible to answer as the sun’s measurable output varies depending on:

• Our Latitude.
• The time of day.
• The season.
• The time of year.
• Cloud cover.
• Relative humidity.
• One’s elevation.

Suffice it to say, one of the advantages of UV Phototherapy is the constancy that one can achieve in one’s treatment from day to day.

Sunlight presents a ‘full spectrum’ of UV light whose energy level arriving on the surface of our planet is dependent on all of the above factors and perhaps others.

Hope this helps?

Do you have any suggestions?

Many psoriasis sufferers seek light therapy, the standard of which is narrowband ultraviolet B (UVB) light therapy, which mimics the portion of the sun’s invisible light rays known to trigger the skin’s production of vitamin D.

Because previous research in people with psoriasis has shown that this treatment raises levels of vitamin D and improves the skin condition, Dr. Caitriona Ryan and her colleagues at St. Vincent’s University Hospital in Dublin, Ireland, wondered if these benefits might be linked.

To investigate, they followed 60 psoriasis patients during an Irish winter — between October 2008 and February 2009. Half were treated with UVB light therapy three times a week until their psoriasis cleared; the others received no light therapy. Vitamin D levels in the blood were measured along the way.

The researchers found that the average patient undergoing UVB light therapy more than doubled their blood levels of vitamin D by the end of the treatment period, which most completed in about 50 days. All of them reached vitamin D sufficient levels, the researchers report in the Archives of Dermatology.

As expected, psoriasis also significantly improved with UVB light therapy. Half the patients started out with psoriasis severity scores above 7.1, and by the end of treatment half had scores of 0.5 or below.

In contrast, three out of every four patients not receiving light therapy remained vitamin D insufficient at the end of the study. They also experienced no overall improvement in psoriasis severity.

When the researchers analyzed the levels of vitamin D and the extent of psoriasis relief, however, they could find no association between the two.

“The improvement in both vitamin D status and psoriasis may be contemporaneous, but unrelated, consequences” of UVB light therapy, Ryan told Reuters Health in an email.

This finding came as no surprise to Dr. Leon Kircik of Indiana University in Indianapolis.

“Any vitamin D in the blood is not going to help psoriasis. You need it on the skin,” he told Reuters Health, pointing to topical vitamin D as an effective psoriasis treatment.

Still, he noted that UVB light therapy is one of the best and safest options for combating psoriasis. So far, it has not been shown to increase the risk of skin cancer, he said, “and it’s been used for a long time, even for pregnant women.”

But Dr. Amra Osmancevic of the University of Gothenburg in Sweden cautions that UVB light therapy remains a known human carcinogen. Its intentional use in healthy people to only induce vitamin D production is not recommended, Osmancevic told Reuters Health in an email.

SOURCE: archderm.ama-assn.org/ Archives of Dermatology, online August 17, 2010

Arch Dermatol. 2010;146(8):836-842. doi:10.1001/archdermatol.2010.195

Phototherapy with ultraviolet (UV) radiation of wavelengths between 280 and 320 nm (UVB) is a safe and effective treatment for a variety of diseases. In addition to standard broadband UVB (bUVB), narrowband phototherapy with fluorescent bulbs emitting near monochromatic UV around 311 nm (nUVB) has become an important treatment for diseases such as psoriasis, atopic dermatitis and vitiligo. In addition to these indications, the number of diseases for which nUVB phototherapy is reported to be effective is continuously growing. The differential effects of nUVB phototherapy in comparison to other UV wavelengths as well as established and new indications for this treatment modality are reviewed.
<See Entire Article – Click Here>

Another UVB BB vs NB Study (Japan 1999) Click Here

See the Video >>

www.youtube.com/watch?v=CbrMS6evGFI

Cheryl and I have met April and Lori at several Vitiligo conferences over the years. Lori has written a book called “DIFFERENT -- Just Like Me”

April and Lori are remakable people in an ever changing world.

Please watch the video!

Chris

A question that comes up quite often is “Should I use Protopic?” or perhaps “Should I use Elidel?” and then the question continues “… while using UVB Narrow Band?”.

Generally speaking, any drug or cream should be avoided and not be applied immediately before or during UVB Narrow Band treatment. Elidel and Protopic and most other things you apply to your skin, change the skin’s sensitivity to UV light. Some drugs increase your sensitivity (Psoralens & others) while others reduce your skin’s sensitivity (sun blocks and the like). All of these should be avoided UNLESS SPECIFICALLY PRESCRIBED by your Dermatologist.

I do recommend that if Protopic, Elidel or other Corticosteroid has been prescribed that you use it following UV treatment or on the alternate days. Do not apply these creams before treatment UNLESS SPECIFICALLY PRESCRIBED by your Dermatologist. It is not safe to apply these creams before treatment as they can increase your skin’s sensitivity to UV light and increase the risk of severe erythema (sunburn).

Do no assume that you know more than your dermatologist!

Avoid sunlight, sun lamps, tanning beds, and phototherapy treatments with UVA or UVB light. If you must be outdoors, wear loose clothing over the skin areas treated with Protopic. Do not use sunscreen on treated skin unless your doctor has told you to.

• Read more: http://www.drugs.com/protopic.html
• Read more: http://www.drugs.com/elidel.html

The entire article can be seen by <Clicking Here>

This report examines the dosimetry of ultraviolet (UV) radiation applied to dermatological treatments, and considers the definition of the radiation quantities and their measurement. Guidelines are offered for preferred measurement techniques and standard methods of dosimetry. The recommendations have been graded according to the American Joint Committee on Cancer classification of strength of recommendation and quality of evidence.

The article discusses options and ideas for treatement. I have listed links at the bootom of this posting to other ideas to help with treatment guidlines.

Recommendations and guidelines

1. Whole-body treatments should be given in ventilated cabins surrounding the patient with radiation sources wherever possible, and it is recommended that obsolete apparatus be replaced. (American Joint Committee on Cancer classification: BIII)
2. Phototherapy clinics should use a UV radiometer to measure irradiances from all UV treatment equipment. The meter should have minimal response outside the UV band and be chosen for dynamic range, linearity and angular sensitivity. (BIII)
3. The meter should be calibrated annually for each type of UV source in use, identifying the method, its traceability to known national standards and the waveband over which irradiance is measured. Irradiance over the full UV band of 250–400 nm should also be measured, in addition to any other band width, to facilitate intercomparisons. (BIII)
4. Built-in UV dosimeters in cabins should agree closely with directly measured irradiance values. Where agreement is outside reasonable tolerance (± 10%), the built-in meter may need adjusting. The supplier or the person responsible for the equipment should be consulted for advice. (BIII) The webmaster has an opinion on the use of dosimetry in home systems <Click Here>
5. Electrical equipment should be tested for compliance with electrical safety standards, and staff should be trained to operate the equipment correctly. Annual checks are acceptable, and written records should be kept. (BIII)
6. Regular consistency checks of all UV irradiation apparatus should be performed, by checking for failed lamps and measuring UV irradiance in a standard reference location to identify any changes. Failed lamps should be replaced promptly, and consistency verified at least monthly. (BIII)
7. Skin irradiances should be measured regularly by the Direct or Indirect Methods, and used to calculate exposure times and to check built-in meters. Measurement every 25–50 h of usage is acceptable, but after installing new lamps, which degrade more quickly when new, re-measure after 10–15 h. (BIII)
8. Patient doses should be prescribed in J cm)2 (or derived units), and cumulative doses calculated and recorded at the end of treatment courses, to quantify lifetime exposure to therapeutic UV. (BII-i)
9. MED ⁄ MPD techniques should be described fully, including the site(s) of test(s), the criteria used to assess erythema, the methodology of masking and exposing test sites, including any devices used for this, and the sequence of doses used (or the ratio between adjacent exposures). (BII-iii)
10. The recommendations in this report should be subject to routine audit, as part of the clinic’s audit programme, to verify that objectives are being met, and to optimize clinical outcomes.

Useful Links and Articles

• This article in Full <CLICK HERE>
• UVB Narrow Band: A Practcal Approach <CLICK HERE>
• Initiating Narrow-band UVB for the treatment of Psoriasis <CLICK HERE>

They report, Compared with broadband UVB:

• Exposure times are shorter but of higher intensity.
• The course of treatment is shorter.
• It is more likely to clear the skin condition.
• Longer periods of remission occur before it reappears.

They also mention that “This range of UV radiation has proved to be the most beneficial component of natural sunlight for psoriasis. Narrowband UVB may also be used in the treatment of many other skin conditions including atopic eczema, vitiligo, pruritus, lichen planus, polymorphous light eruption, early cutaneous T-cell lymphoma and dermographism.”

The original can be found at http://dermnetnz.org/procedures/narrowband-uvb.html - Enjoy!

The Dermalight 80 is made here in the USA by National Biological Corporation under licence to Hoenle and of course by Hoenle the developer of the Dermalight 80. The Dermalight 80  is made in two configurations:

• 110V – 60 Hz (USA, Canada, Japan, Ecuador, Brazil)
• 220V – 50 Hz (Europe and many countries around the world)

There are a few countries around the world that have 220 V – 60 Hz power and we’ve found out the hard way that the 220V – 50 Hz units do not work well in these countries, including Korea, Saudi Arabia and one or two others. When I say the hard way, we have shipped 220V 50 Hz power units to 60 Hz countries and we’ve had to replace them with 110V 60 Hz units with a step down transformer.

The converse is not true. The 110V – 60 Hz unit when used with a step down transformer works well in countries with 220V – 50Hz power.

You can read about our recommendations at < Dermalight – International >

If you live in the USA or Canada or any other country using 60 Hz power then I do recomemnd that you purchase a 60 Hz – Dermalight 80 unit that will work in your country. If you’re in Saudi Arabia, Korea, The Philippines or other country using 220V – 60 Hz power then buy one of the USA models with a step-down transformer. I do recommend that you read this page carefully!

See http://www.dermalight80.com/international.htm#Line_Voltage_&_Frequency__

As somone once said! Caveat Emptor