The letters PUVA stand for Psoralen and Ultra Violet light A.

Psoralens are chemicals which are found in more than 30 common plants.  They alter the skin’s sensitivity to light (either natural sunlight or UVA) and are often used to promote repigmentation of Vitiligo patches.

Psoralens and sunlight have been used for hundreds of years in the Middle East and the Far East as a treatment for vitiligo.  There are some disadvantages to this method of using psoralens as the amount of sunlight received cannot be controlled.  In the UK where there is not enough regular sunlight for this method to be an option, the treatment is given at the outpatients department of a hospital.  We believe that psoralens should only be used when prescribed as a treatment by a qualified medical practitioner.

Psoralens are given as capsules to swallow or as a lotion to paint on the affected areas of the skin, or as a lotion dissolved into bath water in which you have to soak for a short period before UVA treatment.  If taken in capsule form, the best results are achieved if the capsule is taken one or two hours before treatment.

BUT you must remember that the psoralen taken by mouth will make all your skin sensitive to light, and it will make your eyes sensitive too.  So, in order to protect your eyes from possible damage, you must wear dark glasses, or specially treated glasses (preferably the wrap-around type) for at least 8 hours after taking a psoralen capsule.

The UVA part of the treatment is given by a machine which looks rather like a shower cubicle lined with fluorescent tubes.  At first you may dislike the feeling of being shut in a box for the treatment but most people get used to this after a few visits.  The amount of time you spend inside the cubicle is built up gradually in order to avoid burning.  If you notice any soreness or burning be sure to tell the nurse before you have any more treatments as it may be necessary to reduce the amount of time you spend in the UVA light or to cover the affected area during the treatment.

Treatment is usually given 2 or 3 times a week.  It is not safe to give it more often as any redness (burning) can take up to 24 hours to appear and needs to be protected from further exposure.  During the treatment you must wear wrap-around goggles to protect your eyes and you should avoid looking directly at the rays of light.  The reason for these precautions is that the psoralens taken by mouth make your eyes sensitive to ultra violet light which can cause cataracts to develop.  This is why protection for the eyes for the full eight hour period after taking psoralens is essential.

Response to PUVA treatment is very variable.  If there is no improvement within the first three months then the treatment is normally stopped.  If there is some improvement then a course of treatment is likely to be long: often therapy will continue for a year or more and you may require as many as 100 treatments.

Things to bear in mind you are having PUVA treatment:

You should not take psoralens if you are pregnant.

You should always tell the hospital if you are taking, or start taking, any medication during PUVA treatment as some medicines make you more sensitive to light, particularly amiodarone, sulphonamides or tetracyclines.  Many complementary or herbal medicines also contain psoralens or bergamot (which has a similar action to that of psoralen) so you should mention these too and tell the doctor or nurse if you are using coal tar or disinfectant soap.

You should not use a sun bed.

Before treatment your skin should be clean and dry as the PUVA may be less effective if you are using certain creams and ointments.

Do not wear deodorants, perfumes or aftershave during treatment.  Some of them contain oils which make the skin sensitive to light.