Phototherapy

In this episode of Derms and Conditions, host James Q. Del Rosso, DO, sits down with E. James Song, MD, for a discussion on phototherapy and its place in modern dermatology. While phototherapy has long been a safe and effective treatment for various skin disorders, its use has declined due to limited access, inconsistent residency training, and clinician concerns about dosing. They review why these barriers are more logistical than clinical and how newer technologies are making treatment more accessible than ever.They begin by highlighting one of the most significant advances in phototherapy: home-based narrowband UVB devices. These units feature guided dosing modes that adjust treatments based on patient feedback, minimizing risks and removing guesswork. They review real-world evidence from the LITE study, which demonstrated home-based therapy to be at least as effective as in-office treatment, with strong adherence, particularly among patients of color, while maintaining a favorable safety profile.Dr Song then reviews appropriate patient selection, contraindications, and practical steps for prescribing at-home devices, from enrollment forms to choosing unit sizes for full-body or targeted treatment. He also shares pearls on using phototherapy as an adjunct in conditions like psoriasis with psoriatic arthritis, and highlights approved indications that extend beyond psoriasis, including atopic dermatitis, vitiligo, and cutaneous T-cell lymphoma.The conversation concludes with a look at broader implications: phototherapy’s favorable cost-effectiveness compared to biologics, evidence of improvements in systemic inflammatory markers, and emerging research suggesting potential benefits in autoimmune conditions outside dermatology. Tune in to the full episode for practical guidance on this mainstay of dermatologic practice and a renewed perspective on integrating phototherapy into modern care.

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