UV Light Phototherapy for Vitiligo
Howard University Hospital, Vitiligo Center
Rebat M. Halder, M.D., Director

PROCEDURE FOR TOPICAL PUVA THERAPY FOR VITILIGO

Patients are also instructed to avoid unnecessary sun exposure for the next 24 hours following treatments.

(NOTE: Topical PUVA should never be attempted with natural sunlight and should never be prescribed to the patient for home treatment. It is reserved for patients with less than 20% surface involvement with Vitiligo.)

PROCEDURE FOR ORAL PUVA THERAPY FOR VITILIGO

Baseline Laboratory
CBC, SMA, 12, SGPT, ANA
Repeat every 6 months

• Complete baseline ophthalmological exam — initially and yearly
  
• Oxsoralen Ultra (8-MOP) 0.3 mg/kg ingested 1½ hours prior to UVA light exposure
  
• Initial exposure of 0.5 joules/sq cm (0.25 for skin types I & II) with subsequent increments of 0.5 joules/sq cm on every other treatment until persistent trace to 1+ erythema remains in areas of Vitiligo between treatments. If natural sunlight is used, summer mid-day initial exposure of 5 minutes increased by 5 minutes every other treatment.
  
• Treatments administered twice weekly with a minimum of 48 hours between treatments.
  
• Wrap-around sunglasses (i.e., NOIR) to be worn for the first 24 hours after ingestion of psoralen in the presence of any light.
  
• Broad spectrum sunscreen applied to areas of Vitiligo for the first 36 hours after treatment whenever outside.

(NOTE: Oral PUVA is usually indicated for greater than 20% surface involvement with Vitiligo)