having or employing wavelengths shorter than light but longer than X-rays; lying outside the visible spectrum at its violet end; "ultraviolet radiation"; "an ultraviolet lamp"
radiation lying in the ultraviolet range; wave lengths shorter than light but longer than X rays (同)ultraviolet_radiation, ultraviolet_light, ultraviolet illumination, UV
(medicine) the act of caring for someone (as by medication or remedial training etc.); "the quarterback is undergoing treatment for a knee injury"; "he tried every treatment the doctors suggested"; "heat therapy gave the best relief"
"Light box" redirects here. For other uses, see Lightbox (disambiguation).
Light therapy
High-intensity blue light (425 nm) used for the treatment of acne.
ICD-10-PCS
6A6, GZJ
ICD-9
99.83, 99.88
MeSH
D010789
[edit on Wikidata]
Light therapy—or phototherapy, classically referred to as heliotherapy—consists of exposure to daylight or to specific wavelengths of light using polychromatic polarised light, lasers, light-emitting diodes, fluorescent lamps, dichroic lamps or very bright, full-spectrum light. The light is administered for a prescribed amount of time and, in some cases, at a specific time of day.
One common use of the term is associated with the treatment of skin disorders, chiefly psoriasis, acne vulgaris, eczema and neonatal jaundice.[1][2]
Light therapy which strikes the retina of the eyes is used to treat diabetic retinopathy and also circadian rhythm disorders such as delayed sleep phase disorder and can also be used to treat seasonal affective disorder, with some support for its use also with non-seasonal psychiatric disorders.[medical citation needed]
The treatments involve exposing the skin to ultraviolet light. The exposures can be to small area of the skin or over the whole body surface, like in a tanning bed. The most common treatment is with narrowband UVB (NB-UVB) with a wavelength of 311–313 nanometer. It was found that this is the safest treatment.[3] Full body phototherapy can be delivered at a doctor's office or at home using a large high power UVB booth.[4]
Atopic dermatitis
Light therapy is considered one of the best monotherapy treatments for atopic dermatitis (AD), when applied to patients who have not responded to traditional topical treatments. The therapy offers a wide range of options: UVA1 for acute AD, NB-UVB for chronic AD, and balneophototherapy have proven their efficacy over the recent past. Patients tolerate the therapy safely but, as in any therapy, there are adverse effects and care should be taken in its application, particularly to children.[5]
Psoriasis
See also: Goeckerman therapy
For psoriasis, UVB phototherapy has been shown to be effective.[6] A feature of psoriasis is localized inflammation mediated by the immune system.[7] Ultraviolet radiation is known to suppress the immune system and reduce inflammatory responses. Light therapy for skin conditions like psoriasis usually use 313 nanometer Narrowband UVB though it may use UV-A (315–400 nm wavelength) or UV-B (280–315 nm wavelength) light waves. UV-A, combined with psoralen, a drug taken orally, is known as PUVA treatment. In UVB phototherapy the exposure time is very short, seconds to minutes depending on intensity of lamps and the person's skin pigment and sensitivity. The time is controlled with a timer that turns off the lamps after the treatment time ends.
Vitiligo
About 1 percent of the population suffers from vitiligo. Photo therapy is an effective treatment because the skin cells manufacture the pigment when they sense UV light. When they sense UV light the cells manufacture the pigment in order to protect the body from the harming UV light. Treatment is generally required 3 times a week in a clinic and every day at home. It takes about 1 month to achieve re-pigmentation in the face and neck, and 2–4 months in the hands and legs. Narrowband UVB is more suitable to the face and neck and PUVA is more effective at the hands and legs.[8]
Acne vulgaris
Evidence for light therapy and lasers in acne vulgaris as of 2012 is not sufficient to recommend them.[9] There is moderate evidence for the efficacy of blue and blue-red light therapies in treating mild acne, but most studies are of low quality.[10][11] While light therapy appears to provide short-term benefit, there is a lack of long-term outcome data or data in those with severe acne.[12]
Cancer
According to the American Cancer Society, there is some evidence that ultraviolet light therapy may be effective in helping treat certain kinds of skin cancer, and ultraviolet blood irradiation therapy is established for this application. However, alternative uses of light for cancer treatment – light box therapy and colored light therapy – are not supported by evidence.[13] Photodynamic therapy (often with red light) is used to treat certain superficial non-melanoma skin cancers.[14]
Mycosis fungoides can be treated with narrowband UVB light.[citation needed]
Other skin conditions
Phototherapy can be effective in the treatment of eczema, atopic dermatitis, polymorphous light eruption, cutaneous T-cell lymphoma[15] and lichen planus.
Narrowband UVB lamps, 311–313 nanometer is the most common treatment.[16]
Wound healing
Low level laser therapy has been studied as a potential treatment for chronic wounds.[17] Reviews of the scientific literature do not support the widespread use of this technique due to inconsistent results and low research quality.[17][18] Higher power lasers have also been used to close acute wounds as an alternative to stitching.[17]
Retinal conditions
There is preliminary evidence that light therapy is an effective treatment for diabetic retinopathy and diabetic macular oedema.[19][20]
Mood and sleep related
Seasonal affective disorder
Main article: Seasonal affective disorder
The effectiveness of light therapy for treating SAD may be linked to the fact that light therapy makes up for lost sunlight exposure and resets the body's internal clock.[21] Studies show that light therapy helps reduce the debilitating and depressive behaviors of SAD, such as excessive sleepiness and fatigue, with results lasting for at least 1 month. Light therapy is preferred over antidepressants in the treatment of SAD because it is a relatively safe and easy therapy.[22]
It is possible that response to light therapy for SAD could be season dependent.[23] Morning therapy has provided the best results because light in the early morning aids in regulating the circadian rhythm.[22] People affected by SAD have low levels of energy and have difficulty concentrating. They usually have a change in appetite and experience trouble sleeping.[24]
A 2007 systematic review by the Swedish agency SBU found insufficient evidence that light therapy was able to alleviate symptoms of depression or seasonal affective disorder.[25] The report recommended that: "Approximately 100 participants are required to establish whether the therapy is moderately more effective than placebo".[25] Although treatment in light therapy rooms was well established in Sweden, no satisfactory, controlled studies had been published on the subject.[25] This led to the closure of a number of clinics offering light therapy in Sweden.[26]
A Cochrane (organisation) review conducted in 2019 states the evidence base for light therapy as a treatment for prevention of seasonal affective disorder is limited. Therefore, the decision to use light therapy should be based on a person's preference of treatment.[27]
Non-seasonal depression
Light therapy has also been suggested in the treatment of non-seasonal depression and other psychiatric mood disturbances, including major depressive disorder,[28] bipolar disorder and postpartum depression.[29][30] A meta-analysis by the Cochrane Collaboration concluded that "for patients suffering from non-seasonal depression, light therapy offers modest though promising antidepressive efficacy."[31] A 2008 systematic review concluded that "overall, bright light therapy is an excellent candidate for inclusion into the therapeutic inventory available for the treatment of nonseasonal depression today, as adjuvant therapy to antidepressant medication, or eventually as stand-alone treatment for specific subgroups of depressed patients."[32] A 2015 review found that supporting evidence for light therapy was limited due to serious methodological flaws.[33]
Circadian rhythm sleep disorders and jet lag
Main article: Circadian rhythm sleep disorder
Chronic circadian rhythm sleep disorders (CRSD)
In the management of circadian rhythm disorders such as delayed sleep phase disorder (DSPD), the timing of light exposure is critical. Light exposure administered to the eyes before or after the nadir of the core body temperature rhythm can affect the phase response curve.[34] Use upon awakening may also be effective for non-24-hour sleep–wake disorder.[35] Some users have reported success with lights that turn on shortly before awakening (dawn simulation). Evening use is recommended for people with advanced sleep phase disorder. Some, but not all, totally blind people whose retinae are intact, may benefit from light therapy.
Situational CRSD
Light therapy has been tested for individuals with shift work sleep disorder and for jet lag.[36][37]
Sleep disorder in Parkinson's disease
Light therapy has been trialed in treating sleep disorders experienced by patients with Parkinson's disease.[38]
Sleep Disorder in Alzheimer's Disease
Studies have shown that daytime and evening light therapy for nursing home patients with Alzheimer’s disease, who often struggle with agitation and fragmented wake/rest cycles effectively led to more consolidated sleep and an increase in circadian rhythm stability.[39][40][41]
Neonatal jaundice (Postnatal Jaundice)
Further information: Neonatal jaundice
A newborn infant undergoing white-light phototherapy to treat neonatal jaundice.
Light therapy is used to treat cases of neonatal jaundice.[42] Bilirubin, a yellow pigment normally formed in the liver during the breakdown of old red blood cells, cannot always be effectively cleared by a neonate’s liver causing neonatal jaundice. Accumulation of excess bilirubin can cause central nervous system damage, and so this buildup of bilirubin must be treated. Phototherapy uses the energy from light to isomerize the bilirubin and consequently transform it into compounds that the newborn can excrete via urine and stools. Bilirubin is most successful absorbing light in the blue region of the visible light spectrum, which falls between 460-490 nm.[2] Therefore light therapy technologies that utilize these blue wavelengths are the most successful at isomerizing bilirubin.[43]
Techniques
Photodynamic therapy
Main article: Photodynamic therapy
Photodynamic therapy is a form of phototherapy using nontoxic light-sensitive compounds that are exposed selectively to light, whereupon they become toxic to targeted malignant and other diseased cells
One of the treatments is using blue light with aminolevulinic acid for the treatment of actinic keratosis. This is not a U.S. FDA-approved treatment for acne vulgaris.[44]
Light boxes
The brightness and color temperature of light from a light box are quite similar to daylight.
"Light box" redirects here. For other uses, see Lightbox (disambiguation).
The production of the hormone melatonin, a sleep regulator, is inhibited by light and permitted by darkness as registered by photosensitive ganglion cells in the retina.[45] To some degree, the reverse is true for serotonin,[46] which has been linked to mood disorders. Hence, for the purpose of manipulating melatonin levels or timing, light boxes providing very specific types of artificial illumination to the retina of the eye are effective.[47]
Light therapy uses either a light box which emits up to 10,000 lux of light at a specified distance, much brighter than a customary lamp, or a lower intensity of specific wavelengths of light from the blue (460 nm) to the green (525 nm) areas of the visible spectrum.[48] A 1995 study showed that green light therapy at doses of 350 lux produces melatonin suppression and phase shifts equivalent to 10,000 lux white light therapy,[49][50] but another study published in May 2010 suggests that the blue light often used for SAD treatment should perhaps be replaced by green or white illumination, because of a possible involvement of the cones in melatonin suppression.[51]
Risks and complications
Ultraviolet
Ultraviolet light causes progressive damage to human skin and erythema even from small doses.[52][53] This is mediated by genetic damage, collagen damage, as well as destruction of vitamin A and vitamin C in the skin and free radical generation.[citation needed] Ultraviolet light is also known to be a factor in formation of cataracts.[54][55] Ultraviolet radiation exposure is strongly linked to incidence of skin cancer.[56][52][57]
Visible light
Optical radiation of any kind with enough intensity can cause damage to the eyes and skin including photoconjunctivitis and photokeratitis.[58] Researchers have questioned whether limiting blue light exposure could reduce the risk of age-related macular degeneration.[59] It is reported that bright light therapy may activate the production of reproductive hormones, such as testosterone, luteinizing hormone, follicle-stimulating hormone, and estradiol.[60][61]
Modern phototherapy lamps used in the treatment of seasonal affective disorder and sleep disorders either filter out or do not emit ultraviolet light and are considered safe and effective for the intended purpose, as long as photosensitizing drugs are not being taken at the same time and in the absence of any existing eye conditions. Light therapy is a mood altering treatment, and just as with drug treatments, there is a possibility of triggering a manic state from a depressive state, causing anxiety and other side effects. While these side effects are usually controllable, it is recommended that patients undertake light therapy under the supervision of an experienced clinician, rather than attempting to self-medicate.[62]
Contraindications to light therapy for seasonal affective disorder include conditions that might render the eyes more vulnerable to phototoxicity, tendency toward mania, photosensitive skin conditions, or use of a photosensitizing herb (such as St. John's wort) or medication.[63][64] Patients with porphyria should avoid most forms of light therapy. Patients on certain drugs such as methotrexate or chloroquine should use caution with light therapy as there is a chance that these drugs could cause porphyria.[citation needed]
Side effects of light therapy for sleep phase disorders include jumpiness or jitteriness, headache, eye irritation and nausea.[65] Some non-depressive physical complaints, such as poor vision and skin rash or irritation, may improve with light therapy.[66]
History
Many ancient cultures practiced various forms of heliotherapy, including people of Ancient Greece, Ancient Egypt, and Ancient Rome.[67] The Inca, Assyrian and early German settlers also worshipped the sun as a health bringing deity. Indian medical literature dating to 1500 BCE describes a treatment combining herbs with natural sunlight to treat non-pigmented skin areas. Buddhist literature from about 200 CE and 10th-century Chinese documents make similar references.
The Faroese physician Niels Finsen is believed to be the father of modern phototherapy. He developed the first artificial light source for this purpose.[citation needed] Finsen used short wavelength light to treat lupus vulgaris, a skin infection caused by Mycobacterium tuberculosis. He thought that the beneficial effect was due to ultraviolet light killing the bacteria, but recent studies showed that his lens and filter system did not allow such short wavelengths to pass through, leading instead to the conclusion that light of approximately 400 nanometers generated reactive oxygen that would kill the bacteria.[68] Finsen also used red light to treat smallpox lesions. He received the Nobel Prize in Physiology or Medicine in 1903.[69] Scientific evidence for some of his treatments is lacking, and later eradication of smallpox and development of antibiotics for tuberculosis rendered light therapy obsolete for these diseases.[70]
From the late nineteenth century until the early 1930s, light therapy was considered an effective and mainstream medical therapy in the UK for conditions such as varicose ulcer, 'sickly children' and a wide range of other conditions. Controlled trials by the medical scientist Dora Colebrook supported by the Medical Research Council, indicated that light therapy was not effective for such a wide range of conditions.[71]
See also
Blood irradiation therapy
Free-running sleep
Low level laser therapy
Sun tanning
UV-B lamps
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^Westrin, Åsa; Lam, Raymond W. (October 2007). "Seasonal Affective Disorder: A Clinical Update". Annals of Clinical Psychiatry. 19 (4): 239–246. doi:10.1080/10401230701653476. PMID 18058281.
^Mayo Clinic Staff (20 March 2013). "Light Therapy. Tests and Procedures. Risks". Mayo Clinic. Retrieved 7 February 2014.
^Roger DR (2007-12-04). "Practical aspects of light therapy". American Medical Network. Retrieved 2009-06-09.
^F. Ellinger Medical Radiation Biology Springfield 1957
^Moller, Kirsten Iversen; Kongshoj, Brian; Philipsen, Peter Alshede; Thomsen, Vibeke Ostergaard; Wulf, Hans Christian (2014-11-12). "How Finsen's light cured lupus vulgaris". Photodermatol Photoimmunol Photomed. 21 (3): 118–24. doi:10.1111/j.1600-0781.2005.00159.x. PMID 15888127.
^"The Nobel Prize in Physiology or Medicine 1903". Nobelprize.org. Nobel Media AB. 2016-11-01. Archived from the original on 2016-10-22. Retrieved 2016-11-01.
^"Engines of our Ingenuity No. 1769: NIELS FINSEN". Retrieved 2014-04-05.
^Edwards, Martin. "Dora Colebrook and the evaluation of light therapy". The James Lind Library. Royal College of Physicians of Edinburgh and Minervation Ltd. Retrieved 12 February 2017.
External links
Media related to Phototherapy at Wikimedia Commons
Our Friend, the Sun: Images of Light Therapeutics from the Osler Library Collection, c. 1901–1944. Digital exhibition by the Osler Library of the History of Medicine, McGill University
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Mood disorder (F30–F39, 296)
History
Emil Kraepelin
Karl Leonhard
John Cade
Mogens Schou
Frederick K. Goodwin
Kay Redfield Jamison
Symptoms
Hallucination
Delusion
Emotional dysregulation
Anhedonia
Dysphoria
Suicidal ideation
Mood swing
sleep disorder
Hypersomnia
Insomnia
Psychosis
Racing thoughts
Reduced affect display
Depression (differential diagnoses)
Spectrum
Bipolar disorder
Bipolar I
Bipolar II
Cyclothymia
Bipolar NOS
Depression
(Major depressive disorder
Dysthymia
Seasonal affective disorder
Atypical depression
Melancholic depression)
Schizoaffective disorder
Mania
Mixed affective state
Hypomania
Major depressive episode
Rapid cycling
Treatment
Anticonvulsants
Carbamazepine
Lamotrigine
Oxcarbazepine
Valproate
Sodium valproate
Valproate semisodium
Sympathomimetics, SSRIs & similar
Dextroamphetamine
Methylphenidate
Bupropion
Sertraline
Fluoxetine
Escitalopram
Other mood stabilizers
Antipsychotics
Lithium
Lithium carbonate
Lithium citrate
Lithium sulfate
Lithium toxicity
Atypical antipsychotics
Non-pharmaceutical
Clinical psychology
Electroconvulsive therapy
Involuntary commitment
Light therapy
Psychotherapy
Transcranial magnetic stimulation
Cognitive behavioral therapy
Dialectical behavior therapy
v
t
e
Extracorporeal assistance, performance, and therapy (ICD-9-CM V3 99, ICD-10-PCS 5-6)
Ultraviolet light therapy
PUVA therapy (Photopheresis)
Other
Electromagnetic therapy
Hyperthermia therapy
Therapeutic hypothermia
Plasmapheresis
Light therapy
Therapeutic ultrasound
UpToDate Contents
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… ustekinumab have been described in case reports in HIV-associated PsA . Psoralen and pulsed ultraviolet light therapy may be effective for both the skin and joint manifestations. Anti-TNF agents may be beneficial …
… Other drugs or non-pharmacological treatment options that appear to be promising include clofazimine, psoralen and ultraviolet light A (PUVA), photopheresis, radiation therapy, and novel molecules such as a …
… Foundation have issued joint guidelines for the treatment of psoriasis with phototherapy . Therapeutic doses of UV light can be administered as narrowband ultraviolet B (UVB) phototherapy, broadband UVB phototherapy …
…enroll on a clinical trial, the main treatment options are nonpharmacologic therapies, such as extracorporeal photopheresis and psoralen ultraviolet irradiation (PUVA) therapy, and the use of additional immunosuppressive …
… administration. Treatment with triamcinolone can be repeated in four to six weeks for a maximum of three injections. Stabilization therapy can be given with or without concomitant narrowband ultraviolet B (NB-UVB) …
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Thermal burns of the spectacle associated with supplementary heating in native New Zealand geckos.
Gartrell BD, Ahn JY, Khude R, Dougherty N, Johnson K, McCutchan J, Clarke A, Hunter S.
New Zealand veterinary journal. 2020 Mar;68(2)126-133.
The fast and accurate detection of Carcinoembryonic Antigen (CEA) plays an important role in clinical cancer treatment and therapy. An ultrasensitive photoelectrochemical (PEC) immunosensor for the detection of CEA was constructed using CdSe@BiVO co-sensitized TiO nanorods as photoactive materials.
Recent advances of lanthanide-doped upconversion nanoparticles for biological applications.
Li H, Wang X, Huang D, Chen G.
Nanotechnology. 2020 Feb;31(7)072001.
Near infrared (NIR) excited lanthanide-doped upconversion nanoparticles (UCNPs) are emerging as a new type of fluorescent tag for biological applications, which can emit multi-photon ultraviolet, visible or NIR luminescence for imaging or activation of photosensitive molecules. Here, we present a co
ultraviolet therapy: [ ther´ah-pe ] treatment . activity therapy in the nursing interventions classification , a nursing intervention defined as the prescription of and assistance with specific physical, cognitive, social, and spiritual activities to increase the range, frequency, or duration of an individual's (or group's) activity. aerosol ...
Ultraviolet Therapy - physiotherapy By : my friend Abdulaziz Althomali The best sleeping position for back pain, neck pain, and sciatica - Tips from a physical therapist - Duration: 12:15. Tone ...
When ultraviolet light is used for phototherapy, it comes in two different varieties, the New York Times explains: UVA and UVB light. UVA light makes up most of the ultraviolet light in the sun. UVB light has more of an effect on skin ...