Some patients may also have the option to undergo phototherapy at home using specialised devices, after receiving thorough guidance and counselling from trained experts. When undergoing home phototherapy treatments, it is important that patients follow the proper treatment steps and dosage instructions.
For Psoriasis / Eczema
1. Preparation
· UV Goggles. (Patient/User)
· Template (Cardboard cut out or dark colour opaque cloth).
· Home phototherapy device.
· Logbook.
2. Treatment Dose for NBUVB (Narrowband UVB)
Starting Dose | 100mJ |
Increase Dose | 50mJ *Please refer to Section 6 for dose adjustment* |
Maximum Dose | 4000mJ/5000mJ/6000mJ** |
**Please delete appropriately.
3. Calculation of Treatment Exposure Time
Time (sec) | = | Dose (mJ) | ÷ | Irradiance (mW/cm²) |
Example:
100mJ ÷ 5.5mW/cm² = 18 seconds
4. Treatment Frequency
Initial: 2 to 3 times a week (No consecutive days)
5. Side Effects
Common side effects:
· Redness
· Itch
· Tanning
· Blistering
Long term side effects:
· Skin aging
· Skin cancer
6. Treatment Dose Adjustment
Redness | Itch | Tenderness Stinging Pain | Duration | Plan |
No | No | No | - | Increase by 50mJ |
Yes | No | No | Less than 48 hours | Increase by 50mJ |
Yes | Yes | No | Less than 48 hours | Hold Dose |
Yes | No | No | 48-72 hours | Hold Dose |
Yes | Yes | No | 48-72 hours | Hold Dose, itch persist reduce 25% |
Yes | No | No | More than 72 hours | Reduce by 25% |
Yes | No/Yes | Yes | | *Reduce by 50% |
*Only resume treatment after redness had subsided.
7. Missed Treatment
Interval | Adjustment of treatment dose |
>1 week to 2 weeks | Reduce 25% |
>2 weeks to 3 weeks | Reduce 50% |
>3 weeks | Restart to 100mJ |
8. Treatment Advice
· Before starting home phototherapy, take initial photos. Take photos every 3 months to monitor the progress.
· Do not apply any topicals 4 hours before treatment as it will affect UV treatment.
· Avoid sun exposure 24 hours after treatment.
· Continue with the topical medication as prescribed by the doctor.
· Apply moisturizer frequently, at least 3 times a day.
· Monitor for redness, itch, or tenderness after treatment. Adjust treatment dose according to the duration of redness.
· If you experience any discomfort, have a cold shower/cold compress, and apply cold moisturizer cream.
· If you require more advice, call the phototherapy clinic via appointment hotline during office hours.
· Review Doctor as scheduled for monitoring skin progress.
· Yearly maintenance and servicing on home phototherapy device. (Please liaise with vendor)
9. Logbook Sample
Yearly Site: | | | | | | | |
Session No | Date | Dose (mJ) | Time (sec) | Redness | Itch | Tenderness | Comment |
| | | | | | | |
| | | | | | | |
| | | | | | | |
For ease of recording home treatment sessions, patients may download our logbook template using this link:
Home Treatment Logbook.xlsx
For Vitiligo
1. Preparation
· UV Goggles. (Patient/User)
· Template (Cardboard cut out or dark colour opaque cloth).
· Home phototherapy device.
· Logbook.
2. Treatment Dose for NBUVB (Narrowband UVB)
Starting Dose | 50mJ |
Increase Dose | 20mJ *Please refer to Section 6 for dose adjustment* |
Maximum Dose | 4000mJ |
3. Calculation of Treatment Exposure Time
Time (sec) | = | Dose (mJ) | ÷ | Irradiance (mW/cm²) |
Example:
50mJ ÷ 5.5mW/cm² = 9 seconds
4. Treatment Frequency
Initial: 2 to 3 times a week (No consecutive days)
5. Side Effects
Common side effects:
· Redness
· Itch
· Tanning
· Blistering
Long term side effects:
· Skin aging
· Skin cancer
6. Treatment Dose Adjustment
Redness | Itch | Tenderness Stinging Pain | Duration | Plan |
No | No | No | - | Increase by 20mJ |
Yes | No | No | Less than 48 hours | Increase by 20mJ |
Yes | Yes | No | Less than 48 hours | Hold Dose |
Yes | No | No | 48-72 hours | Hold Dose |
Yes | Yes | No | 48-72 hours | Hold Dose, itch persist reduce 25% |
Yes | No | No | More than 72 hours | Reduce by 25% |
Yes | No/Yes | Yes | | *Reduce by 50% |
*Only resume treatment after redness had subsided.
7. Missed Treatment
Interval | Adjustment of treatment dose |
>1 week to 2 weeks | Reduce 25% |
>2 weeks to 3 weeks | Reduce 50% |
>3 weeks | Restart to 50mJ |
8. Treatment Advice
· Before starting home phototherapy, take initial photos. Take photos every 3 months to monitor the progress.
· Do not apply any topicals 4 hours before treatment as it will affect UV treatment.
· Avoid sun exposure 24 hours after treatment.
· Continue with the topical medication as prescribed by the doctor.
· Apply moisturizer frequently, at least 3 times a day.
· Monitor for redness, itch, or tenderness after treatment. Adjust treatment dose according to the duration of redness.
· If you experience any discomfort, have a cold shower/cold compress, and apply cold moisturizer cream.
· If you require more advice, call the phototherapy clinic via appointment hotline during office hours.
· Review Doctor as scheduled for monitoring skin progress.
· Yearly maintenance and servicing on home phototherapy device. (Please liaise with vendor)
9. Logbook Sample
Site: | | | | | | | |
Session No | Date | Dose (mJ) | Time (sec) | Redness | Itch | Tenderness | Comment |
| | | | | | | |
| | | | | | | |
| | | | | | |
|
For ease of recording home treatment sessions, patients may download our logbook template using this link:
Home Treatment Logbook.xlsx