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Phototherapy: what it is, what it is for and how it is used

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Although it may seem somewhat mystical, light can cure, or at least reduce the symptoms of certain medical problems and psychological disorders.

Phototherapy is a set of treatments in which light is used to help increase mood in psychiatric patients and also reduce inflammation and other skin problems. Next we will see in more depth what this technique consists of, especially in the field of psychiatry.

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What is phototherapy?

Phototherapy, also called luminotherapy or light therapy, is a therapeutic tool in which Electromagnetic radiation, that is, light, is used for the treatment of medical diseases and psychopathological disorders.. The type of light applied can be visible, infrared or ultraviolet radiation.

In the field of medicine, phototherapy is used, above all, in the treatment of skin diseases, such as vitiligo or psoriasis. In the case of psychology and psychiatry, it has been found useful for treating mood disorders, especially seasonal affective disorder.

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What does it consist of?

Basically, phototherapy involves exposing the patient to a device, such as a phototherapy lamp, or to sunbathing, so that the light hits their skin and activates biochemical processes. The light from the phototherapy lamp is very similar to natural light.

Phototherapy is believed affects brain chemicals associated with mood and sleep. For this reason it is used in the treatment of seasonal affective disorder, a state disorder of the mood that occurs at a certain time of the year, especially associated with the lack of light natural. For this reason, most people who present it manifest it in autumn or winter.

Which has benefits?

When used in psychopathology, since it is not a pharmacological treatment, phototherapy is associated with a treatment that involves few side effects. In case drugs are already being consumed, especially antidepressants, or is going to psychological therapy, the use of this technique can contribute to increase the effectiveness of these treatments, allowing a lower dose of drugs to be consumed.

It is also used in pregnant or breastfeeding women who cannot take psychoactive drugs because, although not all of them, there is a risk that they will end up in the baby.

What diseases and disorders is it used for?

As we were already commenting, phototherapy It is used especially for dermatological diseases and mood disordersHowever, there are many more conditions where the technique has shown high effectiveness.

Among the mental disorders for which it is used we can find mood disorders such as:

  • seasonal affective disorder
  • Depressions not associated with the season of the year

But, in addition, they are used to treat disorders in which the person presents some kind of imbalance in your sleep cycle, either for work reasons, long trips (jet-lag) or difficulties in falling asleep.

  • jet lag
  • Sleep disorders
  • night work hours
  • Dementia

As for skin diseases, we find psoriasis. In phototherapy applied to this type of problem, UV light needs to be filtered since it can damage both the eyes and the skin.

Possible side effects

In the case of phototherapy applied for mood disorders, despite being a safe technique, it does involves certain risks, which are mild and short-lived. Among these we can find:

  • Headache
  • dizziness
  • Eye fatigue
  • Irritability
  • Nervousness (associated with bipolar disorder)
  • mania and euphoria
  • hyperactivity

Side effects can be controlled by reducing treatment time, staying away from the lamp, take breaks during long sessions or if you change the time of day when you uses. It may also be that they appear immediately after starting the therapy, but that these decrease as the therapy progresses.

Precautions

Although the use of phototherapy may seem harmless, we must not forget that it is a medical treatment, and therefore precautions should be taken when using it, in addition to trusting the professional judgment of the doctor, psychologist or psychiatrist who has used it recommended.

Some of the considerations to take into account before starting light treatment are the know if you have a skin disease that makes it especially sensitive to light and that it may worsen if this technique is applied, as would be the case with systemic lupus erythematosus. It is of special consideration the case of having an eye disease, which makes the eyes more vulnerable to light injuries.

If you are taking a drug, you should ask the professional who prescribed it and look at the package insert to find out if it increases sensitivity to sunlight. Some of the medications that can have this side effect are certain antibiotics, anti-inflammatories or phytotherapeutic treatments, such as St. John's wort.

In people who suffer Bipolar disorder, it is especially important to monitor that phototherapy is being applied, since one of its side effects is to trigger mania.

Ultraviolet light

Phototherapy lamps must be designed to filter ultraviolet light, which is harmful to the skin and eyes. Despite the fact that in most cases, and especially for use on the skin, they are already designed to filter it out, they do not always do so completely.

It is for this reason that special care must be taken with this type of device because, and as we were already saying, although they may seem very harmless, in case there is no good control, there is a risk of suffering from skin problems, such as spots, melanoma and Burns. Go to a dermatologist before and during the application of the technique, even if it is being used for a mood disorder, it is always recommended.

When is it better to start it?

Prescribed phototherapy for people with seasonal affective disorder is usually started at early autumn, when the sky begins to cloud over many regions of the world and the rains. Due to the lack of sun, the disorder appears. It is because of that phototherapy is applied to make up for the lack of light stimulation in people who are more sensitive to it. Generally, the treatment continues until spring, when there is already more outside light and this is enough to maintain a good mood and higher energy levels.

During phototherapy, the person sits or works near a specialized lamp. To be effective, the light from the lamp must enter the eyes indirectly, in addition to hitting the skin. One of the biological bases of depression is related to the lack of light and alterations in sleep cycles, for this reason, when entering through the eye This light makes it possible to regulate sleep cycles, since it helps the brain to regulate itself and, when there is light, it is clear that it is not the time to sleep, that it is day.

But beware! the lamp should not be looked at directly, since it can damage the eyes. The recommendations of the health professional who has recommended it should be followed, in addition to looking at the manufacturer's instructions.

It is not a therapy that automatically induces improvement. It takes time and perseverance, like any other treatment. We should not expect that with a single session we will have a significant improvement in our state of mind.

One of the recommendations is to have this lamp turned on near a place that we frequently inhabit at home., such as the desk, the living room or some other place where we spend a lot of time.

How should it be applied to be effective?

There are three key elements to ensure that this therapy is effective.

1. Intensity

Lamp intensity is recorded in lux (“light” in Latin), which is a measure of the amount of light received. For seasonal affective disorder, their usual recommendation is to use a 10,000 lux intensity lamp, placed at a distance of half a meter from the face.

2. Duration

With an intensity of 10,000 lux, phototherapy usually requires sessions between 20 and 30 minutes. If the intensity of the lamp is lower, let's say 2,500 lux, longer sessions may be needed.

3. time of day

For most people, phototherapy is most effective when done early in the morning, right after waking up. Although, there are people who may find it more useful to receive the sessions at other times of the day. For this, the doctor should be consulted to establish a schedule that best suits the particular case.

Other types of lamps

Other similar products are these.

1. infrared radiation lamp

It is used as thermal therapy, using the infrared camera. It is not visible light, it simply gives off heat, and it is not applied for mood disorders, but for skin problems.

2. Laser

It is a special artificial light, which consists of the amplification of light through a process of stimulated emission of radiation. It is considered a phototherapy technique, although it is not applied in the field of psychological disorders and its application in skin diseases is very specific.

It requires a light and a chemical compound, which can be liquid, solid or gaseous.. The light stimulates the chemical, increasing its energy. It is when the energy falls on the compound that the laser itself appears, seeing itself as a single color and, sometimes, with the ability to cut tissue.

There are two types of lasers for medical purposes: the soft and the hard.

The soft one, with a radiation of 10 - 20 mW (milliwatts), is used by sweeping the skin and has analgesic, anti-inflammatory and tissue regeneration effects.

The hard one has a radiation greater than 10 W (watts), being its use quite powerful. It can cause cell vaporizations, photocoagulations, or even cell explosions. It can be used to cut tissue (laser scalpel), photocoagulate in the case of retinal detachment, or remove tattoos and spots. May have pathogenic effects, is contraindicated in pregnant women and in people with oncological diseases.

About the sunbeds

When talking about phototherapy lamps, one may think that they are similar to sunbeds, that is, they are used to tan. Since the benefits of sunlight are already known in popular culture, There are not a few who can fall into the error of thinking that sunbeds serve as a good alternative to sunlamps., in addition to giving us a brunette for the summer. This is not like this.

It has not been proven that they help alleviate the symptoms of seasonal affective disorder, in addition, they release ultraviolet light that, as we were commenting before, can damage the skin and increase the risk of skin cancer.

Bibliographic references:

  • Golden, R. N., Gaynes, B. N., Ekstrom, B.D. (2015). Efficacy of phototherapy in mood disorders: review and meta-analysis of the evidence. Am J Psychiatry.
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