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Understanding Phototherapy for Eczema and Atopic Dermatitis
Blog January 19, 2025

Understanding Phototherapy for Eczema and Atopic Dermatitis

Dr. Yeonseung Choe
Dr. Yeonseung Choe
Chief Director

Table of Contents

In the previous post on itch management, I mentioned the need to consider all possible means for symptom relief. At that time, I completely forgot to discuss phototherapy, so I'm briefly adding it now.

This is a diagram I showed in the previous post. The diagram indicates that UV-based therapy can be helpful for epidermal hyperinnervation and imbalance of NEF and NRF levels. I explained this in more detail in the previous post, so I will skip over it here. For more details, please refer to the previous post.

Reasons for Body Itching (Causes of Skin Pruritus) - Itching is not limited to skin diseases like atopic dermatitis. It can be caused by various factors.

First, improving skin symptoms through ultraviolet irradiation is called phototherapy. Source: Journal of the Korean Medical Association, Treatment of Atopic Dermatitis.

Phototherapy involves irradiating the skin with light in various ultraviolet wavelength ranges. It is categorized into UVA, UVB, etc., depending on the wavelength range. Among these, the use of only a narrow range of UVB is sometimes specifically called narrow-band UVB.

It is known that the physiological effects vary slightly depending on the ultraviolet wavelength range. If you look at sunscreens, you'll see UV protection capabilities indicated by SPF and PA. SPF primarily refers to UVB protection, while PA refers to UVA protection.

UV protection is emphasized as very important for skin health. Ironically, UV irradiation is also used for the treatment of major skin diseases such as atopic dermatitis and psoriasis. I tend to think of this in terms of the concept pair of eustress and distress.

Separate reports are emerging on the effects of phototherapy using various wavelengths in atopic dermatitis. It seems that experiments are being conducted with various wavelengths to maximize therapeutic effects while minimizing skin irritation. Many studies are appearing that apply excimer lasers using a 308 nm wavelength for various skin diseases such as atopic dermatitis, eczema, and vitiligo.

Phototherapy is more frequently utilized for vitiligo and psoriasis than for atopic dermatitis. Therefore, articles like this can sometimes be seen. Publication of a paper on synergistic effects of combined Western and Korean medicine treatment for vitiligo

Various problems due to vitamin D deficiency caused by insufficient UVB exposure are being discussed. At this point, it's no longer just a skin-related issue, so I'll need to organize my thoughts more on the effects of sunlight.

It seems that the environment is unfavorable in many ways to recommend sunbathing to patients. Fine dust is also an issue. Furthermore, if one doesn't understand the appropriate level of exposure or stimulation, it could actually be detrimental to skin health. In Korean medicine clinics, devices like Phanos are sometimes utilized. In dermatology clinics, narrow-band UVB or excimer lasers are sometimes adopted and used. When dealing with a broad wavelength spectrum, it seems crucial to carefully adjust the intensity of stimulation or exposure time to avoid excessive skin irritation.

Summary

  1. Sunlight, specifically ultraviolet rays of certain wavelengths, can provide beneficial stimulation to the skin, aiding in skin conditioning.

I will continue the discussion on topical Korean medicine formulations next.

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Dr. Yeonseung Choe

Dr. Yeonseung Choe Chief Director

I have met many patients who came after visiting multiple medical institutions and departments for persistent or recurrent conditions. Symptoms normally handled by different specialties—such as abdominal pain, headaches, palpitations, dizziness, and insomnia—may overlap in one person. Sometimes there is no clear improvement despite taking medication for each symptom, and being unwell gradually becomes part of daily life. In these cases, I look beyond individual diagnoses and examine how the symptoms connect and change together. Asking only about the most uncomfortable symptom today does not reveal the full course. I look at when the body first began to change and what happened after illness, surgery, childbirth, or starting and stopping medication. I also review changes in weight, diet, and sleep, then trace which symptoms improved with previous treatment and which remained. Test results, diagnoses, and the course of previous treatment are important for understanding the current condition. Clinical research in modern Korean medicine, physiological and pathological research in modern medicine, and observations recorded in classical Korean medicine texts offer different perspectives on the same body. Rather than fitting a patient into one perspective, I consider what each can and cannot explain and look for clues that connect symptoms and treatment histories that were previously considered separately.

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