Clinical UM Guideline

This document addresses the use of home ultraviolet light (UV) therapy to treat various skin conditions.

Note: Please see the following document that addresses the treatment of skin conditions:

• ANC.00007 Cosmetic and Reconstructive Services: Skin Related

Medically Necessary:

An in-home Ultraviolet B (UVB) light therapy delivery device is considered medically necessary when conditions A and B are met:

1. The treatment is for one of the following conditions:
   1. Atopic dermatitis, when topical treatment alone has failed; or
   2. Cutaneous T-cell lymphoma, including mycosis fungoides and Sézary syndrome; or
   3. Pityriasis lichenoides; or
   4. Pruritus of hepatic disease; or
   5. Pruritus of renal failure; or
   6. Psoriasis, when topical treatment alone has failed; or
   7. Vitiligo, when topical treatment alone has failed;
      and
2. The treatment meets both of the following criteria:
   1. Treatment is conducted under a physician’s supervision with regularly scheduled exams; and
   2. Treatment is expected to be long term (3 months or longer).

Not Medically Necessary:

An in-home UVB delivery device is considered not medically necessary for all other conditions not mentioned above and when the criteria above are not met.

Home ultraviolet light therapy using ultraviolet A (UVA) light devices are considered not medically necessary for all indications.

The following codes for treatments and procedures applicable to this guideline are included below for informational purposes. Inclusion or exclusion of a procedure, diagnosis or device code(s) does not constitute or imply member coverage or provider reimbursement policy. Please refer to the member's contract benefits in effect at the time of service to determine coverage or non-coverage of these services as it applies to an individual member.

When services may be Medically Necessary when criteria are met:

When services are Not Medically Necessary:
For the procedure and diagnosis codes listed above for UVB therapy when criteria are not met or for all other diagnoses not listed; or when the code describes a procedure or situation designated in the Clinical Indications section as not medically necessary such as UVA therapy.

Summary

Home-based narrowband UVB therapy is an effective and evidence-based treatment for several dermatologic conditions such as atopic dermatitis, pityriasis lichenoides, psoriasis, vitiligo, cutaneous T-cell lymphoma, and pruritus related to hepatic or renal conditions. It offers comparable efficacy to office-based phototherapy for individuals requiring frequent treatments, but requires strict safety measures and routine medical oversight to mitigate risks like sunburn. However, UVA therapy remains unsuitable for home use due to the need for photosensitizers and the increased risks of complications.

Description of UV Light Therapy

UV light therapy is an established treatment for skin disorders that uses UV light alone, or in combination, with topical preparations or oral medications. UV therapy involves exposure of the individual’s skin to ultraviolet A (UVA) or ultraviolet B (UVB) radiation using a specialized light source. As an alternative to UV therapy alone, some individuals respond to the Goeckerman or modified Goeckerman treatment, which is comprised of coal tar dressings in combination with exposure to UVB light.

Exposure to UV light, both in the natural and therapeutic setting, brings the risk of skin damage and an increased risk of skin cancer. It has long been known that exposure to UV light is a risk factor in the development of skin cancer. In 2025, a study by Fowler quantified a significant increase in skin mutational burden in individuals undergoing narrow-band UVB therapy. The selection of individuals undergoing UV therapy should be conducted thoughtfully and take multiple considerations into consideration, including minimal erythema dose, Fitzpatrick skin type, prior UV exposure, the condition being treated, and others.

UVA phototherapy is typically given in combination with a photosensitizer, most commonly psoralen. Psoralen makes the skin more sensitive to ultraviolet light when applied directly to the skin or taken orally. This combined approach is referred to as photochemotherapy or PUVA (Psoralen + UVA). PUVA is typically used for more severe cases of skin diseases that fail to respond to topical therapy. Due to higher risk of adverse reactions, PUVA therapy and UVA phototherapy without use of a photosensitizer are generally limited to the office setting (Archier, 2012).

UVB light can be categorized as wide-band (or broad-band) and narrow-band, which refers to the range of wavelengths included in the UV light source. The wide-band devices deliver full spectrum UVB light. The narrow-band devices deliver a very narrow range of the UV light spectrum, focusing on the specific wavelengths most effective for the treatment of disease. In contrast to PUVA therapy, UVA therapy without photosensitizers and UVB therapy do not appear to increase skin cancer risk. In a retrospective study of 3506 individuals with a variety of skin conditions (mostly psoriasis or eczema) treated with UVB phototherapy, there was no significant difference in the incidence of skin cancer in treated individuals compared to the general population (Wang, 2024). Mean follow-up duration was 7.3 years. Likewise, no cumulative dose-response correlation between UVB exposure and skin cancer was observed.

Narrow-band UVB (NB-UVB) treatment is typically offered using a light “booth” or “light box” several times a week for as long as the condition persists. This may be for the lifetime of the individual. In the past, most individuals needed to visit a doctor’s office or other facility for these treatments. However, UVB treatment is available for home use under strict physician supervision.

The supervision of a physician is needed to make sure that the dose of UV light delivered to the treatment area is in the therapeutic range but does not exceed safe levels. Skin cancer screening, skin typing, or phototesting is usually performed prior to treatment to determine the appropriate UV radiation dose. Multiple sessions over 3 or more months are often required to produce clearing of skin lesions. During UV light therapy, individuals need regular medical assessments to evaluate the effectiveness of the therapy and to monitor for the development of side effects such as sunburn, pruritus (itching), photoaging, and, when photosensitizers are used, liver or kidney disease.

UVB home therapy devices

Most individuals undergoing UV treatment can be treated in the office or home. Home therapy with UVB light is an alternative for those who require treatments at a frequency that makes office visits overly burdensome. Concerns regarding over-exposure to unsafe levels of UVB radiation in the home setting have been addressed with the evolution of integrated security features such as digital timers, lockouts, preprogrammed treatment protocols, and exposure counters. As with UVB therapy performed in the office, routine clinical evaluation should be conducted for individuals undergoing home therapy to ensure that exposure is kept to the minimum level compatible with adequate control of disease and the prevention of complications.

Atopic dermatitis (AD)

The initial treatment of AD typically consists of topical and non-pharmacological therapies as well as modifications in individual environments or occupations. Phototherapy is limited to those whose symptoms are not adequately controlled by the initial treatment modalities. There are numerous treatment protocols, but in general, individuals are dosed according to their minimal erythema dose and/or Fitzpatrick skin type. The AAD (2014) notes “Phototherapy can be administered on a scheduled but intermittent basis over time, or more continuously as maintenance therapy, for patients with refractory or chronic disease.”

Cutaneous T-cell lymphoma (CTCL)

Non-Hodgkin lymphoma includes two types of cutaneous lymphomas, T-cell lymphomas (CTCLs) and B-cell lymphomas (CBCLs), with CTCLs accounting for the majority of cutaneous lymphomas. According to the National Comprehensive Cancer Network^® (NCCN) Clinical Practice Guidelines (CPGs) in Oncology^® for Primary Cutaneous Lymphomas, Mycosis Fungoides (MF) is the most common CTCL while Sézary syndrome (SS) accounts for less than 5% of CTCL cases (2025). MF is considered an indolent malignancy and generally is associated with a slow progression while the median survival of SS is only 32 months from diagnosis (Trautinger, 2006). While CTCLs develop in the skin, the disease can progress and involve other areas such as lymph nodes, blood or visceral organs. Prognosis and treatment are dependent upon several factors including, but not limited to extent and type of skin involvement, overall stage, whether extracutaneous disease is present and peripheral blood involvement (NCCN, 2025).

Multiple Sclerosis

Treatment with UVB radiation has been investigated as a way to limit the development of multiple sclerosis (MS) and to improve symptoms. Hart and colleagues (2018) performed a study of 20 individuals with neurological symptoms that are predecessor to MS known as clinically isolated syndrome (CIS). All participants received vitamin D₃ supplementation and half also received UVB therapy. At 1 year, 100% of those in the no phototherapy arm and 70% in the phototherapy arm had converted to MS, but this difference was not statistically significant. Essa and colleagues (2023) studied 47 individuals with relapsing-remitting MS. A total of 24 participants received UVB treatment sessions for 4 weeks while 23 other participants took vitamin D₃ supplementation for 12 weeks. Postural control and cognitive function were tested before and after treatment. Although both groups showed improvement following treatment, there were no statistically significant differences between the two groups for any tested measure  following treatment. Current evidence is insufficient to support the use of UVB as a treatment for MS.

Mycosis Fungoides and Sézary syndrome

Ultraviolet light therapy is an established treatment of MF and therapies have included UVB (broad-band and narrow-band) and UVA treatments (Hodak, 2015). Phototherapy can be used at various stages of MF, either alone or in combination with systemic therapy (Hodak, 2015). The 2025 NCCN CPGs for Primary Cutaneous Lymphomas include a 2A indication for UVB therapy for patch/thin plaques in MF/SS with limited/localized or generalized skin involvement. In addition, NCCN includes a 2A indication for UVB in stage III MF/SS, noting that while generalized skin directed therapies may not be well tolerated in this population, phototherapy can be used successfully. The CPGs note that NB-UVB treatment is available in office or as a home panel or unit.

Because MF is rare, there are very few appropriately powered randomized controlled trials (RCTs) that assess its effectiveness. Most recommendations are based on small studies, case series, or expert opinion. Olsen and colleagues (2016) reported the results of three studies that included home broad-based UVB therapy. These studies included a total of 109 individuals who presented with stage 1A or 1B MF. Home treatments included daily phototherapy while office-based treatments were carried out 3 times per week. A total of 58 individuals received home-based therapy, with 48 of these 58 individuals receiving only home-based therapy and the remaining 10 individuals receiving home therapy after office-based therapy. The authors noted that maintenance regimens within the studies varied and likely affected response duration. Relapse was uncommon while individuals were on maintenance phototherapy (2/18), but was more common once maintenance phototherapy was discontinued (12/23). The authors found that individuals using home-based phototherapy were much more likely to continue maintenance phototherapy than individuals who received office-based phototherapy.

Pityriasis lichenoides

UVB has also been recommended as a treatment for several other conditions. Pityriasis lichenoides is a rare collection of skin disorders that have been reported to progress to cutaneous lymphoma or an ulceronecrotic presentation, both of which carry a significant risk of mortality. Treatment is difficult and aggressive approaches are usually recommended. According to one source, the use of UVB phototherapy has been the most successful treatment method and is considered first-line therapy (Khachemoune, 2007).

Pruritus of hepatic or renal disease

Pruritus associated with hepatic disease and renal failure are difficult to treat. Management is primarily focused on the treatment of the underlying symptoms such as pain and itching. Several treatment options are currently used, and UVB phototherapy has become widely accepted as an important tool in the management of these conditions (Wang, 2010).

Psoriasis

Koek and colleagues (2009) conducted a randomized controlled single-blind trial comparing office-based UVB treatment with home therapy for individuals with plaque or guttate psoriasis. This study involved 196 participants who were evaluated through the initial therapy, with the first 105 participants followed for an additional 12 months post-treatment. The authors reported that both treatments provided significant improvement from baseline, with home therapy being non-inferior to office-based treatment as measured by the psoriasis area and severity index (PASI) and the self-administered psoriasis area and severity index (SAPASI). No significant differences between groups were reported for total cumulative radiation dose or short-term side effects.

Unrue and colleagues (2019) conducted a multicenter, prospective, open-label, interventional study to assess the treatment efficacy, adherence, and satisfaction of an ultraviolet home phototherapy system. The study included 8 participants with stable plaque psoriasis. Matched control and study lesions were assessed on each participant. All participants that completed the 10-week study experienced an improvement in the treated lesions with a mean improvement of 57% in Psoriasis Severity Index (PSI; p<0.0001 vs. baseline, and p<0.0002 compared to the control lesions). Control lesions did not significantly change in PSI over the study period with a mean change of 9% (p=0.1411). No adverse events were reported. Treatment adherence was 96%. These results indicated that the home phototherapy system was a safe and effective monotherapy to manage plaque psoriasis in this group of participants.

The Joint American Academy of Dermatology (ADA)/National Psoriasis Foundation (NPF) guidelines of care for the management and treatment of psoriasis with phototherapy (2019) included the following recommendation:

Recommend No. 1.8
Home NB-UVB phototherapy is recommended for appropriate patients with generalized plaque psoriasis as an alternative to in-office NB-UVB phototherapy. (Strength of recommendation: B; Level of evidence: I)

In 2022, Cohen and colleagues performed a systematic review of the use of home-based devices for the treatment of skin conditions. A total of 4 RCTs evaluating home UVB phototherapy for psoriasis were included (Franken, 2015; Koek, 2009; Paul, 1983; Unrue, 2019). Conflicting evidence was identified for the efficacy of home-based UVB compared to traditional clinic-based administration. Three studies reported either significant improvements in PASI or PSI scores with home UVB use compared to controls, or non-inferiority of home therapy to office-based treatment. However, a study by Paul and colleagues (1983) showed the opposite outcome: while 90% of participants who were treated in a clinic with phototherapy experienced complete clearance of psoriasis lesions, only 40% of participants treated at home achieved the same result. Similar to the ADA/NPF guidelines, the review gave a grade of recommendation of B for home phototherapy (UVB) devices for psoriasis.

In 2024, Gelfand and colleagues published results from the Light Treatment Effectiveness (LITE) study, an open-label, parallel-group, noninferiority randomized clinical trial. This multicenter trial was conducted at 42 academic and private dermatology practices in the U.S. The objective was to compare the effectiveness of home- and office-based NB-UVB phototherapy for psoriasis. Participants were 12 years and older with plaque or guttate psoriasis randomized to receive a home NB-UVB machine or routine care with office-based NB-UVB for 12 weeks, followed by 12 weeks of observation. A total of 783 participants were enrolled: 393 received home-based phototherapy and 390 received office-based phototherapy. The main outcomes were Physician Global Assessment (PGA) score of 1 or lower (clear/almost clear skin) and Dermatology Life Quality Index (DLQI) score of 5 or lower (no to small effect on quality of life) at week 12. Results showed that 32.8% of individuals receiving home-based phototherapy and 25.6% of individuals receiving office-based phototherapy achieved clear/almost clear skin, and 52.4% and 33.6% achieved DLQI of 5 or lower, respectively. Home-based phototherapy was noninferior to office-based phototherapy for PGA and DLQI in the overall population and across all skin phototypes (a classification based on the amount of melanin in the skin). Home-based phototherapy, compared to office-based phototherapy, was associated with better treatment adherence (51.4% vs. 15.9% of participants, p<0.001). There was no evidence of misuse of home-based phototherapy based on dosing data captured from the machines, and there were no discontinuations due to adverse events in either group. The results indicate that home-based phototherapy was as effective as office-based phototherapy for plaque or guttate psoriasis in everyday clinical practice and had less burden to individuals.

Vitiligo

Vitiligo is an acquired depigmenting disorder characterized by well-defined white macules and patches on the skin due to loss of melanocytes. It is relatively common, affecting roughly 0.5-1% of the global population (Al-Smadi, 2023). In the United States, recent studies estimate an overall vitiligo prevalence around 0.76%- 1.11% (including undiagnosed cases). This equates to roughly 1.9 to 2.8 million U.S. adults as of 2020. Both sexes and all ethnic groups are affected at similar rates, though the condition may be more conspicuous on darker skin. Vitiligo can begin at any age but usually starts in childhood or young adulthood. About 50% of affected persons develop vitiligo by 20 years of age. Family history plays a role in some cases (approximately 20% have an affected relative), and vitiligo is often associated with other autoimmune diseases (especially thyroid disorders). The psychosocial impact is significant. Visible lesions can lead to stigma, low self-esteem, and reduced quality of life for many of those affected, underscoring the importance of effective management.

There is no permanent cure for vitiligo; management aims to stop or slow the spread of depigmentation and to restore skin color (repigmentation) as much as possible. An individualized treatment plan is essential. Dermatologists consider the individual’s age, extent and distribution of vitiligo, rate of progression, and impact on quality of life when choosing therapy. Some people with very limited vitiligo or those unbothered by their patches may opt for no medical treatment (using cosmetic camouflage instead), but many seek active treatment to regain pigment.

For localized vitiligo (limited areas), topical corticosteroids and topical calcineurin inhibitors (e.g., tacrolimus or pimecrolimus) are first-line treatments. These immunomodulating agents help suppress the immune attack on melanocytes and can induce repigmentation over months of use. Mid- to high-potency corticosteroid creams or ointments are typically applied to affected patches (often daily or twice daily) for a course of a few months. Corticosteroids can often restore pigment, especially on the face or trunk, but prolonged use may cause skin atrophy or other side effects, so treatment courses are usually limited or intermittent. Topical calcineurin inhibitors, which do not cause skin atrophy, are especially useful for sensitive areas like the face or intertriginous zones and have shown similar efficacy to steroids for vitiligo repigmentation. These topical therapies can be augmented by phototherapy for better results.

Narrowband ultraviolet B (NB-UVB) phototherapy is a cornerstone treatment for moderate to widespread vitiligo. Exposing the skin to NB-UVB light (311 nm) two or three times per week can stimulate melanocyte activity and migration, leading to gradual repigmentation of vitiliginous areas. Phototherapy is often combined with topical agents. For example, a topical steroid or calcineurin inhibitor and then NB-UVB has a synergistic effect. This form of photochemotherapy is different from the Psoralen + UVA (PUVA) therapy described above for psoriasis and does not share PUVA’s risks for adverse events. A randomized trial showed that NB-UVB plus a topical agent (steroid or vitamin D analog) achieved greater repigmentation than phototherapy alone (Al-smadi, 2023). Treatment typically needs to continue for at least 3-6 months before significant improvement is seen, and optimal results may require 12 or more months of consistent therapy. For small, well-defined lesions, targeted phototherapy (excimer laser, a form of 308 nm UVB) can be used on individual spots.

Severe or rapidly progressive vitiligo may require short courses of systemic corticosteroids to halt autoimmune activity and stabilize disease. Traditionally, most other treatments were used off-label, but a major recent advance has been the development of Janus kinase (JAK) inhibitor therapy. In July 2022, the U.S. FDA approved ruxolitinib 1.5% cream (Opzelura) as the first and only medication specifically indicated for repigmentation in vitiligo (FDA, 2022). Ruxolitinib, a topical JAK1/JAK2 inhibitor, is applied twice daily to affected areas (up to 10% body surface area) and can produce repigmentation, particularly on facial vitiligo, with results visible by about 24 weeks in many treated individuals.

Shan and colleagues (2014) published the results of UVB home phototherapy for vitiligo in a prospective uncontrolled trial (n=93). Treatments were administered 3 times each week at variable dosages. Follow-up was conducted every 3 months up to 1 year to evaluate repigmentation and the occurrence of complications. At 1 year of follow-up, 35 participants (38%) achieved excellent repigmentation, 16 (17%) achieved good repigmentation, 15 (16%) showed moderate repigmentation, 16 (17%) had poor repigmentation, and 11 (12%) had no repigmentation. A total of 25 (27%) individuals discontinued treatment due to poor repigmentation. This study was hampered by several design limitations including a lack of randomization and a lack of appropriate comparator groups.

In 2017, Bae and colleagues reported results of a systematic review and meta-analysis of studies of phototherapy for vitiligo. A total of 29 prospective studies reporting outcomes for 1201 individuals undergoing NB-UVB phototherapy were included. Primary outcomes were assessed as mild (≥ 25%), moderate (≥ 50%), or marked (≥ 75%) repigmentation responses on a quartile scale. The results were reported as follows:

The authors concluded that long duration NB-UVB phototherapy enhances treatment response in vitiligo. However, home-based phototherapy was not specifically addressed in this analysis.

A single-center prospective cohort study enrolled 94 individuals with non-segmental vitiligo to evaluate the efficacy and safety of home and outpatient NB-UVB therapy (Zhang, 2019). Over a period of 6 months, 48 participants received treatment at home while another 46 received outpatient treatment. Primary outcomes included efficacy, quality of life and adverse events. Overall, results were similar at 6 months between groups with higher efficacy seen on some measures for the outpatient group.

In 2020, Liu and colleagues published the results of a randomized pilot trial evaluating the efficacy and safety of NB-UVB phototherapy at home compared to hospital management of limited new-onset vitiligo. A total of 100 individuals with new-onset vitiligo (< 3 months) and < 5% body surface area involvement were randomized to either a home-based or a hospital-based treatment group. Participants received UVB phototherapy 3 times a week. At study-end (8 weeks), home- and hospital-based treatment showed similar efficacy but the frequency of adverse events, such as painful erythema, burning, blistering, and excessive hyperpigmentation, were increased in the home-based cohort. The authors noted that some in the home cohort intentionally extended their treatments in an effort to increase efficacy and recommended that attention be paid to avoid overexposure.

In 2021, Ashraf and colleagues published the results of a systematic review of three RCTs addressing home-based phototherapy for vitiligo. Two studies compared home-based with institution-based phototherapy, and one study compared home-based phototherapy with placebo. A total of 195 participants were included. The primary outcome was the effectiveness of home-based phototherapy in achieving repigmentation. Secondary outcomes were adverse effects of treatment, relapse rates and cost comparisons of institution- vs. home-based phototherapy. Therapy regimes varied between studies with four different types of NB-UVB devices used. Variable rates of repigmentation were achieved across studies but there was no significant difference in repigmentation rates between the groups. Adherence to treatment schedules was significantly better in home-based groups although adverse effects were also significantly higher in groups with home-based treatment vs. institution-based treatment (5% vs. 0% and 26% vs. 10%; two trials, 166 participants; RR, 4.69, 95% CI, 2.16-10.21; p<0.0001). These adverse effects included excessive hyperpigmentation, blistering and enlargement of vitiligo patches. No data were reported on long-term maintenance of treatment benefits. The authors concluded that “data were insufficient to form conclusions on effectiveness” of home-based treatment and that it would be difficult to recommend home-based treatment in clinical practice due to the higher risk of adverse events.

Thomas and colleagues (2021) reported the results of the Home Interventions and Light therapy for the treatment of Vitiligo Trial (Hi-Light Vitiligo Trial), an RCT which evaluated the comparative safety and effectiveness of a topical corticosteroid (TCS) and handheld NB-UVB therapy for the management of active limited vitiligo. The trial compared TCS (mometasone furoate 0.1% ointment) alone, NB-UVB alone, and TCS combined with NB-UVB. The primary outcome was treatment success at 9 months at a target patch assessed using the participant-reported Vitiligo Noticeability Scale. Target patch treatment success was noted in 17% (TCS alone), 22% (NB-UVB alone), and 27% (combination treatment) of participants. An adjusted between-group difference of 10.9% (95% CI, 1.0% to 20.9%; p=0.032; number needed to treat=10) showed that combination treatment was superior to TCS alone. NB-UVB alone was not superior to TCS with an adjusted between-group difference of 5.2% (95% CI, 4.4% to 14.9%; p=0.29; number needed to treat=19). Participants with greater than 75% adherence to treatment were more likely to achieve treatment success but experienced a loss of effects once treatment stopped. The results showed that combination therapy was more likely to produce improved treatment response. However, combination therapy was only successful in about one quarter of participants. Although 517 participants were randomized, primary outcome data was only available for 370 participants. Attrition rates were similar in all three treatment arms. Most attrition occurred in the first 3 months of follow-up. Many leaving the trial said they did so because they could not commit the time required for the treatment. The high attrition rate left this trial insufficiently powered to provide precise confidence limits for the outcomes.

The International Vitiligo Task Force has published expert recommendations for the diagnosis and management of vitiligo (van Geel, 2023). A consortium of 42 international vitiligo experts and 4 individuals with vitiligo worked together to develop a consensus management strategy intended to guide decision-making in clinical practice. In assessing therapeutic options, the task force concluded that NB-UVB (in office or home phototherapy) can be recommended in individuals with vitiligo with insufficient response to topical treatment and in extensive or rapidly progressive disease.

Khandpur and colleagues (2025) conducted a systematic review and meta-analysis of the clinical efficacy and safety of home-based handheld NB-UVB device therapy in vitiligo. A total of 13 studies including 557 individuals were assessed. The extent of repigmentation achieved over a median duration of 6 months (range 3-12 months) was determined to be as follows:

Three sessions per week resulted in significantly higher > 50% (p<0.01) and > 75% (p=0.01) repigmentation. Similar extents of repigmentation (good [> 50%] to excellent [> 75%]) were observed with both stable and active vitiligo. Altogether, 11.3% of participants showed no response to therapy. The most reported adverse event was erythema in 33.4% (95% CI: 19.3-49.2%) of treated individuals, with grade 3 and 4 erythema in 27 and 15 participants, respectively. The authors concluded that the NB-UVB device is suitable for home use with proper instructions and is an effective therapeutic option when the treatment frequency is 3 to 4 sessions per week.

There is increasing evidence supporting the benefits of home-based UVB phototherapy, and this treatment is generally accepted as a standard therapy for vitiligo.

UVA home therapy devices

The use of UVA as a home therapy has not been shown to be safe and effective when compared to the other alternatives, such as office or facility-based treatment UVA therapy or UVB therapy. The AAD (2014) notes that given the limited number of head-to-head trials, there is no definitive recommendation regarding which form of phototherapy is more effective. UVA therapy requires the concurrent use of photosensitizers, which greatly increase the risk of complications. UVB therapy does not involve the use of photosensitizers.

Atopic dermatitis: The most common of many types of eczema; atopic dermatitis is a skin disease characterized by areas of severe itching, redness, scaling, and loss of the surface of the skin; when the eruption has been present for a prolonged time, chronic changes occur due to the constant scratching and rubbing.

Erythema: Redness of the skin caused by increased blood flow in superficial capillaries. This can occur due to infection, inflammation, or skin injury. Erythema grades 3 and 4 in response to UV light are serious skin reactions indicating significant sunburn, with grade 3 involving blisters and grade 4 including deeper skin damage that may be permanent.

Mycosis fungoides (Cutaneous T-cell lymphoma): A type of non-Hodgkin’s lymphoma cancer that first appears on the skin.

Pityriasis lichenoides: A skin disorder of children and young adults that is characterized by a rash of unknown cause, which usually goes away on its own.

Plaque: A broad, raised area on the skin.

Pruritus: The medical term for itching.

Psoriasis: A genetic, systemic, inflammatory, chronic disorder, characterized by scaly, erythematous patches, papules, and plaques that are often pruritic (itchiness). It is commonly located over the surfaces of the elbows, knees, scalp, and around or in the ears, navel, genitals or buttocks, but may appear elsewhere. It can be altered by environmental factors and may be associated with other inflammatory disorders such as psoriatic arthritis, inflammatory bowel disease, and coronary artery disease. The major manifestation of psoriasis is chronic inflammation of the skin that may be disfiguring, painful and severely pruritic and may cause significant quality of life issues. Psoriasis is a chronic disease that waxes and wanes during an individual’s lifetime, the severity of which changes by treatment initiation and cessation. Some individuals can undergo spontaneous remissions.

Vitiligo: A skin disorder that causes loss of pigmentation (skin color) in patches. The disorder affects the skin on any part of the body, including the hair, inside of the mouth, and eyes.

Ultraviolet (UV) light: A form of light invisible to the human eye that naturally comes from the sun but can also be produced by artificial light sources such as tanning lamps. Three types of UV light exist: ultraviolet A (UVA), ultraviolet B (UVB), and ultraviolet C (UVC). Exposure to various intensities of UV light may be used as a therapeutic tool to treat a variety of skin conditions.

Peer Reviewed Publications:

1. Al-Smadi K, Ali M, Alavi SE, et al. Using a topical formulation of vitamin d for the treatment of vitiligo: a systematic review. Cells. 2023; 12(19):2387.
2. Archier E, Devaux S, Castela E, et al. Carcinogenic risks of psoralen UV-A therapy and narrowband UV-B therapy in chronic plaque psoriasis: a systematic literature review. J Eur Acad Dermatol Venereol. 2012; 26(suppl 3):22-31.
3. Ashraf AZ, Azurdia RM, Cohen SN. The effectiveness of home-based phototherapy for vitiligo: a systematic review of randomised controlled trials. Photodermatol Photoimmunol Photomed. 2022; 38(5):409-417.
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6. Eleftheriadou V, Thomas K, Ravenscroft J, et al. Feasibility, double-blind, randomized, placebo-controlled, multi-centre trial of hand-held NB-UVB phototherapy for the treatment of vitiligo at home (HI-Light trials: Home Intervention of Light Therapy). Trials. 2014; 15:51.
7. Essa SA, Elokda A, Mosaad D, et al. Efficacy of ultraviolet B radiation versus vitamin D(3) on postural control and cognitive functions in relapsing-remitting multiple sclerosis: a randomized controlled study. J Bodyw Mov Ther. 2023; 35:49-56.
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16. Khandpur S, Singh S, Paul D. Clinical efficacy and safety profile of handheld narrow band ultraviolet B device therapy in vitiligo - systematic review and meta-analysis. Indian J Dermatol Venereol Leprol. 2025; 91(3):321-331.
17. Kleinpenning MM, Smits T, Boezeman J, et al. Narrowband ultraviolet B therapy in psoriasis: randomized double-blind comparison of high-dose and low-dose irradiation regimens. Br J Dermatol. 2009; 161(6):1351-1356.
18. Koek MB, Buskens E, van Weelden H, et al. Home versus outpatient ultraviolet B phototherapy for mild to severe psoriasis: pragmatic multicentre randomized controlled non-inferiority trial (PLUTO study). BMJ. 2009; 338:b1542.
19. Liu B, Sun Y, Song J, Wu Z. Home vs hospital narrowband UVB treatment by a hand-held unit for new-onset vitiligo: a pilot randomized controlled study. Photodermatol Photoimmunol Photomed. 2020; 36(1):14-20.
20. Nikolaou V, Sachlas A, Papadavid E, et al. Phototherapy as a first-line treatment for early-stage mycosis fungoides: the results of a large retrospective analysis. Photodermatol Photoimmunol Photomed. 2018; 34(5):307-313.
21. Paul BS, Stern RS, Parrish JA, Arndt KA. Low-intensity selective UV phototherapy. a clinical trial in outpatient therapy for psoriasis. Arch Dermatol. 1983; 119:122-124.
22. Poligone B, Heald P. Menus for managing patients with cutaneous T-cell lymphoma. Semin Cutan Med Surg. 2012; 31(1):25-32.
23. Shan X, Wang C, Tian H, et al. Narrow-band ultraviolet B home phototherapy in vitiligo. Indian J Dermatol Venereol Leprol. 2014; 80(4):336-338.
24. Thomas KS, Batchelor JM, Akram P, et al. Randomized controlled trial of topical corticosteroid and home-based narrowband ultraviolet B for active and limited vitiligo: results of the HI-Light Vitiligo Trial. Br J Dermatol. 2021; 184(5):828-839.
25. Unrue EL, Cline A, Collins A, et al. Corrigendum: a novel ultraviolet B home phototherapy system: efficacy, tolerability, adherence, and satisfaction. Dermatol Online J. 2019; 25(2):13030 qt3vn1z0s2. Erratum for: Dermatol Online J. 2019; 25(4):13030/qt0750h223.
26. Wang E, Ahad T, Liu YA, et al. Incidence and profile of skin cancers in patients following ultraviolet phototherapy without psoralens: a retrospective cohort study. J Am Acad Dermatol. 2024; 90(4):759-766.
27. Wang H, Yosipovitch G. New insights into the pathophysiology and treatment of chronic itch in patients with end-stage renal disease, chronic liver disease and Lymphoma. Int J Dermatol. 2010; 49(1):1-11.
28. Zhang L, Wang X, Chen S, et al. Comparison of efficacy and safety profile for home NB-UVB vs. outpatient NB-UVB in the treatment of non-segmental vitiligo: a prospective cohort study. Photodermatol Photoimmunol Photomed. 2019; 35(4):261-267.

Government Agency, Medical Society, and Other Authoritative Publications:

1. Akdis CA, Akdis M, Bieber T, et al.; European Academy of Allergology and Clinical Immunology/American Academy of Allergy, Asthma and Immunology/PRACTALL Consensus Group. Diagnosis and treatment of atopic dermatitis in children and adults: European Academy of Allergology and Clinical Immunology/American Academy of Allergy, Asthma and Immunology/PRACTALL Consensus Report. Allergy. 2006; 61(8):969-987.
2. American Academy of Dermatology. Vitiligo: Diagnosis and treatment. Last updated May 25, 2023. Available at: https://www.aad.org/public/diseases/a-z/vitiligo-treatment#:~:text=,appearing. Accessed on August 49, 2025.
3. Arkwright PD, Motala C, Subramanian H, et al.; Atopic Dermatitis Working Group of the Allergic Skin Diseases Committee of the AAAAI. Management of difficult-to-treat atopic dermatitis. J Allergy Clin Immunol Pract. 2013; 1(2):142-151.
4. Centers for Medicare and Medicaid Services. National Coverage Determinations. Available at: https://www.cms.gov/medicare-coverage-database/search.aspx?redirect=Y&from=Overview&list_type=ncd. Accessed August 4, 2025.
   • NCD for Treatment of Psoriasis. NCD #250.1. Effective date not available.
5. Elmets CA, Lim HW, Stoff B, et al. Joint American Academy of Dermatology-National Psoriasis Foundation guidelines of care for the management and treatment of psoriasis with phototherapy. J Am Acad Dermatol. 2019; 81(3):775-804.
6. Leung DY, Nicklas RA, Li JT, et al. Disease management of atopic dermatitis: an updated practice parameter. Joint Task Force on Practice Parameters. Ann Allergy Asthma Immunol. 2004; 93(3 Suppl 2):S1-S21.
7. Menter A, Korman NJ, Elmets CA, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 5. Guidelines of care for the treatment of psoriasis with phototherapy and photochemotherapy. J Am Acad Dermatol. 2010; 62(1):114-135.
8. Mohammad TF, Al-Jamal M, Hamzavi IH, et al. The Vitiligo Working Group recommendations for narrowband ultraviolet B light phototherapy treatment of vitiligo. J Am Acad Dermatol. 2017; 76(5):879-888.
9. National Cancer Institute (NCI). Mycosis Fungoides and Other Cutaneous T-Cell Lymphomas Treatment (PDQ^®). Last modified February 19, 2025. Available at: https://www.cancer.gov/types/lymphoma/hp/mycosis-fungoides-treatment-pdq. Accessed on August 4, 2025.
10. NCCN Clinical Practice Guidelines in Oncology^® (NCCN). © 2025 National Comprehensive Cancer Network, Inc. Primary Cutaneous Lymphoma. V2.2025. Revised April 1, 2025. Available at: http://www.nccn.org/index.asp. Accessed on May 15, 2025.
11. Olsen EA, Hodak E, Anderson T, et al. Guidelines for phototherapy of mycosis fungoides and Sézary syndrome: a consensus statement of the United States Cutaneous Lymphoma Consortium. J Am Acad Dermatol. 2016; 74(1):27-58.
12. Sidbury R, Davis DM, Cohen DE, et al.; American Academy of Dermatology. Guidelines of care for the management of atopic dermatitis: section 3. Management and treatment with phototherapy and systemic agents. J Am Acad Dermatol. 2014; 71(2):327-349.
13. Trautinger F, Knobler R, Willemze R, et al. EORTC consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome. Eur J Cancer. 2006; 42(8):1014-1030.
14. U.S Food and Drug Administration. FDA approves topical treatment addressing repigmentation in vitiligo in patients aged 12 and older. July 22, 2022. Available at: https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-topical-treatment-addressing-repigmentation-vitiligo-patients-aged-12-and-older#:~:text=Action. Accessed on August 4, 2025.
15. van Geel N, Speeckaert R, Taïeb A, et al. Worldwide expert recommendations for the diagnosis and management of vitiligo: position statement from the International Vitiligo Task Force Part 1: towards a new management algorithm. J Eur Acad Dermatol Venereol. 2023; 37:2173-2184.

1. American Academy of Dermatology. Available at: http://www.aad.org. Accessed on August 4, 2025.
2. National Center for Advancing Translational Sciences. Primary cutaneous T-cell lymphoma. Updated July 2025. Available at: https://rarediseases.info.nih.gov/diseases/6226/cutaneous-t-cell-lymphoma. Accessed on August 4, 2025.
3. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Available at: http://www.niams.nih.gov/. Accessed on August 4, 2025.
4. National Psoriasis Foundation. Available at: http://www.psoriasis.org. Accessed on August 4, 2025.

Daavlin
DermaLume 2X^™
Handisol II^®
National Biological Phototherapy
Panosol II^®
Panosol 3D^®
Phototherapy
Psoriasis
SolarC Systems
UVBioTek

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