Address the parts of the disease that impact Quality of Life (QoL) the most with targeted UV phototherapy first.
Consider the patient’s Quality of Life (QoL). Is it the disease in general that drives the patient’s quality of life down, or is it a portion of the disease? Consider the portion of a patient’s vitiligo that extends to their neck and face, drawing attention that the patient feels is unwanted. It is the socially obvious portion of vitiligo that is really driving the reduction in their quality of life.
Consider the eczema patient with a small region of their scalp that itches constantly and wakes them throughout the night. The lack of sleep and constant aggravation makes dealing with that patient’s eczema in other regions of their body that much harder.
Consider a young athlete, military soldier, or policeman who recently developed severe psoriasis on the soles of their feet, and some mild psoriasis on their thighs. It may not be the psoriasis on their thighs that truly bothers them, but the psoriasis on their feet that prevents the athlete from competing, the soldier from marching, and the policeman from being able to pursue someone on foot.
In all of these cases, targeted UV phototherapy offers a safe, effective, and natural treatment option intended to produce results rapidly. By treating the worst part of the disease first with targeted UV phototherapy, healthcare providers can drastically improve a patient’s quality of life, fast. While systemic and biologic drugs are required in some cases, (as in patients that do not respond to less aggressive treatments), their use should be weighed against the effectiveness of the latest targeted UV phototherapy treatments and devices.
Once Quality of Life is improved, non-targeted UV phototherapy can be used to address the remaining disease and provide a low dosage maintenance therapy. Non-targeted UV phototherapy is an excellent treatment for large body surfaces (which is too large to economically treat with targeted UV) and is less toxic than systemic or biologic drug use. Patients should opt for less toxic treatment options first, where applicable, and always be mindful of how any treatment affects their quality of life. Healthcare providers would much rather pursue less aggressive treatments if possible.