What is phototherapy?
Phototherapy is a branch of what is known as physical therapy.
The patient is irradiated with blue light. This rather short-wave light gives off its energy to the irradiated skin and can thus develop its therapeutic effect.
Phototherapy is most commonly used in newborns, but it can also be used for various skin diseases.
It is important to protect the eyes from the incident light during phototherapy, otherwise the retina can be damaged.
Phototherapy helps with these diseases
In pediatric medicine, phototherapy is used in newborns with jaundice (jaundice).
This is a harmless condition that occurs in the newborn.
In this very early phase of life, the children's red blood pigment changes, so that a particularly large number of blood cells have to be broken down. At the same time, the child's liver is often not yet fully mature, so that it is overwhelmed with the breakdown of the blood pigment.
This disease manifests itself, among other things, in the yellowing of the skin, where the bilirubin, a temporary breakdown product of the blood pigment, is stored.
Phototherapy can convert the deposited bilirubin into lumirubin. In this form it can be excreted via the kidneys and bile so that the liver is not stressed. This phototherapy prevents bilirubin from being deposited in the brain at very high concentrations and causing permanent damage.
In addition to neonatal jaundice, skin diseases in particular can be treated with phototherapy. These include, for example, atopic eczema and psoriasis (psoriasis). Other eczema can also be treated well locally. If there are skin changes due to severe kidney dysfunction or a systemic disease such as HIV, phototherapy is also effective against the skin diseases.
Read more on the subject at:
- Photodynamic Therapy
Duration of phototherapy
Phototherapy is usually started in the newborn immediately after the elevated bilirubin levels are detected. Usually you start with it for 24 hours and then check the bilirubin in the blood again. If it has fallen below a certain limit, the therapy can be ended.
However, if the value is still above the limit, the photo therapy will be continued for another 24 hours.
If therapy is started early enough, treatment lasting more than 48 hours is only necessary in the rarest of cases.
Phototherapy has some risks and side effects that are not to be expected at first glance with the light that appears harmless. The systemic effect of light energy is particularly noticeable in newborns.
The additional energy leads to an increased dehydration of the children, as a lot of moisture evaporates before it is properly absorbed by the child. Therefore, the children need to be fed particularly often. Regular weight checks are also important to check whether the child concerned is thriving.
In addition to the evaporation of moisture, sweating can also lead to a loss of electrolytes (blood salts). This can upset the newborn's electrolyte balance, so careful monitoring of blood salts is necessary. Overall, the skin can also react to the blue light, which can lead to so-called dermatitis solaris, i.e. inflammation of the skin.
The eyes are also particularly at risk in newborns. The retina can be damaged by the light radiation and the high energy, which in the long term can lead to visual field defects. In addition, the eyes can become inflamed from exposure.
Another side effect is the brown discoloration of the skin. When the bilirubin is particularly high, much of the bilirubin under the skin is broken down by the photo therapy. The bilirubin changes from a yellowish to a brownish color, which can be seen through the skin.
Read more about this in our next article below: Injury to the visual pathway
Which doctor does phototherapy?
Photo therapy is usually performed by a pediatrician on newborns. Often the neonatal icterus is recognized by a practicing pediatrician.
However, he cannot carry out the therapy for more than 24 hours and therefore sends the children to hospital for inpatient treatment.
Phototherapy, which can be used against skin diseases in adults, is usually prescribed by a dermatologist (dermatologist).
In rare cases, therapy can also be given by a family doctor.
Can you do phototherapy at home?
In newborns, phototherapy almost always has to be carried out under inpatient conditions in the hospital.
The reason for this is on the one hand the long irradiation time of 24 to 48 hours.
In addition, the children are at risk of hypothermia and dehydration, which is why they should lie in a warm bed and their state of health has to be monitored very closely.
This can only be guaranteed under stationary conditions. In adults, local phototherapy is often performed at home. However, phototherapy can also be obtained in the practice.
Is that a cash benefit?
Phototherapy of the newborn for jaundice is one of the health insurance benefits. Of course, the costs for both inpatient admission and phototherapy are covered by the health insurance company.
Depending on the hospital's bed capacity, the baby's mother can usually also be accepted as an accompanying person.
In the case of phototherapy for adults, the therapy is often also covered by health insurance.
However, it is not uncommon for an application to be made beforehand by the treating family doctor or dermatologist. Before starting phototherapy, you should therefore clarify with your health insurance company whether the benefits will be covered.
It is especially difficult if you want to apply for your own therapy device for treatment at home. These are often expensive, but in many cases they can be made available on loan. This is usually possible as a cash benefit.