The Rotherham NHS Foundation Trust. Bath PUVA treatment. Dermatology. patientinformation. Your health, your life, your choice, our passion

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1 The Rotherham NHS Foundation Trust Bath PUVA treatment Dermatology patientinformation Your health, your life, your choice, our passion

2 Hearing about your experience of our services is very important as it means we can pass compliments to our staff and make improvements where necessary. Tell us what you think at If you require this document in another language, large print, braille or audio version, please contact Patient Information on or

3 What is Bath PUVA? Bath PUVA is an effective treatment for controlling certain types of psoriasis and some other skin conditions. It is not however a permanent cure. Patients take a bath containing a special solution then immediately afterwards are exposed to artificial sunlight (UVA). The solution (psolaren) makes the skin more sensitive to ultraviolet light. How often will I need to come for treatment? Treatment is given twice a week with a two day gap between treatments. Treatment usually lasts for a period of 6-8 weeks or longer if necessary. It is important for you to attend all the appointments on the dates given as this is a prescribed regime and missing treatments can delay or even jeopardise the success of the treatment. 3

4 What happens first? Before starting Bath PUVA treatment a Health Education appointment will be arranged. During this appointment you will be given a detailed explanation of the treatment and any possible side effects. The nurse will arrange the appointments for your complete course of treatment and you will asked to sign a consent form. The nurse will loan you a pair of UV protective glasses, which you will be required to wear for 12 hours after treatment. Please bring these glasses with you for each treatment, failure to do so will mean treatment cannot be given. It is important that these glasses are returned to the Dermatology Department once your treatment is completed. What happens when I come for treatment? l Before each treatment you need to remove all make-up, perfume or aftershave and jewellery l Do not apply any creams or ointments before attending for PUVA. Please bath or shower before attending for your appointment l The nurse will ask a few simple questions and will need to see your skin l You will be asked to bathe in a specially prepared bath containing a light sensitising solution (Psoralen) for 5 minutes. If your face or neck are affected these areas should be bathed with a well wrung flannel. Avoid splashing into eyes, if this occurs, rinse out with clean water and notify the nurse 4

5 l You must wear the protective glasses provided immediately after getting out of the bath l The protective glasses are exchanged for green goggles whilst you are in the UVA cabinet. If your face is unaffected a UV visor will be provided l Male patients must wear a sock to protect their genitalia. Female patients are advised to wear no pants. Some patients require additional clothing to be worn. Any clothing/socks needs to be dark coloured and made of thick material and must not be altered during the course of treatment as this could result in severe burning to a previously unexposed area. If you fail to bring the same item then treatment cannot be given l You will be instructed to stand in a special cabinet to enable overall exposure of the body. The nurse will set the UVA cabinet to the correct dose and start treatment l The UVA cabinet is on a timer and will switch itself off. When all the lights have switched off you can step out of the cabinet l After exposure you must ensure that you shower well with soap or shower gel (please bring your own preferred soap or shower gel each visit) to remove any residual Psoralen solution and dry off with a fresh towel l Ensure you are wearing your protective UV glasses following the shower and these need to be worn for 12 hours after treatment 5

6 Are there any other considerations? l Do not apply any creams or ointments before attending for PUVA l Only use creams or ointment to your skin prescribed by your doctor or nurse. Please inform the nurse of any medications or tablets prescribed by your GP before or during the treatment, this will reduce the chance of any drug reactions with PUVA treatment l Do not consume alcohol prior to or for 24 hours after bathing l Please bring suitable footwear to use whilst walking around the department e.g. slippers or flip-flops l Take care whilst in the bath not to slip as bath additives and liners can be slippy Are there any reasons why I can t be treated with Bath PUVA? Bath PUVA is not suitable during pregnancy or when breastfeeding. Women of childbearing age must take adequate contraception precautions for medical reasons. 6

7 Are there any side effects to the Bath PUVA treatment? Like most medical treatments PUVA has its short term and long term risks, but with the controls used, the risks are minimised. Your skin will be closely monitored throughout the course and the nurse will advise you accordingly if you experience any of the following: Short Term l Itching l Sunburn (erythema): It is easy to produce unwanted sunburn with Bath PUVA for 12 hours after treatment, as you are still at risk from natural sunlight. For this period, avoid exposure to direct sunlight even through glass. If you go outside, wear adequate cover. We advise you to apply sun block creams to exposed areas such as hands and face. do not sunbathe or use solariums or sunbeds at any time during the course of the treatment. Avoid florescent lighting when possible as many emit UV light Any of these must be reported to the nurse before any further treatment is given as it may be necessary to reduce the exposure time or miss a treatment. 7

8 8 Long term Bath PUVA is given under strictly controlled methods and therefore the long-term effects are highly unlikely to occur. You must ensure that you fully understand the procedure and precautions to take to minimise these risks: l Eye damage: This is not a risk as long as protective glasses are worn as instructed. Eye impairment can only occur if rays are allowed to enter the eye. During bath PUVA treatment special green goggles are provided to shield your eyes and protective glasses are to be worn for 12 hours after treatment to protect your eyes from UVA radiation whilst you are still photosensitive. This applies on cloudy days and whilst indoors. They can only be removed for sleeping l Ageing of the skin: This is only possible after months or years of Ultraviolet exposure. There is a far higher risk to photo ageing when sunbathing or using solariums or sunbeds indiscriminately. By avoiding sun and other artificial ultraviolet light the risk from PUVA treatment is slight l Photosensitivity to light: There is a slight chance that you may be photosensitive. Please inform the nurse if you are adversely affected by small doses of sun rays l Skin Cancer: After months to years of treatment PUVA may be associated with an increased risk of skin cancer, which is initially slight but gradually increases after 150 treatments

9 If you have any concerns or reactions following treatment it is important that you contact the Dermatology Department for advice. Telephone Monday to Friday 8.00am until 8.00pm Saturdays and Bank Holidays 9.00am until 4.00pm 9

10 How to contact us Dermatology Reception Monday to Friday 9.00am to 4.30pm Telephone Dermatology Department Monday to Friday 8.00am until 8.00pm Saturdays and Bank Holidays 9.00am until 4.00pm Telephone Switchboard Telephone Useful contact numbers NHS Direct Telephone Health Info Telephone Stop Smoking Service Telephone Patient Services Telephone A&E Telephone For GP out of hours, contact your surgery Useful websites We value your comments If you have any comments or concerns about the care we have provided please let us know, or alternatively you can write to: Patient Services The Rotherham NHS Foundation Trust Rotherham Hospital Moorgate Road Oakwood Rotherham S60 2UD Telephone Produced by Charlotte Pickard, August 2007 Revised March 2009, August Revision due August Version: 3.0 The Rotherham NHS Foundation Trust All rights reserved. 10

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