ULTRAVIOLET RADIATION

(UVR)

Radiation between the visible

light & X-ray sections of the
electromagnetic spectrum. (J.
Ritter)

RADIO f IRR VISIBLE LIGHT UVR

 NATURE OF UVR
1. Strongly absorbed in air (*short-
wavelength UVR)
2. Behave like visible radiation in
terms of properties (reflection,
refraction, transmission and
absorption)
3. Transmit more energy, thus,
producing more chemical
changes not just simply heat
 CATEGORIES OF UVR
UVA UVB UVC
Wavelength 320-400 290-320 200-290
(nm)
315-400 280-315 100-280

Other Long Medium Short

Names
Blacklight Erythemal Germicidal

Near Near Far

CATEGORIES OF UVR
Near UVR- nearer the visible
light spectrum but are longer
in wavelength
*Longer wavelength are more
beneficial (BIOTIC)
Shorter wavelength are
ABIOTIC
 PRODUCTIONS OF UVR

I. NATURAL WAY: SUN

II. ARTIFICIAL WAY

I. NATURAL WAY: SUN
5-10% of the sun’s energy is in
the UVR range (180-400 nm)

UVA 6.3% of sunlight during

summer; UVB 0.5%

Both UVA & UVB can be involved

in sunburn and skin diseases
 II. ARTIFICIAL WAY
Passage of electric current thru gas (vaporized
mercury)
Collision with the electrons flowing between the
lamp’s electrodes
Mercury atoms become excited
Excited electrons return to particular electronic
states in the mercury atom
Release some of the energy they have absorbed
RADIATION
 II. ARTIFICIAL WAY

UVR can be produced if the

temperature is high enough
and pressure is low

UVR= T° + P°
 ARTIFICIAL UVR APPARATUS
John Low Wadsworth
1. Kromayer lamp 1. Water-cooled lamp
(Kromayer lamp)
2. Fluorescent lamp 2. Fluorescent lamp
3. Medium pressure 3. Air-cooled lamp (Alpine
mercury arc lamp (Alpine Sunlamp)
Sunlamp)
4. Low pressure mercury
vapor discharge tubes
A. KROMAYER LAMP
a.k.a. water-cooled lamps
requires pre-heating of 5
minutes
a medium pressure mercury
vapor designed to be used in
contact with the tissue (i.e.
treatment of localized pressure
areas and ulcers).
 A. KROMAYER LAMP
wavelengths of the rays produced
are concentrated at 366 nm but a
wide range of both UVA & UVB
are produced.
B. FLUORESCENT LAMPS
low-pressure mercury discharge
tubes with a phosphor coating on
the inside
absorbs short UVR which causes
excitation of the phosphor atoms
and remission at a longer
wavelength
B. FLUORESCENT LAMPS
gives considerable UVA & UVB
output; NO UVC
more commonly used for
Psoriasis affecting large body
areas
 C. ALPINE SUN LAMP
a.k.a air-cooled lamps
generally used for treatment of
generalized skin conditions like
Acne and Psoriasis
Usually applied at a distance of
45-50 cm
D. LOW PRESSURE MERCURY
VAPOR DISCHARGE TUBES
Components:
a. Tube or envelope made of quartz
or special glass to allow UVR to pass
through
b. Metal electrodes sealed in the
ends of the tube
c. Electric circuit to regulate electric
current
 PHYSIOLOGIC EFFECTS
1. Erythema or redding & tanning
- only encountered when UVB (at
250-297 nm) treatment is used.

Minimal Erythemal Dose = smallest

UVR dose to result in erythema
that is just detectable by eye
between 8-24 hrs after exposure
 PHYSIOLOGIC EFFECTS
2. Pigmentation
- results from formation of melanin
in deep regions of the skin &
migration of melanin noticeable
about 2 days after exposure

- UVB at 300 nm
 PHYSIOLOGIC EFFECTS
3. Hyperplasia
- occurs at 72 hrs using UVB

4. Increase skin growth

- increase keratinocyte cell
turnover so that skin grows more
rapidly for a time leading to
shedding of most superficial cells
at an earlier stage
 PHYSIOLOGIC EFFECTS
5. Vitamin D production
- UVB convert sterols in the skin (7-
dehydrocholesterol) to vitamin D
at 280-300 nm

6. Destruction of bacteria
-occurs by suppressing DNA and
RNA synthesis at UVB at 250-
270 nm
 PHYSIOLOGIC EFFECTS
7. Wound healing
- using UVB at 260-280 nm

8. Increase production of RBC

9. Stimulation of steroid metabolism

- UVR promotes vasomotor responses
causing antirachitic effect
 PHYSIOLOGIC EFFECTS
10. Immunosuppressive effects
- UVB destroys Langerhans cells &
stimulate proliferation of
suppressor T cells
 PHYSIOLOGIC EFFECTS
11. Conjunctivitis / photokeratitis /
cataract
- conjunctivitis occur at UVB with
270 nm
- cataracts at UVA since it can
pass thru the eye’s lens
 PHYSIOLOGIC EFFECTS
12. Premature aging of the skin
(dry, wrinkled, decreased function
of sebaceous and sweat glands)

13. Skin cancers

14. Psychological effects

 INDICATIONS OF UVR
1. Skin diseases
a.) Psoriasis treatment
b.) Acne vulgaris treatment

 Toaccelerate skin growth, help

control infection, sterilize skin
surface temporarily
 INDICATIONS OF UVR
2. Healing of wounds (venus
ulcers & pressure sores)

 To increase rate of skin growth and

to provide antibiotic effect
 INDICATIONS OF UVR
3. Vitiligo
 Tanning and thickening of the
skin

4. Protection of hypersensitive skin

 INDICATIONS OF UVR
5. Alopecia

6. Treatment of vitamin D
deficiency
 INDICATIONS OF UVR
7. Pruritus due to biliary cirrhosis
or uremia

8. Jaundice for newborn babies

 CONTRAINDICATIONS
1. Acute skin conditions (acute
eczema, dermatitis)

2. Skin damage due to ionizing

radiations like deep X-ray therapy
 CONTRAINDICATIONS
3. Systemic lupus erythematosus
can be triggered or exacerbated

4. Photoallergy / photosensitivity
(albinism will not tolerate UVR)
 CONTRAINDICATIONS
5. Porphyrias (rare metabolic
disorder)

6. Pellagra (dermititis due to

severe niacin deficiency)
 CONTRAINDICATIONS
7. Acute febrile illness (pulmonary
tuberculosis, severe cardiac
involvement, acute diabetes
mellitus)

8. Recent skin graft

 PRECAUTIONS
Patients with:
a.) little pigmentation, often seen in
blondes and redheads.
b.) conditions like syphilis, alcoholism,
cardiac or renal disease, acute psoriasis,
acute eczema, elderly and infants.
 PRECAUTIONS
c.) Ingested certain food like
strawberries, eggs or shellfish before
treatment.
d.) Taking any of the ff: birth control,
pills, tetracycline, diuretics and
insulin.
e.) Recent superficial heat treatment
before UVR radiation.
 DANGERS OF USING UVR
1. Eyes (conjunctivitis)
2. Overdose (too long exposure; too close
to the lamp)
3. Previously protected skin
4. Electric shock
5. Burns
6. Chill
7. Sensitizers
8. Change of lamp
 LEVELS OF UVR ERYTHEMA
E1 E2 E3 E4
Latent 6-12 hrs 6 hrs 3 hrs Less than
period 24 hrs
Appearan Mildly Definite Very Angry red
ce pink pink-red; red;does
blanches not
on blanches
pressure on
pressure
Approx. Less 2 days 3-5 days A week
duration than 24
of hrs
erythema
Skin edema None None Some Blisters
 LEVELS OF UVR ERYTHEMA
E1 E2 E3 E4
Skin None Slight Hot& Very
discomfort soreness; painful painfu
irritation
l
Desquamatio None Powder In thin In
n y sheets thick
sheets
Relation to 1 2.5 5 10
dose causing
E1
 SELECTION OF DOSAGE LEVEL
DOSAGE FREQUENCY

1. E1 or Minimal Erythemal Given daily

Dose may be given to total body
area
2. E2  up to 20% of total body Every second day
area

3. E3  up to 250 square cm of Every third or fourth

normal skin day

4. E4  up to 25 square cm of Once a week or every

normal skin forth night
CALCULATION OF UVR DOSAGE

Basis: determined by performing

skin test to get MED or E1

Two units of measurements to

consider:
a.) length of time (seconds)
b.) distance from the lamp (mm)
CALCULATION OF UVR DOSAGE

Levels of dosage intensity

a.) E1= determined by the skin
test
b.) E2= 2.5 x E1
c.) E3= 5 x E1
d.) E4= 10 x E1
If the E1 of the patient is 50 s at a
distance of 200 mm, find E3 at
200 mm.
CALCULATION OF UVR DOSAGE

Progression of dosage:
a.) E1 is progressed by 25% of the
preceding dose

b.) E2 is progressed by 50% of the

preceding dose

c.) E3 is progressed by 75% of the

preceding dose
If E1 is 30 s at 200 mm, find the
second progression (P2E1).
CALCULATION OF UVR DOSAGE

Alteration of intensity with distance

-guided by Law of Inverse Square
which states that as the distance
between the source and the patient
increases, the intensity decreases in
proportion to the square of the
distance.
Formula: I = 1/ d2
nt= ot x nd2
od2
CALCULATION OF UVR DOSAGE

Using Kromayer lamp:

-use the levels of dosage for intensity
since the distance is always at 25
mm.

Using air-cooled lamps:

-distance is from the burner of the
lamp to the patient and follow the
Inverse square law formula.
Using the kromayer, if the E1 of the
patient is 2 s I/C, find the E1 at
100 mm.
Using the air cooled lamp, if the E1
at 400 mm is 30 s, find the E1 at
200 mm.
CALCULATION OF UVR DOSAGE
Using an applicator:
1.) Compute for coefficient of the
applicator:
*Length of applicator in mm divided
by 25
2.) Compute for applicator dose:
*in-contact dose (secs at mm) x
coefficient of applicator (in mm)