UVR

Ultra Violet Radiation

By:
Dr S Bhavithra devi
Objectives
 1. UVR- definition,production of UVR,
principles of production
 2. UVR- types, types of UV generators
 PUVA
 3. UVR- test
 4. Physiological uses, therapeutic effecets of

UVR Effects,
 Dangers, contra indications of UVR
 5. UVR- sensitizers & filters
 UVR test dose calculation
 Did you know that sunlight
contains different types of
ultraviolet radiation that
can affect our health and
well-being?
 Ultraviolet radiation (UVR) is
a form of energy that’s
invisible to the human eye,
with wavelengths between
10nm and 400nm.
 It is between visible light
and x-rays in the
electromagnetic spectrum.
UVR
Types of UVR can actually be beneficial for us!
The therapeutic part of the ultraviolet
spectrum can be divided into three categories:
UVA, UVB, and UVC. UVA and UVB are biotic,
where as UVC is abiotic.

 UVA ⇒ 400-315 nm
 UVB ⇒ 315-280 nm
 UVC ⇒ below 280 nm
PROPERTIES
 UVA rays have longer wavelengths (400-315 nm) and
can penetrate deep into the skin, which can cause
skin damage over time. However, UVA can also be
used to treat certain skin conditions like psoriasis
and eczema.
 UVB rays have shorter wavelengths (315-280 nm) and
are responsible for sunburns and skin damage. But
don’t worry – in small doses, UVB can also stimulate
the production of vitamin D, which is essential for
strong bones and a healthy immune system.
 UVC rays have the shortest wavelengths (below 280
nm) and are the most harmful to living organisms.
Luckily, UVC is mostly blocked by the Earth’s ozone
layer before it reaches us.
Production of UVR

The Sun emits a broad spectrum of

ultraviolet radiation, including UVA, UVB, UVC. Both
UVA and UVB reach the earth from the sun.
however, UVC is filtered out by the ozone layer. For
therapeutic purposes, some form of generator is
used to emits UVR.
Types of UVR Generators
Two types of UVR generators-
 Mercury vapor lamp– can be of two types;

◦ Air cooled medium pressure mercury vapor (Alpene sun lamp)

◦ Water cooled mercury vapor lamp (kromayer lamp)
 Fluorescent lamps
A) Mercury Vapor Lamp-
mercury-vapor lamp is a gas-discharge lamp that uses an electric
arc through vaporized mercury to produce light. These are used for the
production of ultraviolet rays for therapeutic purposes.
B) Fluorescent tubes
 One of the major problems with the mercury lamp is that it produces a certain

proportion of short ultra-violet rays.

 Special fluorescent tubes have been designed that produce mostely long-wave

ultraviolet rays, which is beneficial for treatment

 These tubes are about 120 cm long and made of a special glass that allows

long-wave ultraviolet to pass through.

 Inside the tube, a special coating called phosphor absorbs and re-emits the

short-wave ultraviolet as longer waves.

 A low-pressure arc is set up inside the tube between its ends by a process of

ionization similar to that described for the mercury vapor tube.

 Depending upon which particular phosphor is used, the output of the tube

may be part UVB and part UVA (280-400) or UVA (360-400nm), as in the
Theraktin tunnel

 The theraktin tunnel is

a semi-cylindrical frame in
which are mounted four
fluorescent tubes.
 Each tube is mounted
in its own reflector in such
a way that an even
irradiation of the patient is
produced, allowing
treatment of the whole
body in two halves.
 Normally fluorescent tubes
with a spectrum of 280-
400 nm are used.
PUVA apparatus

 For the treatment of psoriasis,

where a large amount of UVA,
is required, the fluorescent
tubes are used.
 The tubes are usually
mounted in a vertical battery
on a wall, or four sides of a
box surrounding the patient.
 This form of ultra-violet is
usually given two hours after
the patient has taken a
photoactive drug such
as psoralen: hence the
term PUVA (psoralen
ultraviolet A)
Absorption of UV
The superficial layer of Rays in body
our body is skin. it is a
protective layer of our
body. it absorbs the
ultraviolet light and The extent of the reaction
prevent its penetration or damage depends on the
down to unprotected or wavelength of ultraviolet
weak cells. and the amount of
ultraviolet absorbed.
 UVC is absorbed in the
epidermis along with
UVB, and UVA may
penetrate as far as the
capillary loops in the
dermis.
Physiological Effects of UVR
Immediate acute effects
1) Erythema:
 Erythema is reddening of the skin as a result of

an inflammatory reaction stimulated by

ultraviolet rays ⇒ release of histamine like
substance ⇒ dilation of the capillaries and
arterioles and exudation of fluid into skin.
 The Erythema reaction has been used to

classify doses of ultra-violet given to patients.

there are 4 degrees of erythema E1, E2, E3,
and E4.
Degree Latent
Appro. Skin
of Period Appearanc Skin Desquamatio Relation
duratio discomfor
Erythem (hours e edema n to E1
n t
a )

6-12
E1 Mildy pink <24 h None None None x1
h

Definite
pink red,
Slight
E2 6h blanches 2 days None Powdery x 2.5
soreness
on
pressure.

Very red,
3-5 Hot and
E3 3h does not Some Thin sheets x5
days painful
blanch

Very
E4 <2 h Angry red 1 week Blister Thick sheets x 10
2) Pigmentation:
 Pigmentation or tanning of the skin follows the erythema.
 Its amount varies with the intensity of the erythema.
 It is due to the increased deposition of the pigment

melanin formed in the basal cell layer of the skin by the

melanoblasts and migrates to the superficial layers of the
epidermis.
3) Desquamation (increased skin growth):
 Desquamation or peeling is proportional to the intensity

of the erythema.
4) Vitamin D production:
 UVB is able to convert sterols in the skin, such as 7-

dehydro-cholesterol to vitamin D.
 Vitamin D is required to assist in the absorption of

calcium and phosphorous from the intestine to blood

stream.
 Suberythemal dosage of UVB are adequate to promote
5) The Prophylactic effects:
 The resistance of the body to infection is increased as a result of the

stimulation of reticuloendothelial system ⇒ antibodies against bacteria and

toxins.
6) Immunosuppressive effects:
 UV destroys Langerhan’s cell and stimulates the proliferation of suppressor

T cells, ( T cells are regulatory in that they inhibit antibody production)

 This immunosuppressive effects may contribute to the development of skin

cancer.
 In short, UV radiation induces a state of relative immunosuppression that

prevents tumor rejection.

7) Effect on eye:
 Strong doses of UVB and C radiation to the eyes can lead

to conjunctivitis and photokeratitis results in

◦ Irritation of the eye,
◦ A feeling of grit in the eye,
◦ Watering of the eye and
◦ Aversion to light (photophobia).
 In severe cases intense pain and spasm of the eyelid may be present this is
also known as a ‘Snow Blindness’.
 While UVB and C are absorbed in the cornea,UVA can pass through to be
absorbed mainly in the lens of the eye.

Long term/chronic effects
1)Solar elastosis and ageing-
 Prolonged exposure of UVR lead to, premature ageing

of the skin, this is especially so in the fair-skinned.

 Decrease function of sebaceous and sweat glands.
 Loss of elastic tissue
 The skin becomes wrinkled, dry and leathery.

2) Cancer-
 Skin cancers, basal cell, and squamous cell

carcinomas.
 Carcinogenesis is a danger, as these rays may have an

effect on DNA and thus on cell replication.

 Shorter ultraviolet waves should be avoided and

courses of treatment should not exceed four weeks.

Minimal erythema dose
UVR Dosages

Skin response to UVR depends upon:

 Quantity of UVR energy applied to the skin
 Biological responsiveness of skin.

1) Quantity of UVR energy applied to the skin,

which depends upon-
 Output of the lamp.
 Distance between the lamp and the skin
 Angle at which radiation falls on the skin
 Time for which radiation is applied on the

skin.
2) Biological responsiveness of skin-

 The following skin types are described, from

the most reactive through to the least

Skin Type
DESCRIPTION
Type I Always burn never tan

Type II Always burn tan slightly

Type III Sometime burn Always tan

Type IV Never burn Always tan

Type V Pigmented skin

Type VI Heavily Pigmented skin

Calculation of dosage
 E1 is determined from the skin test and the other
erythemal dosages can be calculated as follows-
◦ Suberthermal 75% of E1
◦ E2 = 2.5×E1
◦ E3 = 5×E1
◦ E4 = 10×E1
◦ Double E4 = 20×E1
E4 and double E4 are used on an open wound
Minimal erythema dose (MED)– The smallest dose of
UVR to result in erythema that is just detectable by
eye at between 8-24 hours after exposure is called
minimal erythemal dose
Progression of UV dosage
Dosage can be progressed as follows:
 Suberythermal – previous dose plus 12.5%
 E1- previous dose plus 25%
 E2- previous dose plus 50%
 E3- previous dose plus 75%

Dosage used on open wounds are not progressed because

there is no epidermis to thickness.

Alteration of the intensity with distance

 To irradiate a smaller area the source is moved nearer to

the patient but the time of exposure must be altered to

maintain the same intensity under the law of inverse
squares.
NOW TIME = OLD TIME × (NEW DISTANCE)² / (OLD
DISTANCE)²
Therapeutic Effects and Uses of UVR
A) Psoriasis
 Psoriasis is a chronic skin disease of unknown causes,

 which are manifested either as silvery scales covering the pink

or red plaques (chronic discoid psoriasis), or the small lesions

scattered on the trunk, postural psoriasis, generalized postural
and erythrodermic psoriasis, flexural psoriasis.
 In about 7-42percent of patients with psoriasis, there might

occur arthritis, called psoriatic arthritis.

 The aim of ultraviolet irradiation is to decrease the rate of DNA

synthesis in the cells of the skin and thus slow down their
proliferation.
 It must be realized that, the long ultraviolet rays like UVB, UVA

are beneficial for the treatment of psoriasis but no UVC.

 The different treatment regimens include:

◦ The Goeckerman regimen: This consists of the application of coal tar 2-

3 times a day with general UVB radiation given once a day, as
a suberythemal or E1(MED) dose.
◦ Leeds or Ingram regimen:
◦ PUVA (Psoralen ultra-violet A):
B) Acne vulgaris
 Ultraviolet radiation is given in E2 doses for acne vulgaris,

with the following aim-

 An erythema will bring more blood to the skin and so

improve the condition of the skin

 Desquamation will remove comedones and allow free

drainage of sebum, thus reducing the number of lesions.

 The UVR will have a sterilizing effect on the skin.

C) Eczema
 This patients are benefited by mild doses of UVR.

D) Chronic infection
 Ultraviolet radiation at high doses are helpful for the

treatment of chronic infection.

 An E4 dose can use for it.
E) Vitiligo
 One evidence suggests that topical glucocorticoids and psoralen-UVA

(PUVA) or narrowband UVB at a wavelength of 311nm are effective for

the management of this condition.

F) Treatment of vitamin deficiency

 As already stated, cholecalciferol (vitamin D3) is formed in the skin, by

the action of UVB and UVC on 7-dehydrocholesterol.

 Exposure to artificial UVR or artificial sun light is curative for vitamin D

deficiencies such as rickets, osteomalacia, and senile osteoporosis.

G) Protection for hypersensitive skin

 Person who work outside in the strong sunshine region, can have reduce

effects of sun burn .

H) Hypertension
 Suberythemal doses of UVB reducing blood pressure.

I) Pruritus
 Pruritus due to uremia in patient with chronic renal failure also shows
Contraindications of UVR
 Irradiation of the eyes

 Skin cancer

 Pulmonary tuberculosis

 Cardiac, kidney and liver disease

 Systemic lupus erythematosus

 Fever

Precautions to the Use of UVR

 With patients taking photosensitizing medication

 Photosensitivity

 Recent Radiotherapy

 Until the effects of the prior dose have disappeared

Dangers of UVR
 Burn

 Premature skin aging

 Carcinogenesis