Heliotherapy is the use of natural sunlight for the treatment of certain skin conditions. It is a form of phototherapy. It is also called climate therapy. The ultraviolet (UV) part of the sunlight spectrum has beneficial effects in small doses.
Short wavelength UVB and longer wavelength UVA induce vitamin D production and other chemicals that protect skin cells.
UV radiation is anti-inflammatory, immune suppressing, and anti-proliferative.
The daylight part of the sunlight spectrum can also be useful in the treatment of skin conditions, for example in combination with the photosensitising agent, methyl aminolevulinic acid, for daylight photodynamic therapy (PDT) to treat actinic keratoses.
What skin conditions respond to heliotherapy?
Inflammatory skin conditions treated with heliotherapy are similar to those treated with other forms of phototherapy.
Heliotherapy has been found to reduce extent and severity of psoriasis and to improve the quality of life for patients. It rarely completely clears psoriasis, and in 10%, sun exposure aggravates psoriasis.
After 2–4 weeks of heliotherapy, there may be an improvement in atopic dermatitis/eczema immediately after treatment and several months afterwards. Note that sunlight can also result in photoaggravated eczema.
Other skin conditions
Other skin conditions such as vitiligo have also traditionally been treated with sunlight. Heliotherapy may be combined with topical or oral trisoralen, which enhances the effect of sunlight alone, but also increases the risk of sunburn and may cause side effects such as pigmentation.
Benefits of heliotherapy
Heliotherapy is available everywhere, although it is weather and climate-dependent.
Heliotherapy is affordable, especially in countries where phototherapy is inaccessible
Avoid excessive sun exposure. Heliotherapy is not suitable for very fair skinned or photosensitive individuals. Note that the sun is a class 1 carcinogen.
Undertake exposures at the same time/s of day, each day.
Continue prescribed treatment (check with your dermatologist). Continue regular emollient use.
Dead Sea Basin method: 10–20 minutes exposure twice daily, with daily increments of 10 minutes to reach a maximum of 3–6 hours per day (depending on geographic location and other factors). Recommended for a total of 3–4 weeks.
Minimal erythema dose (MED) method: the MED can be determined for the patient. This is the dose or time exposed to the sun that is required for the skin to be just discernibly pink 24 hours after exposure. The subsequent increase in dose/time depends on the Fitzpatrick skin prototype of the patient. Note: MED will be accurate only for the time and day on which it was measured.
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