PUVA is one of the oldest methods used for treating vitiligo. Oral PUVA therapy is used for people with more extensive vitiligo (affecting greater than 20 percent of the body) or for people who do not respond to topical PUVA therapy. Oral psoralen is not recommended for children under 10 years of age because of an increased risk of damage to the eyes, such as cataracts.

For patients who cannot go to a PUVA facility, the doctor may prescribe psoralen to be used with natural sunlight exposure. The doctor will give the patient careful instructions on carrying out treatment at home and monitor the patient during scheduled checkups.

PUVA therapy involves the ingestion of Oxsoralen-Ultra® (Methoxsalen Capsules, USP, 10mg) 1.5 to 2 hours prior to exposure to UVA light. The dose of Oxsoralen-Ultra® capsules you take is held constant and is determined by your weight. The interval between taking Oxsoralen-Ultra® capsules and being exposed to light is also held constant because peak levels of psoralen are usually reached in the skin between 1 to 2 hours after ingestion.

Skin Burning. Serious burns from either UVA or sunlight (even through a window glass) can result if the recommended dosage of the drug and/or exposure schedules are exceeded.3,9 Nausea. Nausea may occur after taking the Oxsoralen-Ultra® (Methoxsalen Capsules, USP, 10mg) capsules. This may be avoided or lessened by taking the medication with milk or low-fat food.3,9 Itching. Itching commonly occurs as a result of light treatment. Numerous ointments are available to soothe mild itching.

Take Oxsoralen-Ultra® (Methoxsalen Capsules, USP, 10mg) capsules 1.5 to 2 hours prior to your scheduled treatment. After taking the capsules, stay out of the sun and wear UVA-blocking glasses. Avoiding the sun prevents overexposing the skin to UVA rays, which could lead to a sunburn. The glasses prevent UVA rays from entering the eyes and potentially causing cataracts. If you must travel in the sun, wear clothing that covers your arms and legs as well as a hat to protect your head and face.

Most private insurers do cover it as a treatment for severe, recalcitrant, disabling psoriasis. You will likely be required to remit a standard copay amount as determined by your medical insurance company. Check with your insurer for coverage details and copay amounts. Medicare also covers a portion of PUVA therapy for psoriasis treatment.10

Studies show that PUVA therapy clears psoriasis in 84% of the patients who undergo it and that it induces long remission times, even without maintenance therapy.1,5

Yes. If your physician finds that you are a good candidate for PUVA therapy, he or she will write you a prescription for Oxsoralen-Ultra® in conjunction with exposure to UVA light.3

PUVA therapy involves treatment with UVA light while UVB therapy involves treatment with Ultraviolet B light.

Skin cancer. Some people are at a higher risk than the normal population for developing skin cancer, including people who have had previous non-melanoma skin cancer, arsenic therapy or X-ray therapy to the skin, as well as individuals with extremely light complexions which always burn and never tan. In general, these patients are not considered for PUVA therapy unless strong extenuating circumstances exist in favor of it.

Many experts suggest that tanning beds (also known as tanning booths and solariums) not be used in place of PUVA lamps or Narrow Band UVB lamps or even natural sunlight. The problem with tanning beds is that the lamps in these devices usually emit a much stronger, broader spectrum of UV rays, and may not be as safe or effective for people treating vitiligo, and may result in severe burning or other side effects.