Heliotherapy

What is heliotherapy?

Heliotherapy is the use of natural sunlight to treat certain skin conditions. It is a form of phototherapy. Also called climate therapy.

How does heliotherapy work?

The ultraviolet (UV) part of the spectrum of sunlight has beneficial effects in small doses.

• Short-wavelength UVB and longer-wavelength UVA induce the production of vitamin D and other chemicals that protect skin cells.
• UV radiation is antiinflammatory, immunosuppressant, and antiproliferative.

The daylight part of the sunlight spectrum may also be useful in the treatment of skin conditions, for example in combination with the photosensitizing agent, methyl aminolevulinic acid, for “daylight.” photodynamic therapy (PDT) to treat actinic keratosis.

What skin conditions respond to heliotherapy?

Inflammatory skin conditions treated with heliotherapy are similar to those treated with other forms of phototherapy.

Psoriasis

Heliotherapy has been found to reduce the extent and severity of psoriasis and improve patients' quality of life. It rarely completely eliminates psoriasis, and in a 10%, sun exposure aggravates psoriasis.

Atopic dermatitis/ /eczema

After 2 to 4 weeks of heliotherapy, there may be improvement in atopic dermatitis/eczema immediately after treatment and several months later. Keep in mind that sunlight can also cause photoaggravated eczema.

Other skin conditions.

Other skin conditions, such as vitiligo, have also been traditionally treated with sunlight. Heliotherapy can be combined with current or oral trisoralen (see PUVA), which increases the effect of sunlight alone, but also increases the risk of sunburn and can cause side effects such as pigmentation.

Benefits of heliotherapy

Benefits included:

• Heliotherapy is available everywhere, although it is weather and climate.dependent.
• Heliotherapy is affordable, especially in countries where phototherapy is inaccessible

Disadvantages of heliotherapy

The disadvantages of heliotherapy include:

• Side effects: sunburn, risk of photosensitivity reaction, long-term skin aging and skin Cancer
• Variable dose: The amount of UV in sunlight depends on latitude, ozone amounts, seasonal variation, time of day, cloud cover, rainfall, and aerosol content of the air.
• Variable exposure time for an individual: this depends on your Fitzpatrick skin phototype, previous exposure to UV radiation, the presence or absence of photosensitivity, and the condition being treated.

How to use heliotherapy

General points:

• Avoid excessive exposure to the sun. Heliotherapy is not suitable for very light or photosensitive individuals. Please note that the sun is a class 1 carcinogen.
• Hold exposures at the same time/s of the day, each day.
• Continue the prescribed treatment (check with your dermatologist)
• Continue regularly emollient use.

The regimens include:

• Dead Sea Basin Method: Exposure for 10 to 20 minutes twice daily, with daily 10-minute increments to reach a maximum of 3 to 6 hours per day (depending on geographic location and other factors). Recommended for a total of 3 to 4 weeks.
• Minimum erythema Dose Method (MED): The MED for the patient can be determined. This is the dose or time of sun exposure required for the skin to have a visible pink color 24 hours after exposure. The subsequent increase in dose/time depends on the patient's Fitzpatrick skin phototype. Note: MED will be accurate only for the time and day it was measured.

Check your local reports Ultraviolet radiation levels. In New Zealand, the sun protection alert warns people to protect themselves during certain times of the day during the summer months. Global Solar Ultraviolet Index (UVI) describes the level of solar energy UVR on the surface of the Earth in different places. Safe exposure can be calculated using a smartphone app that displays geographically and real-time UV levels specific to Fitzpatrick skin type.

The dead sea basin

Traditionally, the Dead Sea has been used as a location for heliotherapy, particularly for patients with psoriasis. The sea is approximately 400 m below sea level, therefore it selectively filters UV radiation, leaving a higher concentration of UVA to UVB than that found at sea level. Additionally, the Dead Sea has an ideal climate for being outdoors, with moderate to high temperatures, low humidity, a large number of sunny/clear days and little rain per year. This allows the use of the sea for treatment at least 8 months a year.