PUVA Treatment (Hand and/or Foot Immersion)

This information has been produced to provide you with knowledge of Hand and/or Foot Immersion PUVA Treatment, and aims to answer any question that you may have.

What is Immersion PUVA?
P = Psoralen in a diluted solution, into which the hands and/or feet are soaked prior to treatment.
UVA = Ultra violet A light.

What skin conditions is Hand and/or Foot Immersion PUVA Treatment prescribed for?
Hand and/or Foot Immersion PUVA treatment is prescribed for psoriasis or eczema that is affecting the hands and/or the feet.

Where is the treatment carried out?
In the PUVA unit, an out-patient department located in the basement corridor, opposite pharmacy, Victoria Wing, at the Royal Victoria Infirmary. The unit is open from 8.30 am to 12.00 noon and 12.45 pm to 3.30 pm, Monday to Friday.
The telephone number for the PUVA unit is (0191) 2824214.

When will I attend?
You will usually have treatment twice a week either on a Monday and a Thursday or a Tuesday and Friday because it takes three days for the effects of your previous treatment to be seen.
Appointments are pre-arranged and a course of treatment will usually last 7-8 weeks. If you fail to attend for treatment on three consecutive treatment days without informing a nurse you will be discharged to the care of your GP.

How will the treatment be carried out?
On treatment days:

• At home do not use emollients prior to attending for your treatment.
• On arrival at the PUVA unit please inform the nurse.
• Your hands and/or feet will be soaked for 15 minutes in the dilute Psoralen solution, during which time you will wear protective glasses provided by the unit. This is to protect your eyes from splashes.
• After this time you will wait for 30 minutes before being exposed to UVA light.
• During treatment you will wear protective glasses and visor, please wear long sleeves and trousers to protect the skin from the light.
• Prior to every treatment your skin will be assessed by a member of the multidisciplinary team, and your progress discussed.
• Your treatment will last a few minutes at first and will build up during the course.
• After each treatment you will need to wash your hands/feet to remove any Psoralen solution, and protect these areas from natural sunlight for the rest of the day.
• Female patients should not become pregnant during the course of treatment.
• Do not use a sun bed or indulge in sunbathing during your course of treatment.
• If you have any concerns or worries please discuss these with the phototherapy staff.

Are there any side effects?
During treatment some burning of the skin may occur, this redness can take 2-3 days to appear and can last for more than one week, which may cause some discomfort. Itching and dryness may occur but is alleviated by the frequent use of moisturisers such as Epaderm, Aqueous cream or Diprobase.

What if this treatment does not work?
If this treatment is not successful in treating your skin condition you may be prescribed oral 8-methoxypsoralen by the Doctor instead of your current treatment. Please see the nurse in-charge of the phototherapy unit who will be able to provide you with a leaflet regarding this treatment and give you further information.

Long Term
Patients who have received continuous PUVA treatment for several years or who have had the equivalent of around 10-15 PUVA courses of average length, are known to be at risk of developing certain forms of skin cancer. For this reason we do not recommend maintenance treatment once the skin has cleared, and we try to keep courses of treatment as short as possible and widely spaced. Any queries regarding this will be discussed with you during your doctor's consultatio