Blue light therapy is a special form of light therapy and is used primarily for the treatment or prophylaxis (prevention) of so-called icterus neonatorum. This physiological jaundice is due to hyperbilirubinemia (increased concentration of bilirubin) and is a consequence of the short life span of the fetal erythrocytes (red blood cells of the newborn). Bilirubin is a water-insoluble breakdown product of hemoglobin (red blood pigment). Before birth, bilirubin is transported by the placenta to the mother’s liver, where it is further broken down. After birth, however, the fetal liver is not yet fully capable of performing this task, and bilirubin is deposited, manifesting as yellowing (jaundice) of the skin and mucous membranes. Treatment of this jaundice is necessary because of the possibility of dangerous damage to the brain, which is called bilirubin encephalopathy or kernicterus. Blue light therapy is also called cold light therapy (synonym: UVA1 cold light therapy) and is additionally used to treat various skin diseases.
Indications (areas of application)
- Icterus neonatorum (neonatal jaundice).
- Morphea – or scleroderma; a collective of diseases belonging to the autoimmune diseases that affect the vascular and connective tissue system.
- Mastocytosis – two main forms: cutaneous mastocytosis (skin mastocytosis) and systemic mastocytosis (whole body mastocytosis); clinical picture of cutaneous mastocytosis: Yellowish-brown spots of varying size (urticaria pigmentosa); in systemic mastocytosis, there are also episodic gastrointestinal complaints (gastrointestinal complaints), (nausea (nausea), burning abdominal pain and diarrhea (diarrhea)), ulcer disease, and gastrointestinal bleeding (gastrointestinal bleeding) and malabsorption (disorder of food absorption); In systemic mastocytosis, there is an accumulation of mast cells (cell type that is involved in, among other things, allergic reactions). Among other things, involved in allergic reactions) in the bone marrow, where they are formed, as well as accumulation in the skin, bones, liver, spleen and gastrointestinal tract (GIT; gastrointestinal tract); mastocytosis is not curable; course usually benign (benign) and life expectancy normal; extremely rare degeneration mast cells (= mast cell leukemia (blood cancer)).
- Severe atopic eczema (neurodermatitis)
- Parapsoriasis (psoriasis) – a disease similar to psoriasis.
- Pruritus (itching) with different causes.
The procedure
Blue light therapy is used for jaundice neonatorum in the wavelength range of 420-480nm. The light initiates a photochemical process that provides conversion of bilirubin into a water-soluble isomer (structurally altered form of a molecule). This substance is non-toxic (toxic) and can be excreted independently of glucuronidation (degradation process to eliminate waste products in the liver). To ensure therapeutic success, blue light is applied prophylactically in the first 24-48 hours in low birth weight infants. In accordance with guidelines, blue light therapy is used as follows:
- Birth weight above 2-2.5 kilograms with a serum bilirubin concentration of 310 μmol/l
- Birth weight over 2.5 kilograms with a serum bilirubin concentration of 220 μmol/l
In addition to the treatment of icterus neonatorum, other indications exist due to the following effects:
- Quieting pruritus (itching).
- Promotion of wound healing
- Nervous attenuation
- Antiphlogistic effect (anti-inflammatory)
If blue light therapy is applied from these points of view, the application time is 20-30 minutes, while the distance of the light source from the skin surface is about 15-20 cm. Conclusion: In the treatment of icterus neonatorum, blue light therapy is a standard therapy. However, blue light therapy also achieves good results in alleviating some dermatological diseases.
