Methoxsalen (Topical)

Methoxsalen is used along with sunlight or ultraviolet light for the treatment of vitiligo and other conditions.

Overview

Methoxsalen is used in combination with ultraviolet light for the treatment of a condition called vitiligo. Vitiligo is a condition wherein the skin loses color.

Methoxsalen is a psoralens medication that is used with sunlight or ultraviolet light A. It is only available with a prescription and can only be used under the direct supervision of a doctor. The treatment is applied to the skin topically as a lotion and is prescribed as Ultramop lotion.

Following the use of this treatment, patients will need to spend a period of at least 72 hours out of direct sunlight. Patients must also avoid tanning, sunbathing and sunbeds throughout the duration of the treatment.

Condition treated

  • Vitiligo

Type Of Medicine

  • Psoralens

Side Effects

In addition to the desired effects from treating vitiligo with Methoxsalen, other unwanted side effects may also occur from its use. While not all of the side effects listed may occur, when they do, the patient may need to seek medical attention.

The following side effects will commonly occur from the use of this medication:

  • Cold sores
  • Darkening of the skin
  • Depression
  • Dizziness
  • Drying of the skin
  • Headache
  • Itching of the skin
  • Leg pain
  • Mild skin changes when this drug is used along with UVA light treatment
  • Nausea
  • Nervousness
  • Redness of the skin
  • Sleep problems (insomnia)
  • Tenderness of the skin
  • Trouble sleeping (insomnia)

In addition to these side effects, there is also an increased risk of the patient experiencing the development of skin cancer after use of Methoxsalen. Once you have had the treatment you should regularly check the treated area and should show your doctor anything that concerns you. Signs to look out for include wounds that don't heal, skin growths, moles, changed growths, changed moles and other skin abnormalities.

Methoxsalen use can also cause a premature aging of the skin to occur. This can be permanent and is similar to the effects experienced from sunbathing for long periods of time.

Other side effects that have not been listed here could also occur from the use of Methoxsalen. You should consult your doctor if you experience any other side effects from use.

Dosage

Certain foods may increase your sensitivity to light when you are taking this medication. You need to avoid these foods before and after use. In particular, patients should avoid consuming limes, parsley, figs, parsnips, mustard, carrots and celery.

This medication should only be used under the direct supervision of your doctor and should never be applied elsewhere.

After your treatment and exposure to UVA, you should wash the treated area thoroughly with soap and water. You should then cover the area and wear sunscreen to protect the area from the sun.

The following dosing information should be used as a guideline only and should not be used to change your dose. You should only ever use the medication as directed by the administering doctor.

Adults and children aged over 12 should be treated as follows:

  • Apply the medication to the affected area.
  • Allow to dry for 2 minutes
  • Apply again 1½ 2 hours later and then begin UVA exposure.

Use in children below the age of 12 is not recommended.

Interactions

Certain medications should never be used in conjunction with one another. This is because they can interact in the body and cause severe medical problems to occur. In less serious cases medications may stop one another from working or may increase the side effects of other medications. To avoid any interactions you must inform your doctor of all other treatments that you are using for any condition. This includes all prescribed medications, over the counter treatments and any applications or cosmetics that you are applying to the affected area. When using Methoxsalen you should be particularly certain to inform your doctor if you are taking any of the following medications:

The use of the following with Methoxsalen is not normally recommended. In some cases, you may be treated with both medications, however, and your doctor may change the dose or frequency of use of one or the other to avoid interactions:

  • Tegafur
  • Pirfenidone
  • Clozapine
  • Anagrelide

The use of the following medications with Methoxsalen may increase the side effects experienced. Your doctor may prescribe both with changes to the frequency of use or dose:

  • Phenytoin

  • Fosphenytoin

Methoxsalen can also interact with other medications that have not been listed herein. This list was compiled for severity and is not all-inclusive. Ensure your doctor knows about all treatments or substances you are taking.

Certain foods can increase the sensitivity to light and should be avoided with the use of this medication. These food include the following:

  • Carrots
  • Celery
  • Figs
  • Limes
  • Mustard
  • Parsley
  • Parsnips

Other medical problems can also affect the use of Methoxsalen. You should inform your doctor if you have any other medical problems so interactions can be avoided. This is especially important in the following cases

These treatments may be worsened by the use of PUVA:

  • Sunlight allergy
  • Infection
  • Lupus erythematosus
  • Porphyria
  • Skin cancer
  • Skin conditions
  • Heart disease
  • Blood vessel disease

Other medical conditions not listed herein could also impact upon the use of Methoxsalen. You should ensure that your doctor if fully aware of all medical conditions from which you suffer or have suffered in the past before you undergo this treatment.

Warnings

Before you use this medication and treatment it is important that you strongly consider the risks of use. This treatment may increase your risk of developing cancer in the future. You should weigh the risks against the benefits of use and you should do so with your doctor. You must ensure that all of the following has been considered:

Cancer' Methoxsalen is a very strong and potent medication that will make your skin more sensitive to the effects of sunlight. If it is used incorrectly it will cause sunburn to occur and it can also increase the occurrence of skin cancers. It may also cause a premature aging of the skin. You should only ever use it as directed and should not use it for any other purpose or on any other part of the body. You must discuss these risks with your doctor before treatment.

Allergies ' You must inform your doctor if you have any allergies. It is especially important that you inform your doctor if you or anyone in your family has an allergy to sunlight. This condition can be made much worse through the use of this treatment and this may also be irreversible.

Pediatric ' This medication has only been tested down to the age of 12. You should not use this medication on anyone below this age.

Geriatric' There are no known limitations to the use of this medication in the elderly. Elderly patients are, however, more likely to be suffering from other conditions that may affect the use of this treatment.

Pregnancy' There is a risk to the use of this medication when you are pregnant. You must inform your doctor before you begin use if you are pregnant and must tell your doctor straight away if you become pregnant during use.

Breastfeeding' There are no studies to determine the risk of use during breastfeeding. You should discuss breastfeeding with your doctor before you begin use of this medication.

You will need to attend multiple sessions with your doctor for treatment and for checkups. It is very important that you attend these and ensure you are on time and prepared for the treatment. Remember to avoid eating the foods listed in advance of these appointments.

Methoxsalen will increase your sensitivity to light and you should take extra caution to cover up following this. Even on a cloudy day or behind a window you may still experience sunburn on the treated area. After each treatment you must wash the area thoroughly with soap and warm water to get the topical lotion off. You should then avoid going outside in daylight hours and if you have to then you should ensure that the area is covered for at least the next 12-48 hours. If you cannot cover the area then you must wear at least SPF30 suncream on the treated area to protect it. If you have a fair complexion and are susceptible to burning normally then you must take even more care in the sun. If you have any questions about this then you should consult your doctor before treatment. Burns in the treated area must be avoided. They will be slower to heal and your risk of developing cancer will be greatly increased.

Do not sunbathe or go to a sunbed at any stage during your course of treatment with Methoxsalen. You should be especially cautious for 72 hours after treatment and should not plan any time in the sun at this time.

This medication can cause your skin to become dry and cracked. You should not do anything to treat this, however, without first consulting your doctor. Do not apply any moisturizers or creams that have not been approved by the doctor. You should also avoid the use of any cosmetic treatments in this area as they may irritate it.

Storage

Store this medication below 40°C..

Keep out of the reach of children and store only in a hospital environment. Do not allow patients to take the treatment home.

Summary

Methoxsalen is a treatment for a condition called vitiligo. Vitiligo is a treatment where the pigmentation of the skin is lost. Methoxsalen increases the sensitivity of the skin to light so that UVA light can be targeted to this area to darken the area with lost pigmentation.

This treatment is largely cosmetic and should not be undertaken lightly. The use of this medication can increase your risk of developing skin cancer and this risk needs to be taken seriously. You should discuss this with your doctor before you begin treatment with Methoxsalen.

This medication should only ever be administered by a medical professional trained in its use. Do not allow a patient to use this treatment at home.

After treatment, you will need to avoid contact with sunlight for a period of at least 72 hours.