Neonatal Phototherapy: A Novel Therapy to Prevent Allergic Skin Disease for At Least 5 Years

Abstract

Background: Preventing the development of allergic skin disease in children is the best way to treat the disease. Objectives: Ultraviolet (UV)-free blue light phototherapy has been reported to treat atopic eczema. We evaluated the effect of neonatal phototherapy on allergic skin disease in children. Methods: We randomly recruited 117,041 children from an insurance research database. Those with neonatal jaundice and receiving neonatal phototherapy were classified as the icteric-phototherapy group (n = 4,744), those with neonatal jaundice and not receiving phototherapy were classified as the icteric-non-phototherapy group (n = 5,003), and those without jaundice were classified as the non-icteric group (n = 107,294). We reviewed claims from birth to age 5 years. The prevalence of atopic dermatitis (AD), clinical visit times, and topical prescriptions for allergic skin disease at different ages were compared among groups. Results: AD prevalence was lower in the icteric-phototherapy group than in the icteric-non-phototherapy group. Moreover, clinical visit times for allergic skin disease were lower at age 1–4 years, and topical agent prescription for allergic skin disease were lower at age 1–5 years, in the icteric-phototherapy group than in the icteric-non-phototherapy group. The decreased use of topical agents could reach 64.29%. The 5-year complications of skin disease and cancer in the phototherapy group were not higher. Conclusions: To our knowledge, this is the first study to report on the effect of UV-free blue light therapy on allergic skin disease in newborns. Blue light therapy in newborns may be a novel method to efficiently prevent allergic skin disease for at least 5 years.

Neonatal jaundice, phototherapy and childhood allergic diseases: An updated systematic review and meta‐analysis

“…Nineteen studies were in the qualitative synthesis. [10][11][12][13][14][15][25][26][27][28][29][30][31][32][33][34][35][36][37] In the end, fourteen studies reporting the effect estimate were synthesized in the meta-analysis. Our search did not reveal any ongoing and unpublished studies.…”

Reply to the Letter to the Editor “Shining a Light on Concerns about Phototherapy to Prevent Allergic Skin Disease”

“…Our study [2] comprised 4,744 jaundiced infants treated with phototherapy, 5,003 jaundiced infants not treated with phototherapy, and 107,294 anicteric infants. For a study of allergic skin disease, I believe that the sample size is satisfactory.…”

“…The decreased frequency of clinical visits for allergic skin disease and reduced prescription of topical agents was 38.3% for boys aged 2 years (Table 3) [2] and 64.3% for girls aged 4 years (Table 4) [2], respectively. The large number of subjects and the dramatic decrease in clinical visits and topical agent use suggest that using blue light to prevent allergic skin disease is feasible.…”

“…Therefore, in our article, we wrote: “We did not find an association among cancer, recurrent/chronic skin disease, and neonatal phototherapy. However, a longer observation period is necessary” [2]. Furthermore, in our Conclusion, we wrote: “More studies, including the data of severity of the hyperbilirubinemia, age of peak bilirubin, and type of phototherapy, are necessary before preventive phototherapy could be widely used on a preventive basis” [2].…”

Shining a Light on Concerns about Phototherapy to Prevent Allergic Skin Disease

“…A recent report from a retrospective review of administrative claims data in Taiwan published in Neonatology concluded that “Blue light therapy in newborns may be a novel method to efficiently prevent allergic skin disease for at least 5 years” [1]. The effect size is tiny, the evidence to support this claim is weak, and we are concerned that it could lead to harm to newborns and their families.…”