Paul & Sue Hazelden
- Paul's Light Treatment -

Introduction

Because of a serious deterioration in the condition of my skin, I was booked in to a course of Light Treatment at the BRI ('Bristol Royal Infirmary') in the Autumn of 2005. Not only was it very effective, but aspects of the whole experience were quite surreal.

The Mechanics

The treatment lasted 8 weeks. It seems they do either 6 or 8 week blocks, and I asked for the full amount. Treatment is on the Monday, Wednesday and Friday of each week, although in the first week you have to go in for assessment on the Tuesday and Thursday as well.

The Dermatology Department is just behind and above the BRI: that hill must be one of the steepest in Bristol, and not one to race up if you are cutting it fine for an appointment.

I work within easy walking distance of the BRI, which was very convenient - it generally took just 6 minutes to get there. I booked my appointment for 11 o'clock each time, and set an alarm to go off at 10:45, which worked fine. Incredibly, given my hectic schedule, I only needed to move one of the appointments - everything else fitted in neatly before or after.

The Sessions

Apart from examinations, each session was essentially the same. I would book myself in at reception, collect a hospital gown, find a changing room, take off all my clothes, put on the gown, walk a few yards to the machine (basically an upright sunbed), take off the gown, stand in the machine while it did its stuff, then go back to the changing room, use some moisturiser, and get dressed again.

I had to wear eye goggles, of course, and they told me I had to wear a sock on what the nurse delicately described as my 'private parts'.

After a few weeks, I was developing quite a suntanned face, so they insisted I wear a face mask. It looked like a face shield you use when welding, and had to be washed after each session - which is not easy when your hands are covered with moisturiser.

The Experience

At the physical level, standing up in a sun bed was a very enjoyable experience, and I was astonished at how much my skin improved as a result. But, apart from the treatment itself, the whole experience was regularly punctuated with quite surreal incidents.

It started in the pre-treatment meeting, when I was told I would have to wear a sock. I asked why. "To cover your 'private parts'." But why do I need to cover them? "Because you do not want to expose them to the light." Pause. Are you saying that my genitals are more sensitive to light than the rest of my skin? "No." The Nurse was clearly getting a bit flustered at this point. I told her that I spent very little time in the sun, and that my buttocks were no more used to sunshine than my genitals. So, if they were both as sensitive to light, and both as little exposed to it, why the difference? Because them's the rules, it seems.

I tried to find out several times how much light I was getting. How did time in the machine equate to time spent sunbathing?

On one occasion, I was told there was no equivalent, because the light produced by the machine is different from the light produced by the sun. Which is daft, because the only thing they were worried about was the risk of skin cancer - they mentioned this repeatedly, and they were regularly warning us off sunbathing because of the risk of skin cancer. So how does the risk from five minutes in the machine equate to the risk from five minutes sunbathing? Sorry, you can't compare the two.

I tried this conversation with another Nurse. This time, I was more specific. How does the risk from the machine compare to the risk from sunbathing at mid-day at the height of Summer? I think just the mention of sunbathing freaked this Nurse. It worried all of them: any mention of it would always produce the "Sunbathing - Cancer - BAD!" response. This time, it was even more entertaining. After the standard "Sunbathing gives you cancer" response, she went on to explain that many people do not realise the sun is always dangerous, even in Winter. The sun does not change its strength, so it is just as dangerous in Winter as it is in Summer, and just as dangerous in the evening as it is at mid-day. I decided not to pursue the conversation beyond this point.

I found it very perplexing that Dermatology will only give me a very few courses of Light Treatment - someone mentioned a maximum lifetime exposure of 200 somethings - because of the risk of skin cancer, but they absolutely refused to give my any information that would let me calculate how the risk from these 200 units compares to the risk from exposure to the sun outside the hospital. They tell me the sun is 'very dangerous' but they will give me the same treatment whether I spend hours in the sun every week of every Summer, or whether (as is the case) I hardly ever spend time in the sun and have not done any sunbathing since our family holidays in Polzeath.

The 200 'somethings' I discovered much later are 200 treatments. Yes, it really does not make any difference whether you have the lowest possible dose each time, or the highest, you are only allowed 200 sessions in a lifetime. Because of the risk of skin cancer. As the Americans say, "Go, figure."

I should also mention that I used to be very self-conscious about my body. As a child at the swimming pool, I would either use an individual changing cubicle, or wrap a towel around me to preserve my modesty - despite the fact that it was a male only changing room. I realised this was absurd, and over the years have trained myself to be more accepting of and comfortable with my body. This discipline came in very handy, as the nurses would regularly check that the treatment wasn't doing any harm, so I would need to take off the gown and stand there naked while a lady (all the nurses in this department were female) wandered round examining various parts of my anatomy. I was very glad that I had acclimatised myself over the years to cope with nudity.

On the 'not doing any harm' front, another regular oddity was the interrogation before each session. Since the last treatment, have I experienced any irritation or itching? The first time, of course I answered yes. That's why I'm here: my body is covered with eczema. No - any irritation or itching caused by the treatment. How do I tell whether it is caused by the treatment? No idea. They clearly had to ask this each time, and I rapidly learned to give the right answer. I wonder if everyone struggles to answer that question both honestly and helpfully?

Links

Just a few selected links:

• Eczema.  More about Paul's experience and some thoughts about treatment.
• Paul's Health.  The introduction and overview page.
• Sauna.  More about Paul's experience of the sauna, what it is and what it does for you.