Topical Methoxsalen (Oxsoralen, Uvadex) is used in combination with ultraviolet light therapy for the treatment of hypopigmented skin patches.

Topical Methoxsalen (Uvadex, Oxsoralen) Uses:

• It is used for the repigmentation of idiopathic vitiligo.

Read the details of oral methoxsalen here: Methoxsalen (Oxsoralen) Tablets & Capsules - Uses, Dosage, Side effects.

Topical Methoxsalen (Uvadex, Oxsoralen) Dose in Adults:

Note: Oxsoralen has been discontinued for more than a year in the US. 

Note: For recommendations on UVA exposure, consult the therapy regimens.

Topical Methoxsalen (Uvadex, Oxsoralen) Dose in the treatment of Vitiligo:

• The lotion is applied by a healthcare provider before UVA light exposure, not exceeding more than once a week
• The frequency of application is determined by the erythema response.

Topical Methoxsalen (Uvadex, Oxsoralen) Dose in Children:

Note: Oxsoralen has been discontinued for more than a year in the US.

Topical Methoxsalen (Uvadex, Oxsoralen) Dose in the treatment of Vitiligo: 

• Children 12 years and older:

  • Refer to adult dosing.

Uvadex Pregnancy Risk Factor C

• It has not yet been tested in pregnant human females or animals.

Use during breastfeeding:

• It is unknown if the drug will be excreted into breastmilk.
• The manufacturer recommends that lactating women use topical methoxsalen.

Topical Methoxsalen Dose in Renal Disease:

No dosage adjustment is recommended when used topically.

Dose in Liver disease:

No dosage adjustment is recommended when used topically.

Side effects of Methoxsalen (Uvadex, Oxsoralen):

• Dermatologic:

  • Burning sensation of skin
  • Erythema
  • Skin blister
  • Skin irritation

Contraindications to Methoxsalen (Uvadex, Oxsoralen):

• Allergy to methoxsalen or any component of formulation
• Patients suffering from photosensitive skin conditions such as albinism and porphyriacutanea tarda, erythropoietic or variegate porphyria and systemic lupus-erythematosus and xeroderma pigmentosum.
• Skin cancers that are aggressive
• History of Melanoma and Melanoma
• Children younger than 12 years old

Uvadex Warnings & Precautions

• Burns

  • Patients can sustain serious burn injuries from exposure to ultraviolet radiation. 
  • Patients who don't wear sunscreen or protective clothing and who expose to sunlight for longer periods of time are more at risk for sunburns.

• Cataracts

  • To prevent cataract formation, methoxsalen concentrations in the lenses.
  • Patients should protect their eyes from direct and indirect sunlight for at least 24 hours following the use of the drug.
  • The risks associated with topical application are minimal, as systemic exposure is very low.

• Photosensitivity

  • Avoid sun exposure and use of sunlamps for at least eight hours after the use.
  • After receiving combined methoxsalen/UVA therapy, patients should wear protective clothing and eyewear. Sunscreens should not apply to areas with psoriasis.
  • It is best to not use it on sunburnt skin until you are completely healed. 
  • Avoid sunbathing for at least 24 hours prior to the treatment, and several days afterwards.
  • Patients who are exposed to the sun a lot due to their occupation should avoid it.

• Skin cancer:

  • Systemic therapy can increase the risk of skin cancers, including basal cells, melanoma and squamous cells.
  • Patients at high risk for developing cancers should use it with caution, especially those who have had previous exposure to coal tar, ultraviolet radiation, ionizing radiation or arsenic.

• Basal cell carcinoma

  • Patients who have had basal cell carcinoma in the past shouldn't use it.
  • Patients at high risk for basal cell carcinoma should be closely monitored.

Monitoring Parameters:

Monitor the response to therapy and sunburn.

How to administer Topical Methoxsalen (Oxsoralen, Uvadex)?

• Before applying the medicine over hypopigmented areas, wear protective gloves.
• Avoid burns and photosensitization of the unaffected areas.

Mechanism of action of Methoxsalen (Oxsoralen, Uvadex):

• It causes cellular replication to be inhibited by covalent bonds with DNA nucleotide bases pyrimidine nucleotide.
• This results in inhibition of DNA synthesis.
• It results in thickening the stratum corneum, increased pigmentation and an increase in melanocyte production.
• The methoxsalen molecular is stimulated by sunburn and ultraviolet rays to create a "triplet electronic condition" in the skin. 
• The skin's reaction to this excited molecule is photosensitization, and an inflammatory reaction.
• Following the erythematous reaction, skin repair takes place over several days or weeks.
• This results in melanocyte production as well as hardening of skin (stratum corneum).

International Brands of Methoxsalen:

• Oxsoralen
• Geroxalen
• Lukodermine
• Meladinina
• Meladinine
• Melanocyl
• Melaoline
• Metholen
• Mopsalem
• Oxsoralen Lotion
• Oxsoralen Ultra (
• Uvadex
• Vitilen Lotion

Methoxsalen Brand Names in Pakistan: