For small spots of vitiligo, it is possible to use psoralen as drops, applied only on the spots. This method does not have side effects since the amount is very low.
For larger area, the psoralen is taken as a pill, and the amount is high (10 mg); some patients experience nausea and itching after ingesting the psoralen compound. For these patients PUVA bath therapy may be a good option.
Long term use of PUVA therapy with a pill has been associated with higher rates of skin cancer.
The most significant complication of PUVA therapy for psoriasis is squamous cell skin cancer. Two carcinogenic components of the therapy include the nonionizing radiation of UVA light as well as the psoralen intercalation with DNA. Both processes negatively contribute to genome instability.