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In ADULT hepatocellular or hemolytic jaundice the main concerning problem is LIVER FAILURE or DYING RED BLOOD CELLS, not elevated bilirubin levels. (*)

In BABIES, jaundice is usually caused by immature liver cells not being able to properly process the huge amounts of bilirubin that come their way. The baby's liver will eventually grow into its role, but in the mean time, the HIGH LEVELS OF UNCONJUGATED (not processed by liver) BILIRUBIN are what's really dangerous.

That's because babies also have an immature hemato-encephalic (blood-brain) barrier. The unconjugated bilirubin crosses into the neural tissue and causes damage (look up "kernicterus"). The goal of phototherapy is to reduce the bilirubin levels (by converting it to a soluble form, ready for excretion from the body) and thus prevent harm to the brain.

Elevated bilirubin in adults is more or less harmless, so therapy should be directed at removing the cause of the jaundice (usually something serious): there's no point in sticking the patient under a lamp just to make him look less yellow.

(However, if you really wanted to do that, I suspect it wouldn't be as effective as with babies because adult bodies have a much smaller surface-to-volume ratio and phototherapy is done by illuminating the surface of a patient's body.)

* PS There's also a third class of jaundice, called obstructive jaundice. Ducts leading bile from the liver become clogged. However, in this type, it's conjugated (already processed) bilirubin that builds up in the blood so I didn't mention it earlier. I'm not even sure if phototherapy would work on this type of bilirubin...?

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