What is the phototherapy treatment for psoriasis?
Natural sunlight contains ultraviolet (UV) light. UV light kills T cells in skin, reducing redness and slowing the overproduction of skin cells that causes scaling.
Sunshine. Brief, regular periods of exposure to natural sunlight can improve or clear psoriasis in some people. This approach to treating psoriasis is called climatotherapy. Sunburn should be avoided because it can make psoriasis worse. Exposure to sunlight is not recommended for people who are sun-sensitive. Sun exposure can cause aging of the skin. An annual medical checkup is advised because sun exposure can increase the chance of skin cancer.
Ultraviolet B (UVB) phototherapy. UVB is light with a short wavelength that is absorbed in the skin's epidermis. An artificial source can be used to treat mild and moderate psoriasis. Some physicians will start treating patients with UVB instead of topical agents. A UVB phototherapy, called broadband UVB, can be used for a few small lesions, to treat widespread psoriasis, or for lesions that resist topical treatment. This type of phototherapy is normally given in a doctor's office by using a light panel or light box. Some patients use UVB light boxes at home under a doctor's guidance. A newer type of UVB, called narrowband UVB, emits the part of the ultraviolet light spectrum band that is most helpful for psoriasis. Narrowband UVB treatment is superior to broadband UVB, but it is less effective than PUVA treatment (see next paragraph). It is gaining in popularity because it does help and is more convenient than PUVA. At first, patients may require several treatments of narrowband UVB spaced close together to improve their skin. Once the skin has shown improvement, a maintenance treatment once each week may be all that is necessary. However, narrowband UVB treatment is not without risk. It can cause more severe and longer lasting burns than broadband treatment.
Psoralen and ultraviolet A phototherapy (PUVA). This treatment combines oral or topical administration of a medicine called psoralen with exposure to ultraviolet A (UVA) light. UVA has a long wavelength that penetrates deeper into the skin than UVB. Psoralen makes the skin more sensitive to this light. PUVA is normally used when more than 10 percent of the skin is affected or when the disease interferes with a person's occupation (for example, when a teacher's face or a salesperson's hands are involved). Compared with broadband UVB treatment, PUVA treatment taken two to three times a week clears psoriasis more consistently and in fewer treatments. However, it is associated with more shortterm side effects, including nausea, headache, fatigue, burning, and itching. Care must be taken to avoid sunlight after ingesting psoralen to avoid severe sunburns, and the eyes must be protected for one to two days with UVA-absorbing glasses. Long-term treatment is associated with an increased risk of squamous-cell and, possibly, melanoma skin cancers. Simultaneous use of drugs that suppress the immune system, such as cyclosporine, have little beneficial effect and increase the risk of cancer.
Light therapy combined with other therapies. Studies have shown that combining ultraviolet light treatment and a retinoid, like acitretin, adds to the effectiveness of UV light for psoriasis. For this reason, if patients are not responding to light therapy, retinoids may be added. UVB phototherapy, for example, may be combined with retinoids and other treatments. One combined therapy program, referred to as the Ingram regime, involves a coal tar bath, UVB phototherapy, and application of an anthralin-salicylic acid paste that is left on the skin for 6 to 24 hours. A similar regime, the Goeckerman treatment, combines coal tar ointment with UVB phototherapy. Also, PUVA can be combined with some oral medications (such as retinoids) to increase its effectiveness.
More information on psoriasis
What is psoriasis? - Psoriasis is a disease whose main symptom is gray or silvery flaky patches on the skin which are red and inflamed underneath when scratched.
What types of psoriasis are there? - Types of psoriasis include plaque psoriasis, guttate psoriasis, pustular psoriasis, erythrodermic psoriasis, flexural psoriasis, psoriatic arthritis, and nail psoriasis.
What causes psoriasis? - Psoriasis is driven by the immune system. Psoriasis is the growth of too many skin cells. The first outbreak of psoriasis is often triggered by emotional or mental stress or physical skin injury.
How is psoriasis diagnosed? - Physicians diagnose psoriasis by examining the affected skin. In people with psoriatic arthritis, the arthritis usually follows the appearance of psoriasis.
What triggers psoriasis? - Psoriasis triggers include streptococcal infection, sun exposure, drug reactions, hormonal factors, psychological factors, and skin trauma.
What are the psoriasis symptoms? - Symptoms depend on the type of psoriasis the individual has and may include bright red areas of raised patches (plaques) on the skin, tiny areas of bleeding, and itching.
What are the psoriasis risk factors? - The risks associated with developing psoriasis are similar to the triggers of the disease. The most significant risk factor for psoriasis is a family history of the condition.
What is the treatment for psoriasis? - The treatment is chosen on the basis of the pattern of psoriasis and its severity. Treatments for psoriasis can often control the disease for long periods.
What is the topical treatment for psoriasis? - Some patients with psoriasis respond well to ointment or cream forms of corticosteroids, vitamin D3, retinoids, coal tar, or anthralin. The medication that is best may depend on the type and location of the psoriasis.
What is the phototherapy treatment for psoriasis? - Phototherapy treatment for psoriasis uses ultraviolet (UV) light to kill T cells in skin, reducing redness and slowing the overproduction of skin cells that causes scaling.
What is the systemic treatment for psoriasis? - Systemic treatment for psoriasis involves taking medicines internally by pill or injection. Systemic psoriasis treatment drugs include methotrexate, retinoids, cyclosporine.
What is plaque psoriasis? - Plaque psoriasis can is a disease with very clearly defined area of skin which has a raised, red and inflamed section of skin covered in silvery scales.
What is guttate psoriasis? - Guttate psoriasis is a type of psoriasis that looks like small, salmon-pink drops on the skin. Guttate psoriasis is characterised by multiple tiny areas of psoriasis.
What is flexural psoriasis? - Flexural psoriasis is a form of psoriasis found in the armpits, groin, under the breasts and in other flexion creases (skin folds) such as those around the genitals and buttocks.
What is pustular psoriasis? - Pustular psoriasis is an uncommon form of psoriasis. People with pustular psoriasis have clearly defined, raised bumps on the skin that are filled with pus (pustules).
What is erythrodermic psoriasis? - Erythrodermic psoriasis is a particularly inflammatory form of psoriasis that often affects most of the body surface. Erythroderma is a generalised redness of the skin.
What is scalp psoriasis? - Scalp psoriasis range from very mild with fine scaling to very severe with thick, crusted plaques. Scalp psoriasis scales appear powdery with a silvery sheen.