Psoriasis Light Treatments

Psoriasis is a skin disease where active cells reproduce in a few days instead of the normal month, causing reddening, swelling and plaque growth. The disease affects 2 to 2.6 percent of the population. Ultra Violet (UV) light in sunlight suppresses the process leading to psoriasis: Activated T-cells die and the turnover of skin cells lessens. Light treatments for psoriasis replicate sunlight and also combine topical and oral medicine.

Natural

Daily, short, non-burning exposure to the sun clears or improves psoriasis in many people. Therefore, exposing affected skin to sunlight is one initial psoriasis therapy, according to Dr Steven Feldman (see "Resources" below). Sunlight contains UVA, a long wavelength, that penetrates deeper than the short wavelength UVB, which is absorbed in the skin's epidermis, says Dr Feldman. Some physicians treat patients with UVB instead of topical agents. These UVB treatments are performed 3 to 5 times per week.

Narrowband

As of 2009, narrowband UVB treatment is gaining in popularity. It gives out the part of the UV light spectrum most helpful for psoriasis. UVB phototherapy is applied to treat widespread psoriasis,or lesions that do not respond to topical therapy. Normally given in a doctor's office, with a light box or light panel, patients can use a UVB box at home, with doctor's guidance. It is safe and effective for long term control.

PUVA

Combining oral or topical applications of psoralen with UVA light is called the PUVA treatment. Psoralen increases the skin's sensitivity to UVA and physicians use it when 10 percent or more of the patient's body is affected. It is also used for sensitive areas, such as the face and hands. Success rates for PUVA are higher than broadband UVB. In fact, PUVA therapy, when taken two or three times a week, shows more consistent clearance and after fewer sessions.

Side Effects

Avoid sunlight after taking psoralen to prevent severe sunburn. Protect the eyes with UVA-absorbing glasses for one to two days. There are more short-term side effects from PUVA including burning and itching, fatigue nausea and headache. Long-term therapy may bring an increased risk of squamous-cell and, possibly, melanoma skin cancers. Taking drugs that suppress the immune system, like cyclosporine, have little benefit and can increase the risk of cancer.

Combinations

Adding retinoids like acetretin makes UV light treatment more effective. Non-responding patients may benefit from the Ingram regime, says Dr Feldman. This involves a coal tar bath, UVB therapy and an application of a salicylic acid paste for 6 to 24 hours. The Goeckerman therapy combines coal tar ointment with UVB. PUVA can go with oral medications such as retinoids for increased effectiveness. Unfortunately, the treatments are very time-consuming and do not fit most working people's lives.

Tanning Beds

Uncontrolled clinical trials show tanning beds produce good results, but Dr Feldman warns against psoralens in conjunction with the beds saying that they are useful for patients who cannot get to a physician's UVB phototherapy, but usual warnings about over-use still apply. He also notes that tanning beds are not medically supervised.

References

• Light Therapy
• Advances In Psoriasis Treatment