PsoriasisNet Article
Is Phototherapy Right for Your Psoriasis?

Even with many newer psoriasis treatments available today, phototherapy (treatment that exposes the skin to light) remains an option for many people living with psoriasis. Phototherapy can effectively clear psoriasis that does not respond to other treatments. It can treat a stubborn patch or widespread psoriasis. Studies show that phototherapy offers some people long periods (6 to 12 months or longer) without psoriasis. And it can do this in a cost-effective way.

Another advantage is that phototherapy does not weaken the body’s ability to fight infections like some psoriasis treatments. Phototherapy may be a treatment option for people who are HIV (Human Immunodeficiency Virus) positive or have AIDS (Acquired Immune Deficiency Syndrome).

Dermatologists can prescribe some types of phototherapy for pregnant women and women who want to get pregnant.

The biggest drawback to phototherapy is that most types of phototherapy use UV light. This means that phototherapy is not right for everyone.

Patients are Carefully Screened Before Phototherapy
Before writing a prescription for phototherapy, a dermatologist gathers the patient’s complete medical history and performs a physical exam.

To gather the medical history, a dermatologist will ask about past and current medical conditions. It is essential that the dermatologist know about any light sensitivity, organ transplant, skin cancer, or suspicious mole. These do not necessarily mean that phototherapy cannot be a treatment option, but some precautions may be needed.

It also is crucial for a dermatologist to know about all medications and supplements (current and recently taken). Many of these interact with UV light and can cause an unwanted reaction.

A physical exam also is essential. This exam will include a full-body skin exam to check for signs of skin cancer.

Who Should Not Have Phototherapy?
Because phototherapy exposes the skin to UV light, it is not appropriate for everyone. If a person has lupus erythematous (an autoimmune disease that worsens with exposure to the sun) or xeroderma pigmentosum (a rare disease that makes a person extraordinarily sensitive to sunlight and prone to developing many skin cancers), phototherapy will not be prescribed.

To receive phototherapy, a person must be able to tolerate heat. For some types of phototherapy, it is essential to be able to stand and walk without help.

Phototherapy Requires Close Monitoring
If phototherapy is an appropriate treatment, regular follow-up appointments with the dermatologist are essential. During these appointments, the dermatologist will examine the patient to see if the phototherapy is effective and check for signs of skin cancer. Experts recommend that patients be examined about once a month and sometimes more often.

Phototherapy Involves Time Commitment
While there are many types of phototherapy, all require a number of treatment sessions. These treatment sessions usually takes place in a dermatologist’s office or psoriasis clinic.

If excimer laser therapy is prescribed, a patient typically receives 2 treatments per week for 2 to 5 weeks. The pulsed dye laser requires 5 to 6 treatment sessions within 3 to 4 weeks.

Another type of phototherapy, UVB phototherapy, requires 2 to 5 visits per week for several weeks. To receive Goeckerman therapy (or Ingram’s), a person must be available Monday through Friday for several hours a day for about 3 to 5 weeks.

If phototherapy proves effective, a dermatologist may prescribe a UVB home unit. Even this option requires time. It takes time to use the home unit as directed and keep all follow-up appointments with the dermatologist.

Trust a Dermatologist
If you believe that phototherapy may be a treatment option for you, be sure to talk with a dermatologist. These doctors have the training and experience to make sure that phototherapy provides a safe and effective treatment for psoriasis and other skin conditions.

More Information
Psoriasis Treatment: Lasers and Other Light Therapies
Information about the different types of phototherapy approved to treat psoriasis

References:
American Academy of Dermatology. “American Academy of Dermatology Issues New Guidelines for the Management of Psoriasis With Ultraviolet Light Therapy.” News release issued October 22, 2009. Available at www.aad.org/media/background/news/Releases/
American_Academy_of_Dermatology_Issues_New_Guideli4/. Last accessed January 25, 2010.

de Leeuw J, Tank B, Bjerring PJ et al. “Concomitant treatment of psoriasis of the hands and feet with pulsed dye laser and topical calcipotriol, salicylic acid, or both: a prospective open study in 41 patients.” Journal of the American Academy of Dermatology February 2006; 54: 266-71.

Menter A, Korman NJ, Elmets CA et al. “Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 5. Guidelines of care for the treatment of psoriasis with phototherapy and photochemotherapy.” Journal of the American Academy of Dermatology January 2010; 62: 114-35.

Morison WL, Atkinson DF, Werthman L. “Effective treatment of scalp psoriasis using the excimer (308 nm) laser.” Photodermatology Photoimmunology & Photomedicine August 2006; 22: 181-3.