Phototherapy is the original psoriasis treatment – did you know that? For as long as people have had the disease, they've treated it with sunlight. Even today, with all the high-tech remedies available, light therapy continues to be one of the most effective treatments for psoriasis. Does it actually work? We help find the answer for you in this article!
Ultraviolet Light Therapy
When ultraviolet light hits the skin, it does all kinds of things. Ultraviolet light kills the immune cells in the skin that contribute to psoriasis, and research suggests that UV light may also disrupt the faulty signals between immune cells and skin cells that lead to psoriasis lesions.
With relatively few side effects, phototherapy is an effective—yet underused—treatment, experts say. Phototherapy is a great treatment to start with, though not everyone will receive the same results from it. And it should be utilized with the advice from your dermatologist before beginning.
Types of Phototherapy
Phototherapy is usually administered on an outpatient basis in a dermatologist’s office two to three times a week, using a walk-in light booth that looks like a tanning bed. Lightboxes for home use are also available, as well as handheld light therapy devices.
There are two main types of phototherapy:
Ultraviolet B light (UVB), one of the components of sunlight, is especially effective for treating psoriasis. During the treatment, patients are exposed to the light for just a few seconds at first, and the exposure time is gradually increased to several minutes per treatment. UVB treatment is sometimes administered with topical treatments such as coal tar, anthralin, or just mineral oil (but those treatments should not be used as they are actually worse for treating psoriasis). A form of UVB light known as narrow-band (NB-UVB) has been shown to be even more effective than UVB and is increasingly being used by dermatologists.
Although not as potent as UVB, ultraviolet A light (UVA) is also used to treat psoriasis. UVA treatment generally takes longer than UVB—exposure times can reach 15 to 20 minutes—but at these higher doses, it's also effective in clearing lesions. UVA light is often combined with an oral medication known as psoralen (a treatment known as PUVA).
A newer variation of phototherapy uses excimer or pulsed-dye lasers to target individual plaques. Research suggests that laser therapy may require fewer treatments and produce longer remissions, but since this technique is so focused it is not very practical for people with widespread lesions. However, roughly eight out of 10 people with psoriasis have lesions only in small, isolated spots, and laser therapy may grow more popular as the technology becomes faster and more effective.
To Use UVB or Not?
Patients generally require about 20 phototherapy sessions before they see an improvement in their skin. Although response rates vary, studies suggest that 65% of the patients who receive UVB treatment and 75% of the patients who receive NB-UVB will experience significant skin clearance. Although UVB treatments are more widely used, PUVA may actually be more effective.
The psoralen molecule used in PUVA is believed to be largely responsible for the increased risk. Psoralen, which is ingested orally or applied topically, enters the body’s cells and, when activated by UV light, changes their DNA. This process kills off immune cells close to the skin and helps control psoriasis, but it also leads to collateral damage that can cause skin cancer in the long run.
Because of the risk of skin cancer, PUVA is typically reserved for the most severe and stubborn psoriasis cases. PUVA can be a very effective treatment. It’s at least as effective as narrowband UVB, but it causes an increased risk of skin cancer, therefore dermatologists recommend it with caution.
UVB light is known to cause skin cancer as well, but studies have not shown any increased risk of skin cancer among psoriasis patients who have undergone UVB phototherapy.
If it’s so effective, why isn't phototherapy used more?
Although phototherapy is considered a first-line treatment for psoriasis, patients and dermatologists alike report that it is often impractical.
Convenience is a factor since patients need to visit their doctor’s office several times a week during business hours. But it can also be expensive; for each treatment, most insurance companies charge an office-visit co-pay, which tends to be higher than drug co-pays.
Tanning Beds: Yay or Nay?
The National Psoriasis Foundation, the American Academy of Dermatology, the United States Department of Health and Human Services, and the World Health Organization all discourage the use of commercial tanning beds for treating psoriasis. The spectra of light in tanning beds vary greatly and often include wavelengths of light that are carcinogenic and photo-damaging. The ultraviolet radiation from these devices can damage the skin, cause premature aging and increase the risk of skin cancer.
Good Old Sunshine
As people have known for thousands of years, natural sunlight is an effective treatment for psoriasis, although the effects may take several weeks to materialize. To avoid sunburn and overexposure, the National Psoriasis Foundation recommends only sunbathing after discussing it with your doctor. Sunburns can actually exacerbate psoriasis, therefore shorten your time out in the sun. Some doctors recommend going into the sun for a few minutes without sunscreen and then applying at least SPF 15 to avoid any psoriasis flares.
Skin Care for Psoriasis
The first step for treating psoriasis should always be what you’re putting on your skin. As a skin condition, your skin care regimen should be tailored to helping soothe, reduce, and nourish your skin from the harsh results of a flare up. Wild Naturals has a full line of eczema and psoriasis products for hair, face, and body! Discover truly aided skin with the right skin care for psoriasis! Shop the online store here and see the difference what truly can happen when you treat your psoriasis the right way!