Psoriasis and Phototherapy

Phototherapy, also known as “light treatment," involves using ultraviolet light alone or in combination with medication. In addition to limited natural sunlight, exposure to a certain wavelength of artificial ultraviolet light called ultraviolet light B (UVB) is very effective for people with moderate to severe psoriasis or plaque areas that do not respond to other treatments.

More severe psoriasis can be treated with ultraviolet light A (UVA) and a medication called psoralen. (Psoralen is an oral or topical medication that makes the body more sensitive to light. This treatment is known as PUVA. See below for more information on PUVA.)

The excimer laser is a type of laser is designed to produce ultraviolet radiation at a very specific wavelength. The excimer laser is used to treat small, resistant plaque areas of psoriasis.

Exposure to light can suppress the immune system (activated T cells) in the skin, thus reducing inflammation and slowing the rapid growth of skin cells, two common symptoms of psoriasis. Phototherapy might also help treat psoriasis by helping the body make more vitamin D.

Read more details about Phototherapy.

Most phototherapy is given 3-5 times per week for 1-3 months by using a light panel or light box at a clinic or in your doctor’s office. In certain cases, you may be able to use a light box or light panel in your home under your doctor’s guidance.

Traditionally, the wavelength of UVB treatments was “broadband.” Today, newer sources provide narrow-band UVB, which emits the part of the ultraviolet spectrum that is most helpful to treating psoriasis.

Possible Complications

The UV lights may negatively affect your skin in a number of ways, including:

• Skin conditions could temporarily worsen
• Itchy skin
• Red skin due to exposure to the lights
• Burning of the skin

PUVA treatment specifically may cause:

• Nausea (if you took the psoralen pills)
• Burning skin
• Cataracts (lens of eye becomes cloudy, affecting vision)
• Headache
• Fatigue

If you have received a great number of phototherapy treatments, you may be at risk for:

• Premature aging of the skin, such as wrinkling and dryness
• Age spots or freckles may appear

Factors that may increase the risk of complications include:

• Allergy to sunlight
• Pregnancy or nursing
• Medical conditions (such as skin cancer or lupus ) that require you to avoid the sun
• History of skin cancer
• Liver disease (phototherapy may increase medicine levels in the blood)

Call Your Doctor

After arriving home, contact your doctor if any of the following occurs:

• Signs of infection, including fever and chills
• Redness around the skin lesions or any discharge
• Severe skin burning, pain, or blistering
• Side effects you experienced due to the treatment continue or worsen
• Development of new or surprising symptoms

In case of an emergency, CALL 911.

Phototherapy treatments are sometimes combined with other treatments for a stronger therapy program. PUVA is one such combination therapy.

PUVA is used for more widespread psoriasis (involving more than 10% of the skin) and commonly for psoriasis limited to hands and feet (bath or soak PUVA). The treatment combines ultraviolet light A (UVA) with the medication psoralen. )Psoralen makes the body more sensitive to the effects of light.) After a person is given psoralen either orally or topically, he/she is exposed to a carefully measured amount of UVA light. This treatment may require up to 25 exposures over a 2-3 month period before clearing occurs.