Psoriasis: Phototherapy Treatment and its Different Types

psoriasis treatmentOver 7.5 million Americans are suffering from psoriasis. Psoriasis is a skin disorder that brings about itchy patches of chunky, red skin that may also have silvery scales. For the most part, the patches will appear on the back, elbows, face, feet, knees, palms, and scalp, but they could also turn up on other areas of the body. A complication with the immune system gives rise to psoriasis. Skin cells that evolve deep in the skin go up to the surface in a process known as cell turnover. Under normal circumstances, this process takes four weeks; but in psoriasis, it comes off in just a few days since the cells ascend double-time.

If you have psoriasis, you might require extra help to keep your symptoms manageable; and phototherapy is one effective treatment that you may need to try.

Phototherapy medicates psoriasis by aiming ultraviolet rays on the sores. It is mainly carried out in a doctor’s clinic; but, thanks to portable phototherapy lamps, it can now be performed even in your own home.

The approved UV light sources used in phototherapy are lasers, PUVA, and UVB. It is important that you inform your doctor first before doing phototherapy treatment. It is also a must to limit your sun exposure and to protect clear parts of your skin at the time of treatment.

UVB Phototherapy

In UVB (ultraviolet light B) phototherapy, a device is employed to beam ultraviolet rays to the affected skin. These rays enter the skin, and cause cell turnover to slow down. UVB phototherapy should be done two to five times a week for it to work. It is an efficient course of treatment for patients with moderate to severe cases of psoriasis, plaque psoriasis (psoriasis vulgaris), or thin plaques, as well as for people who are normally receptive to natural sunlight.

There are two kinds of UVB: broadband and narrowband. Broadband UVB has been used for many years in phototherapy. It has a long safety record, and it is mostly available in the US. The narrowband UVB is a newer innovation that releases a more precise range of UV wavelengths, requiring fewer therapy sessions compared to broadband UVB treatment.

PUVA Phototherapy

PUVA (psoralen UVA) combines psoralen (a light-sensitizing treatment) with UVA exposure. PUVA dispels psoriasis lesions in 85 to 90 percent of patients; although this can only be done in a medical clinic, unlike UVB phototherapy.

Psoralen is usually taken orally, 75 to 120 minutes prior to treatment; although in certain cases, psoralen is applied topically. Topical psoralen is great for treating persistent lesions, especially on the hands and feet. Exposure to UVA light should happen within 15 minutes once topical psoralen is applied because after several minutes, light sensitivity falls radically. Frequently, if you are using topical psoralen, the amount of UVA required could be lessened. This method can help patients who are unaffected by oral PUVA, but obtain positive outcomes with the topical PUVA approach.

Laser Therapy

Two types of lasers are used in psoriasis treatment.

Excimer lasers transport ultraviolet light similar to that of narrowband UVB. This laser treatment is intended for mild to moderate cases of plaque psoriasis. It has the capability to aim at small, discrete psoriatic lesions; and its only possible side effect is mild sunburn.

Pulsed dye lasers, on the other hand, work through the emission of a different kind of light. This light extinguishes the minute blood vessels that nourish psoriasis lesions. Patients normally require fewer treatments with pulsed dye laser compared to excimer laser. Probable side effects are bruising and scarring.

Good Effects of UVB on the Skin

Gases around the earth cut off 98.7% of the sun’s ultraviolet radiation from piercing through our atmosphere. The 2.3% that penetrates may have bad effects when you get overly exposed, but in moderation, it actually has good effects on the skin.

UV radiation between 290 and 320 nm is referred to as ultraviolet-B (UVB). UVB radiation mostly affects human beings. UVB exposure generates the manufacture of vitamin D in the skin at a rate of up to 1,000 IUs per minute. Vitamin D has important roles in blood pressure, bone growth and maintenance of bone density, calcium metabolism, cell proliferation, immunity, insulin secretion, and the normal functioning of the nervous system.

UVB also fuels the production of new melanin that brings on ample increase in the dark-colored pigment of the skin. Additionally, UVB activates the cells to cause the expansion of the epidermis. As a result, UVB is accountable for the darkening and thickening of the outer skin layers, creating a defense mechanism against further UV damage.

UVB exposure can also restrain the clinical symptoms of multiple sclerosis due to vitamin D synthesis. In addition, UVB produces nitric oxide (NO) that can reduce blood pressure level and, in most cases, improve cardiovascular health.

UVB light is employed as a form of therapy for psoriasis, which is a long term skin problem that causes skin cells to grow too fast, causing thick, red, silvery, or white patches to appear on the skin. Studies have shown that when psoriasis, as well as vitiligo and eczema are exposed to UVB rays, there is a delay in the development of the skin cells, relieving the symptoms.

Before, UVA radiation was used together with psoralens in treating psoriasis; however, this combination produced a dramatic increase in skin cancer cases. These days, UVB radiation is used by itself because it is proven to be more effective. Also, a finer form of UVB has been developed, called narrowband, which contains only the wavelengths that are thought out to be most valuable in psoriasis treatment. In treating psoriasis, vitiligo, and eczema, UV light with a wavelength of 311 nm is most potent, which is why UVB lamps, like the Dermalight 80 handheld UV-B Phototherapy Lamp and DermaHealer handheld UV-B Phototherapy Lamp, make use of UV-B/311nm narrowband lamps.

UVB phototherapy has been proven effective in clearing the skin, and this commonly takes up to around 30 treatments over a period of several weeks. Treatment is mainly administered in hospitals using fully controlled courses supervised by a trained staff; although portable handheld UVB phototherapy lamps are now widely used in homes as well. Countless studies have demonstrated that narrowband UVB is far more superior to broadband UVB in clearing psoriasis, with shorter treatment times and reduced risk of sunburn-like side effects after treatment.