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About Phototherapy

Psoriasis is a common skin disorder presenting with red, scaly plaques which may occur on the body, extremities, scalp and even the face. Phototherapy for psoriasis is beneficial because it can target large areas of skin without the side effects of oral or topical medications. During phototherapy sessions, a machine emitting rays of narrow band UVB (NB-UVB) light is directed at the area of the body being treated. A session takes only a few minutes, and patients can receive treatment several times a week. Other phototherapy options such as PUVA therapy has been well described for psoriasis; however, its limitations include nausea and light sensitivity reactions, as well as long-term skin cancer concerns. Older, conventional broad band UVB phototherapy has been used for over 60 years to treat psoriasis. However, risks of redness, burns and skin cancer have been an on-going concern. Today, NB-UVB phototherapy is a wonderful alternative for patients with fairly extensive disease. NB-UVB offers significant advantages over conventional UVB in the treatment of patients with moderate to severe psoriasis vulgaris, including faster resolution of skin lesions, a higher percentage of patients attaining clearing of disease, and the ability to achieve these results with an easy-to-administer, non-reddening dosing schedule.

Benefits

  • NB-UVB is a useful and well-tolerated treatment option for patients with eczema. Over many treatment sessions, patients see reduction or complete elimination of eczematous patches.
  • Clinical studies show the peak therapeutic effectiveness of UVB to be within the range of 295-313 nm, but wavelengths below 300 nm can cause redness or severe burning and increase the risk of skin cancer.
  • NB-UVB virtually eliminates superfluous and harmful UV by emitting only wavelengths 311-312 nm. (Conventional broad-band UVB lamps emit a variety of wavelengths ranging from 280-330 nm).
  • Eliminating UV in wavelengths below 311 nm permits higher intensities and longer exposure times, so patients can derive the maximum benefit from phototherapy.
  • The increased effectiveness permits even more aggressive treatment approaches, resulting in a shorter course of treatment.
  • Published research papers confirm that patients not only avoid the danger of serious burning from sub-erythemal exposure, they may also enjoy longer remission periods after treatment.
  • Remission periods are similar to those with PUVA therapy and markedly superior to broad band or conventional UVB treatment. Studies show 38-40 percent of narrow-band treated patients require no additional therapy for at least 12 months.
  • NB-UVB can also be used to treat patients with hand dermatitis or dyshidrosis – a condition that causes blisters on the palms of the hands and soles of the feet. Creams are often messy and have poor results.

Alternatives

Topical agents, Excimer Laser Treatments, Conventional broad band UVB, PUVA, New Biologic Agents, Soriatane, Methotrexate, Cyclosporine

How Does it Work?

Before light treatment, some patients apply mineral oil to their psoriatic plaques. Patients stand in a phototherapy unit (Houva 11) containing a bank of 48 fluorescent tubes with peak emission at 311 nm. For limited hand or foot disease, patients sit with the affected areas placed in a specific hand and foot device. Scalp disease is treated by a specifically designed light-based hair comb. Therapy is administered 2-3 times a week, on nonconsecutive days. Affected segments of the skin are exposed during each treatment. A predetermined starting dose of light is administered, with subsequent increases of approximately 10-15% for each treatment.

Who is a Candidate?

All patients with psoriasis who do not have a contraindication for light therapy, (such as lupus, or other photosensitizing diseases) may undergo this therapy. Smaller areas of psoriasis can alternatively be treated with the excimer laser.

What can I Expect?

Reduction or elimination of psoriasis plaques.

Results may vary.

Safety & Side Effects

Adverse side effects are rare. Redness and itching can occur, and resolves spontaneously. Blistering, exaggerated increased pigmentation and scarring are possible though rare. Proper eye protection is required during treatments. The specific risks and the suitability of these procedures for a given individual can be determined only at the time of consultation. All procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally.

Recovery Time

Usually none. Many patients may have some pinkness of the skin for a few days.

Does it Hurt?

No.

Before Treatment Instructions

Many patients will benefit from the application of mineral oil to the skin plaques before the procedure to enhance the penetration of the light.

After Treatment Instructions

Avoid excessive sun exposure for a few days after the procedure.

Who Performs the Treatments?

Our Physicians, physician assistants and registered nurses perform the procedure.

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