Light Therapy for Psoriasis

What Is Light Therapy?

For most people, over-the-counter medications are sufficient to address psoriasis (an autoinflammatory skin condition); others may need phototherapy, especially if the skin remains itchy, scaly, and red. Phototherapy, also known as light therapy, is one of the most effective treatments for psoriasis. The procedure involves exposing the skin to regulated amounts of ultraviolet (UV) radiation. Healthcare professionals often prescribe phototherapy with other treatments when conventional therapies fail to provide alleviation and are particularly useful for treating moderate to severe psoriasis covering large areas of the body. In addition to psoriasis, phototherapy is also performed for other skin disorders, such as lichen planus (a chronic inflammatory disease that causes a rash on the skin or sores inside the mouth), atopic dermatitis (eczema), vitiligo (a chronic autoimmune disorder that causes white patches to appear on the skin), and cutaneous T-cell lymphoma (a type of cancer that affects the skin and is caused by a mutation in T cells).

Why Is Phototherapy Prescribed for Psoriasis?

Phototherapy is seldom used on its own. Instead, it is generally suggested when topical medications, such as corticosteroids, cannot provide relief. This is because it helps improve the effects of topical therapies. For moderate to severe psoriasis, phototherapy is used with oral or injectable drugs to temper inflammation from within. Phototherapy treatment can:

• Suppress an overly active immune system.

• Slow and rapidly growing skin cells.

• Reduce or eliminate the itching.

• Reduce inflammation and allow healing.

Is Light Therapy Good for Psoriasis?

In fact, light therapy for psoriasis can be a helpful treatment for the condition if used appropriately. In addition to lowering irritation and assisting with symptom management, it dramatically enhances skin look. To reduce dangers, it should be used under a healthcare provider's supervision, just like any other medical treatment.

Types of Phototherapy

The following is a list of the several kinds of phototherapy procedures:

1. Ultraviolet Light B (UVB):

Natural sunlight contains ultraviolet light B (UVB), which is a useful treatment for psoriasis. When UVB rays enter the skin, they slow down the proliferation of damaged skin cells. UVB treatment includes UVB phototherapy, in-office or home UVB phototherapy, or excimer laser. For a predetermined amount of time, the skin is exposed to an artificial UVB light source on a regular basis. There are typically two types of UVB treatment: narrow-band and broad-band.

• Narrow-Band UVB: It is the most common light therapy. It can clear psoriasis symptoms faster and produce more prolonged remissions. Narrow-band UVB light bulbs emit a narrow range of ultraviolet light and may need fewer treatments per week.

• Broad-Band UVB: This type of phototherapy is the oldest form of light therapy for psoriasis and uses a wider wavelength than narrow-band therapy. Broad-band light therapy is less effective than narrow-band therapy and is more likely to cause side effects. Therefore, it should be done for cases where narrow-band is not a treatment option.

2. Psoralen + Ultraviolet Light A (PUVA):

• Ultraviolet light A (UVA) is relatively inefficient for psoriasis treatment unless used with light-sensitizing agents known as psoralens. This process is called PUVA. It delays excessive skin cell growth and can alleviate psoriasis symptoms for varying periods.

• There are three central administration ways for PUVA: topical cream, lotion, or gel, mixed with bathwater, or as a pill.

• PUVA treatment is most effective for guttate psoriasis (tiny, red, scaly, teardrop-shaped patches all over the body), stable plaque psoriasis (results in dry, itchy, elevated skin patches known as plaques), and psoriasis of the palms and soles.

• PUVA removes psoriasis symptoms effectively and has long-lasting results. However, using this therapy for a long time can raise the risk of skin cancer. So it is typically only recommended for severe cases or other treatments that have not worked.

• This treatment also has adverse effects such as exhaustion, nausea, headaches, burning, and itching.

• As psoralen makes the body extra sensitive to light, one should protect the skin and eyes by taking measures such as wearing glasses that block ultraviolet light and wearing sunscreen after treatment.

3. Sunlight:

• Although UVB and UVA are found in sunlight, UVB works best for treating psoriasis. This is because UVB from the sun functions similarly to UVB in phototherapy treatments. However, using sunlight is not prescribed for everyone with psoriasis.

• In addition, sunlight is not as effective for treating psoriasis as prescription phototherapy. Too many rays from the sun can worsen the psoriasis symptoms and raise the chances of getting skin cancer.

• Some topical drugs, such as Tazarotene and coal tar, can increase the risk of sunburn.

• People using PUVA or other light therapy should restrict or avoid exposure to natural sunlight unless directed by a health care professional.

• Speak to a health care professional to determine whether or not treating sunlight is right.

4. Lasers:

• Lasers use highly focused beams of light to target the skin affected with psoriasis patches, reducing side effects and lowering the risk of skin cancer.

• This requires fewer treatments compared with other types of phototherapy.

• The excimer laser releases a high-intensity beam of ultraviolet B. It can target mild-to-moderate psoriasis-affected skin areas. Research suggests it is a particularly effective treatment for scalp psoriasis. However, there is a dearth of long-term data to determine how long gains will remain with excimer treatment. This treatment is done twice weekly in a healthcare professional's office for four to five weeks.

• Pulsed dye laser (PDL) is also used to treat psoriasis. PDLs utilize a liquid with an organic dye to make a laser that produces gentle bursts of focused light beam onto carefully targeted skin areas. The heat clears away damaged blood vessels but maintains the surrounding skin as safe as possible.

• Laser treatment though typically does not have few side effects, some people may experience some discomfort which includes bruises, sunburns, and scars in at the treated areas.

5. Grenz Rays:

• This is a less popular strategy. Medical practitioners recommend this treatment using superficial X-ray equipment, which emits soft X-rays that function similarly to UV light.

6. Photodynamic Therapy:

• Though uncommon, healthcare professionals may suggest photodynamic therapy to treat psoriasis.

• This therapy uses special medicines that boost the effects of a light source.

• Unfortunately, side effects of burned skin can limit this approach's effectiveness in treating psoriasis.

What Are the Benefits and Drawbacks of Light Therapy?

Benefits

By exposing the afflicted skin to particular UV light wavelengths, phototherapy reduces inflammation and speeds up skin repair by slowing down the proliferation of skin cells. Due to its direct impact on skin cell turnover, UVB light is the most widely used treatment for psoriasis and is known as light therapy.

Risks and Potential Side Effects

Phototherapy is performed in a healthcare professional's office under controlled conditions. However, despite this precaution, people can still experience side effects. Possible side effects of phototherapy include:

• A stinging or itching sensation.

• Sores and redness on the skin.

• Signs of premature skin aging include loose skin, dark spots, and leathery skin.

• Mild sunburn is generally not severe and often resolves by changing the ultraviolet (UV) dosage.

• Possibility of cold sores in people prone to them.

• Blisters.

• A higher risk of skin cancer.

Can Anyone With Psoriasis Use Phototherapy?

While healthcare professionals prescribe phototherapy for many people, it is not recommended for people who have:

• Medical problems that make them more susceptible to developing skin cancers, like Gorlin syndrome ((ana uncommon genetic condition that raises the risk of skin cancer and other cancers) or xeroderma pigmentosum (extreme sensitivity to ultraviolet (UV) rays).

• Melanoma (a kind of skin cancer that has the potential to spread to other body parts) or any other type of skin cancer.

• Medical conditions that make them sensitive to UV light, such as lupus (an autoimmune condition) or porphyria (a condition of the skin and nervous system).

• Medications such as antibiotics, antifungals, and diuretics (water pills) make them more sensitive to UV light.

Phototherapy in People of Color

People of color can benefit from phototherapy just as much. However, the outcomes may differ depending on their skin type. People with darker skin tones should consult a healthcare provider to determine the right kind and amount of treatment because they may be more susceptible to hyperpigmentation.

Conclusion

Phototherapy is one of the most effective psoriasis treatments that involves exposing the skin to ultraviolet light regularly and under medical supervision. Besides reducing the pain and itchiness of the condition, it can help people manage their condition and improve their quality of life. However, to safely treat phototherapy, it is best to speak to a healthcare professional about a suitable treatment option.