Light Therapy for Psoriasis - Things You Need to Know

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 in combination with other treatments when conventional therapies fail to provide relief. It is particularly beneficial for treating moderate to severe psoriasis that covers 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 generally suggested with topical medications, such as corticosteroids, for quick and effective relief. For moderate to severe psoriasis or when infections occur during psoriasis treatment, phototherapy is used in conjunction with oral or injectable medications to mitigate inflammation from within. Phototherapy treatment can:

• Suppress an overly active immune system.

• Slow down and rapidly grow skin cells.

• Reduce or eliminate itching.

• Reduce inflammation and allow healing.

Is Light Therapy Good for Psoriasis?

Light therapy for psoriasis can be a helpful treatment if used appropriately. In addition to reducing irritation and aiding in symptom management, it significantly enhances the skin's appearance. To minimize 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 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, which can be performed in-office or at home, or with an excimer laser. For a predetermined amount of time, the skin is exposed to an artificial UVB light source regularly. There are typically two types of UVB treatment: narrow-band and broad-band.

• Narrow-B and UVB:

It is the most common light therapy. It can clear psoriasis symptoms more quickly and produce longer-lasting remissions. Narrow-band UVB light bulbs emit a narrow range of ultraviolet light, which may require fewer treatments per week.

• Broad-B and UVB:

This type of phototherapy is the oldest form of light therapy for psoriasis, utilizing 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 treating psoriasis unless used in conjunction 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 methods for PUVA: topical cream, lotion, or gel, applied to the skin, mixed with bathwater, or administered as a pill.

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

• PUVA effectively removes psoriasis symptoms and provides long-lasting results. However, using this therapy for a long time can raise the risk of skin cancer. It is typically recommended only for severe cases or when other treatments have been ineffective.

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

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

3. Sunlight:

• Although UVB and UVA are found in sunlight, UVB is most effective 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.

• Additionally, sunlight is less effective than prescription phototherapy in treating psoriasis. Too many sun rays can worsen psoriasis symptoms and increase the risk of 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 to do so by a healthcare professional.

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 lack of long-term data to determine how long the gains will last with excimer treatment. This treatment is administered twice weekly in a healthcare professional's office over a period of 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 onto carefully targeted skin areas. The heat clears away damaged blood vessels but maintains the surrounding skin as safe as possible.

• Laser treatment, although it typically has few side effects, some people may experience discomfort, which can include bruising, sunburn, and scarring in 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 utilizes special medications that enhance the effects of a light source.

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

What Are the Benefits and Drawbacks of Light Therapy?

Benefits:

• By exposing the afflicted skin to specific wavelengths of UV light, phototherapy reduces inflammation and accelerates skin repair by slowing 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.

• Psoriasis not only affects the skin, but there is also a connection between psoriasis and mental health. Chronic flare-ups and visible lesions may lead to stress, anxiety, or low self-esteem. Managing psoriasis effectively with light therapy can improve overall quality of life.

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 with a reduction in UV exposure.

• The 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 (an uncommon genetic condition that raises the risk of skin cancer and other cancers) or xeroderma pigmentosum (extreme sensitivity to 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 include lupus (an autoimmune condition) and porphyria (a condition affecting the skin and nervous system).

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

Phototherapy in People of Color

People of color can also benefit from phototherapy. However, the outcomes may differ depending on their skin type. Individuals with darker skin tones should consult a healthcare provider to determine the appropriate type and dosage of treatment, as they may be more susceptible to hyperpigmentation.

Conclusion

Phototherapy is one of the most effective treatments for psoriasis, which involves exposing the skin to ultraviolet light under medical supervision on a regular basis. Besides reducing the pain and itchiness associated with the condition, it can help people manage their condition and improve their overall quality of life. However, to safely treat psoriasis, it is best to speak to a skincare specialist about a suitable treatment option before proceeding with the treatment.

Key Takeaways

• Light therapy (phototherapy) is a safe and medically-monitored therapy that can be used to treat moderate to severe psoriasis where drugs administered topically do not help.

• The most popular and efficient treatment is UVB phototherapy, specifically narrow-band UVB, which has the lowest rate of rapid skin cell growth and fewer side effects than other treatments.

• Phototherapy is not a treatment that all people can take; patients with photosensitive diseases, skin cancers, or those who take medications that are sensitive to UV should seek proper advice.