Psoriasis is a chronic, hereditary, non-contagious skin condition that affects nearly 6 million people in the U.S. Psoriasis occurs in different forms and in varying degrees of severity and extent on the body. It usually affects young adults, but may be seen in children, teens, and older adults. It can be triggered by preceding strep infections, prior sunburn, stress, or certain oral medications, but most commonly occurs without a clear-cut cause (idiopathic).
Plaque psoriasis is the most common form of the disease. It is characterized by inflamed red raised thickened areas with silvery scale most often on the scalp (especially around the ears and hairline), elbows, knees, lower back, and buttocks. It may also involve the hands, feet, genitals, and nails. It commonly improves during the summer, recurs in the winter months, and can be a localized, temporary condition or a bothersome lifelong condition. It can be barely noticeable or can be accompanied by itching, burning, pain, swelling, cracking, and flaking. Other less common forms of psoriasis include guttate, pustular, erythrodermic, and inverse psoriasis. Your dermatologist can determine your type of psoriasis and the best treatment options for you.
Phototherapy is the use of ultraviolet light to treat skin disorders. It can be used for more extensive cases of moderate-to-severe psoriasis, as well as other light-responsive dermatologic conditions. Although topical medications are usually the first approach to treat psoriasis, patients with more extensive or disabling cases can be treated with phototherapy. Ultraviolet light works by causing reactions in the proliferating skin cells to decrease their rate of growth and by eliminating certain immune cells in the skin, leading to clearing of the psoriasis lesions.
We have offered phototherapy as a treatment for psoriasis and other skin conditions for over 30 years. We currently treat patients with a fully computerized state-of-the-art Daavlin Narrow-band UVB phototherapy unit. Hand and foot psoriasis and eczema are treated with a dedicated Narrow-band UVB hand and foot unit. Patients generally receive 2-3 treatments per week. The session consists of the patient applying mineral oil and then exposing the skin to the narrowband UVB light inside the unit, while shielding the eyes, face, and genital area. Improvement is usually noted after several weeks to months of treatment, patients then go onto a maintenance schedule of decreasing frequency of treatments. Another option we offer is the XTRAC laser which uses a focused beam of Narrow band UVB to target lesions that are hard to reach with standard UVB or topical therapies. The main risk of all types of phototherapy is the potential for redness and tenderness of the skin, which we try to avoid by carefully monitoring the dosing and the patient's response at each visit while increasing the light dose in defined increments according to a well-established protocol to achieve clearing or significant improvement.
Phototherapy can also be used in conjunction with various topical medications as well as with stronger oral systemic or newer injectable biologic medications to control more extensive or resistant cases of psoriasis. Dr. Eric Treiber and Dr. Danielle Engler have a particular interest in psoriasis and extensive experience using all possible modalities, including the oral and injectable systemic medications and phototherapy.