Is Phototherapy Right for Your Psoriasis?
Even with many newer psoriasis
treatments available today, phototherapy (treatment that exposes the
skin to light) remains an option for many people living with
psoriasis. Phototherapy can effectively clear psoriasis that does
not respond to other treatments. It can treat a stubborn patch or
widespread psoriasis. Studies show that phototherapy offers some
people long periods (6 to 12 months or longer) without psoriasis.
And it can do this in a cost-effective way.
Another advantage is that phototherapy does not weaken the body’s
ability to fight infections like some psoriasis treatments.
Phototherapy may be a treatment option for people who are HIV (Human
Immunodeficiency Virus) positive or have AIDS (Acquired Immune
Dermatologists can prescribe some types of phototherapy for pregnant
women and women who want to get pregnant.
The biggest drawback to phototherapy is that most types of
phototherapy use UV light. This means that phototherapy is not right
Patients are Carefully Screened Before Phototherapy
Before writing a prescription for phototherapy, a dermatologist
gathers the patient’s complete medical history and performs a
To gather the medical history, a dermatologist will ask about past
and current medical conditions. It is essential that the
dermatologist know about any light sensitivity, organ transplant,
skin cancer, or suspicious mole. These do not necessarily mean that
phototherapy cannot be a treatment option, but some precautions may
It also is crucial for a dermatologist to know about all medications
and supplements (current and recently taken). Many of these interact
with UV light and can cause an unwanted reaction.
A physical exam also is essential. This exam will include a
full-body skin exam to check for signs of skin cancer.
Who Should Not Have Phototherapy?
Because phototherapy exposes the skin to UV light, it is not
appropriate for everyone. If a person has lupus erythematous (an
autoimmune disease that worsens with exposure to the sun) or
xeroderma pigmentosum (a rare disease that makes a person
extraordinarily sensitive to sunlight and prone to developing many
skin cancers), phototherapy will not be prescribed.
To receive phototherapy, a person must be able to tolerate heat. For
some types of phototherapy, it is essential to be able to stand and
walk without help.
Phototherapy Requires Close Monitoring
If phototherapy is an appropriate treatment, regular follow-up
appointments with the dermatologist are essential. During these
appointments, the dermatologist will examine the patient to see if
the phototherapy is effective and check for signs of skin cancer.
Experts recommend that patients be examined about once a month and
sometimes more often.
Phototherapy Involves Time Commitment
While there are many types of phototherapy, all require a number of
treatment sessions. These treatment sessions usually takes place in
a dermatologist’s office or psoriasis clinic.
If excimer laser therapy is prescribed, a patient typically receives
2 treatments per week for 2 to 5 weeks. The pulsed dye laser
requires 5 to 6 treatment sessions within 3 to 4 weeks.
Another type of phototherapy, UVB phototherapy, requires 2 to 5
visits per week for several weeks. To receive Goeckerman therapy (or
Ingram’s), a person must be available Monday through Friday for
several hours a day for about 3 to 5 weeks.
If phototherapy proves effective, a dermatologist may prescribe a
UVB home unit. Even this option requires time. It takes time to use
the home unit as directed and keep all follow-up appointments with
Trust a Dermatologist
If you believe that phototherapy may be a treatment option for you,
be sure to talk with a dermatologist. These doctors have the
training and experience to make sure that phototherapy provides a
safe and effective treatment for psoriasis and other skin
Psoriasis Treatment: Lasers and Other
Information about the different types of phototherapy approved to
American Academy of Dermatology.
Academy of Dermatology Issues New Guidelines for the Management of
Psoriasis With Ultraviolet Light Therapy.” News release issued
October 22, 2009. Available at
accessed January 25, 2010.
de Leeuw J, Tank B, Bjerring PJ et al. “Concomitant treatment
of psoriasis of the hands and feet with pulsed dye laser and topical
calcipotriol, salicylic acid, or both: a prospective open study in
41 patients.” Journal of the American Academy of Dermatology
February 2006; 54: 266-71.
Menter A, Korman NJ, Elmets CA et al. “Guidelines of care for
the management of psoriasis and psoriatic arthritis: Section 5.
Guidelines of care for the treatment of psoriasis with phototherapy
and photochemotherapy.” Journal of the American Academy of
Dermatology January 2010; 62: 114-35.
Morison WL, Atkinson DF, Werthman L. “Effective treatment of scalp
psoriasis using the excimer (308 nm) laser.” Photodermatology
Photoimmunology & Photomedicine August 2006; 22: 181-3.
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developed by the American Academy of Dermatology
Phototherapy should be
performed under the direction of a dermatologist who has
appropriate training and expertise in this area. To find
a dermatologist who has this expertise, you may want to
use Find a Dermatologist. This tool allows you search
for dermatologists who specialize in phototherapy. You
also can search for dermatologists who specialize in
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