Where does the UVB light exist?

Type:Uv phototherapy   Time:2015-05-13 9:42:47 Sunlight

Although both UVB and ultraviolet light A (UVA) are found in sunlight, UVB works best for psoriasis. UVB from the sun works the same way as UVB in phototherapy treatments.

Short, multiple exposures to sunlight are recommended. Start with five to 10 minutes of noontime sun daily. Gradually increase exposure time by 30 seconds if the skin tolerates it. To get the most from the sun, all affected areas should receive equal and adequate exposure. Remember to wear sunscreen on areas of your skin unaffected by psoriasis.

Avoid overexposure and sunburn. It can take several weeks to see improvement. Have your doctor check you regularly for sun damage.

Some topical medications can increase the risk of sunburn. These include tazarotene, coal tar, Elidel (pimecrolimus) and Protopic (tacrolimus). Individuals using these products should talk with a doctor before going in the sun.

People who are using PUVA or other forms of light therapy should limit or avoid exposure to natural sunlight unless directed by a doctor.


Psoralen + UVA (PUVA)

Like UVB, ultraviolet light A (UVA) is present in sunlight. Unlike UVB, UVA is relatively ineffective unless used with a light-sensitizing medication psoralen, which is administered topically or orally. This process, called PUVA, slows down excessive skin cell growth and can clear psoriasis symptoms for varying periods of time. Stable plaque psoriasis, guttate psoriasis, and psoriasis of the palms and soles are most responsive to PUVA treatment.

The most common short-term side effects of PUVA are nausea, itching and redness of the skin. Drinking milk or ginger ale, taking ginger supplements or eating while taking oral psoralen may prevent nausea. Antihistamines, baths with colloidal oatmeal products or application of topical products with capsaicin may help relieve itching. Swelling of the legs from standing during PUVA treatment may be relieved by wearing support hose.


Laser Treatments

Excimer laser

The excimer laser¡ªrecently approved by the Food and Drug Administration (FDA) for treating chronic, localized psoriasis plaques¡ªemits a high-intensity beam of ultraviolet light B (UVB).

The excimer laser can target select areas of the skin affected by mild to moderate psoriasis, and research indicates it is a particularly effective treatment for scalp psoriasis. Researchers at the University of Utah, for example, reported in The Journal of Drugs in Dermatology that in a small series of patients, laser treatment, combined with a topical steroid, cleared scalp psoriasis that resisted other treatment.

Individual response to the treatment varies. It can take an average of four to 10 sessions to see results, depending on the particular case of psoriasis. It is recommended that patients receive two treatments per week, with a minimum of 48 hours between treatments.

There is not yet enough long-term data to indicate how long the improvement will last following a course of laser therapy.

Pulsed dye laser

Like the excimer laser, the pulsed dye laser is approved for treating chronic, localized plaques. Using a dye and different wavelength of light than the excimer laser or other UVB-based treatments, pulsed dye lasers destroy the tiny blood vessels that contribute to the formation of psoriasis lesions.

Treatment consists of 15- to 30-minute sessions every three weeks. For patients who respond, it normally takes about four to six sessions to clear the target lesion.

The most common side effect is bruising after treatment, for up to 10 days. There is a small risk of scarring.


Tanning beds

Some people visit tanning salons as an alternative to natural sunlight. Tanning beds in commercial salons emit mostly UVA light, not UVB. The beneficial effect for psoriasis is attributed primarily to UVB light. National Psoriasis Foundation does not support the use of indoor tanning beds as a substitute for phototherapy performed with a prescription and under a doctor's supervision. Read more on the Psoriasis Foundation position on indoor tanning beds »

The American Academy of Dermatology, the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention all discourage the use of tanning beds and sun lamps. Indoor tanning raises the risk of melanoma by 59 percent, according to the American Academy of Dermatology and the World Health Organization. In May 2014, the FDA reclassified sunlamps (which are used in tanning beds and booths) from Class I (low risk) to Class II (moderate risk) products. The FDA can exert more regulatory control over Class II products, according to a press release on the FDA website.

The ultraviolet radiation from these devices can damage the skin, cause premature aging and increase the risk of skin cancer.

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