Does Darker Skin Provide Any Protection From The Sun
The American Academy of Dermatology says that yes, thanks to melanin , people of color do have a lower risk of developing skin cancer than Caucasians. But when they do get it, it’s usually diagnosed at a more advanced stage and that makes treatment more difficult. Roughly 52% of African Americans and 26% of Hispanics find out they have after it has already started to spread, compared to 16% of Caucasians.
Although Moy and her son like being in the sun , Moy has fair skin and, not surprisingly, says she burns “pretty easily.””It was never really an option for me to be in the sun for any extended period of time to try and help my psoriasis,” she says. Her husband is of Chinese descent, so Andy’s skin is more olive, making it slightly less risky for him to catch some rays.
Ironically, even if you never sunburn, you can get skin cancer. The AAD says that approximately 9,500 of us are diagnosed with skin cancer every single day and reminds us that exposure to natural and artificial ultraviolet light
Add to that, research has found that people with psoriasis appear to have an increased risk of developing cancer, specifically skin cancer, possibly due to the fact that psoriasis is an inflammatory disease and is strongly linked to cancer.
Challenges To Light Future Research Directions
Although light therapy is effective for psoriasis, there are serious, serious roadblocks, Katz stressed, including both financial and time commitment barriers.
The reimbursement for light therapy is moderately low and patients are expected to come in for therapy two to three times per week for at least 8 to 12 weeks, according to Katz. Also, insurers may not always cover a visit and a light treatment on the same day. Many offices do not offer either narrowband or excimer laser because its not economically feasible, she added.
As a dermatologist, you need to be able to afford to offer light to patients, she told Healio. You have to dedicate part of your real estate to a light box and you have to dedicate your staff to light therapy. You have them assisting and delivering light. You need people who are properly certified and trained, you need to be able to offer light to enough patients to pay for that real estate.
However, Katz also said that the overall cost of phototherapy is much less than the cost of any of the biologics.
Economic research is needed that show these challenges, Katz said.
I would love to see economic studies that essentially force the hand of perhaps the insurers to restructure the way in which they cover this very valuable and safe treatment for patients, she said. Were talking about great cost savings to everyone. That really is a concern.
Do I Have To Wear Sunblock
Yes. Yes, and yes. If you do decide to bask in the day’s rays, follow the same guidelines as other people who don’t have psoriasis, says the National Psoriasis Foundation . Use a broad-spectrum, water-resistant product, with an SPF of 30+. Theres one caveat, however: Since sunscreen may absorb into skin and irritate psoriasis patches, instead made with ingredients like zinc oxide or titanium dioxide which are more gentle for sensitive skin.
Slather on the sunblock to all exposed skin areas at least 15 minutes before bounding outside. Don’t skimp on face, scalp, upper back and shoulders, which tend to burn easily. And dont forget to reapply every two hoursespecially if youve been sweating, swimming or showering.
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Does Light Therapy Help Reduce Psoriasis Symptoms
UV light therapy approaches such as UVB phototherapy and psoralen plus ultraviolet A can effectively reduce psoriasis symptoms. But the treatment involves quite a lot of effort because you need several sessions per week. Repeated and long-term light therapy can also increase the risk of skin cancer.
Psoriasis can often be effectively treated with a good skincare routine and medication applied to the affected areas of skin. But this doesnt always help enough in moderate and severe psoriasis. UV light therapy is then considered. This treatment, also known as phototherapy, can be used on its own or in combination with topical medication or tablets. It involves exposing the affected areas of skin to ultraviolet light . UV light reduces inflammation and slows the production of skin cells.
The treatment is usually given three times a week in a dermatology practice or hospital. It takes place in special cabins with fluorescent lamps that emit UV light of a certain wavelength. There are also lamps that can be used to treat individual parts of your body, such as your head, hands or feet.
Tanning beds can’t be used for light therapy because they dont allow you to control the exact spectrum and dose of light you are exposed to.
Steroid Creams Or Ointments
Steroid creams or ointments are commonly used to treat mild to moderate psoriasis in most areas of the body. The treatment works by reducing inflammation. This slows the production of skin cells and reduces itching.
Topical corticosteroids range in strength from mild to very strong. Only use them when recommended by your doctor.
Stronger topical corticosteroids can be prescribed by your doctor and should only be used on small areas of skin or on particularly thick patches. Overusing topical corticosteroids can lead to skin thinning.
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What Is Narrowband Uvb Treatment
Narrowband UVB is used to treat guttate and plaque psoriasis that is particularly widespread or has not responded to topical treatments. Narrowband UVB treatment may sometimes also be referred to as TL-01 this is the name of the most commonly-used narrowband UVB lamp.
UVB treatment is given in a phototherapy unit usually in a hospital Dermatology department or clinic – by a team of health professionals. A Dermatologist calculates precisely how much UVB light each persons skin should be subjected to, and will increase the exposure over the course of the sessions.
Treatment is usually given two or three times a week, for up to ten weeks. The individual stands in the UVB cabinet for a period of a few seconds to several minutes at a time. Depending on which areas of the body are being treated, they may be advised to cover up certain areas, and leave other areas exposed. You should always ask your Dermatologist or the member of staff administering the UVB treatment if you have any questions about this.
Does Sun Therapy Work For Everyone With Pso
“Sunlight definitely isn’t for everybody,” says dermatologist Jennifer Stein, M.D., of NYU Langone Health. “Although some patients report that they improve in the summer, some patients do worse.”
When she has gotten too much sun and a resulting sunburn, Moy says she sometimes does get a “little flare of psoriasis,” even though she’s “really well managed” most of the time.
“I don’t really recommend hanging outside in the sun to treat psoriasis, especially if it’s extensive, which requires more targeted therapies,” says Dr. Cheng. “Patients sometimes tell me, ‘My other doctor said to just go outside,’ but knowing what we do about skin cancer, you really can’t do that anymore.”
For more advanced psoriasis cases, Dr. Cheng’s first line of defense isnt the sun. Rather it includes such as Cosentyx and Tremfya .
For people who swear by the sun for treating their psoriasis , Dr. Stein and other dermatologists prefer phototherapy. “Its a reliable and safer way of treating skin with UV light in a controlled way,” says Dr. Stein.
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How Effective Are The Different Types Of Light Therapy
Light therapy is often an effective treatment for psoriasis: It is estimated that the symptoms improve noticeably or go away completely for a while in 50 to 90 out of 100 people.
It is currently thought that PUVA using psoralen tablets is more effective than narrow band UVB phototherapy. But side effects are also more common and the associated risk of skin cancer may be greater. So it is a good idea to talk to your doctor and carefully weigh the pros and cons of PUVA therapy using psoralen tablets.
PUVA therapy using psoralen added to a bath has also been shown to relieve psoriasis symptoms more effectively than UVB phototherapy alone. And light therapy combined with bathing in a solution of common salt or Dead Sea salt appears to be more effective than UV light therapy without bathing, but it is less effective than PUVA therapy using psoralen added to a bath. PUVA therapy using psoralen tablets, PUVA therapy using a psoralen bath solution, and light therapy combined with bathing in a salt solution all share one common disadvantage: the effort involved.
Where Is Uv Light Treatment Done
In the past, UV light treatment has normally been done in a doctors office and usually involved stand-up, full body length lamps to treat the area. This has the side effect of exposing the entire body to UV light instead of just the area that you need to target and it doesnt on areas that are covered, like psoriasis on the scalp.
Todays UV light treatment is moving from the doctors office to the home. This allows patients to treat themselves in privacy, makes it less expensive because they dont have to pay for a doctors visit every time they go for treatment, and allows them to fit it into their already busy schedules.
Home treatment is also great for anyone with mobility issues or transportation problems.
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How Long Can I Expose My Skin To The Sun Before Burning
This depends on many factors, including:
The strength of the sunThis can be assessed by the UV index, announced in summertime weather reports. The UV index is a number representing the strength of the sun, and ranges from 1 to 11+. 1-2 represents low UV, 3-5 moderate UV, 6-7 high UV, 8-10 very high UV and 11+ extreme UV. In the UK the UV index rarely goes above 6 or 7.
Other factors also need to be taken into consideration. For the UK some very approximate guidance can be given on how long individuals can tolerate the sun before burning. Assuming moderate sun strength , and for previously unexposed and currently unprotected skin, then exposure times possible before onset of sunburn are approximately: phototype I, 5-10 minutes phototype II, 10-20 minutes phototype III, 20-30 minutes phototype IV, 40 minutes .
Your sun sensitivityThis is assessed by the Fitzpatrick phototyping scale, which describes how the skin reacts to sun exposure. It was developed in 1975 by Thomas B. Fitzpatrick, the American dermatologist, as a way to classify the typical response of different types of skin to sunlight. The Fitzpatrick scale remains a recognised tool for dermatological research into human skin pigmentation.
What increases the chances of burning?This also depends on many factors, including:
- Which areas of skin are exposed
Scalp, neck, face , upper back and shoulders are more sensitive to the sun than the lower legs.
- How much exposure you have already had
For example, a sunscreen.
How Does Phototherapy Work
The exact cause of psoriasis is not fully understood and the effects of UV on the skin are complicated, so a precise explanation of how phototherapy works is not possible. PUVA and UVB phototherapy may also work in slightly different ways. However, a simplified description of the mechanisms of phototherapy will help to explain some of its side effects and restrictions.
Taking a simplified model of psoriasis as an example, the too-sensitive skin immune system causes localised patches of inflammation and the overproduction of skin cells, in turn causing the visible plaques. Phototherapy stops the overproduction of skin cells by either damaging their DNA or by preventing the cells from dividing by locking the DNA . It also suppresses the skin immune system to stop the psoriasis process. The twin processes of interfering with DNA and suppressing the immune system in the skin can also cause skin cancer, so phototherapy can increase cancer risk. Therefore, to safely benefit from UV phototherapy it is best administered under professional medical supervision.
During treatment, goggles must be worn to protect the eyes and most people also wear a clear UV-blocking visor to protect the skin of the face . Men must wear genital protection.
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Psoriasis And Vitamin D
Vitamin D can help reduce inflammation throughout your body. The nutrient, as well as the UV rays from light exposure, can help clear or prevent psoriasis plaques. Sunlight triggers your body to make the nutrient, which is beneficial to strong bones and immune function. Vitamin D is a nutrient found in few foods naturally.
A study published in the found that people with psoriasis tend to have low vitamin D levels, particularly in colder seasons. People with low levels of vitamin D can boost their levels by consuming:
- fortified milk and orange juice
- fortified margarine and yogurt
When Is Uv Therapy Used
The National Institute for Health and Care Excellence recommends that UVB therapy be offered to people with plaque or guttate psoriasis that cannot be controlled with topical treatments alone. They are likely to have tried a number of different topical treatments before being offered UVB therapy . It recommends that PUVA treatment be considered to treat palmoplantar pustulosis .
If it is found that some areas of psoriasis are slow to respond, do not show a satisfactory response, or are in some hard-to-treat areas , a topical treatment might be prescribed alongside UV therapy. It is important to remember that the effects of UV therapy are temporary in most cases the psoriasis will come back at some point. If psoriasis is returning very quickly after a course of UV therapy, it may be time to move on to another type of treatment.
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Does Normal Sunlight Help
Regular sunlight has been used for centuries to treat psoriasis and other skin conditions. Some people suggest using a sunblock on unaffected areas then covering the affected areas about 10 or 15 minutes after youve been in the sun.
You just have to be careful since sunburn can actually have the opposite effect on psoriasis and actually make it worse. Short exposure times are key.
Make sure you talk to your doctor before you decide to try sun exposure just to make sure its right for you.
How To Use Phototherapy At Home
A doctor will explain how a person should use the phototherapy unit at home. People will need to follow their instructions carefully, as UV rays can damage the skin, causing premature aging, sunburn, and skin cancers.
Some doctors will start phototherapy in a hospital setting before recommending that a person continue the treatment at home. The doctor will explain the importance of protecting sensitive areas of the body, such as the eyes and genitals, and when to apply moisturizers. They will also explain how to position the light box to target the appropriate area and how far away from the unit a person should stand.
The doctor will assess a persons medical history and note any medications they are taking, including supplements and herbs. Based on the persons skin type, they will recommend an initial dose for the first few treatments, building up gradually from there.
A person must allow at least a 24-hour interval between sessions and will need to reduce their exposure time if they regularly miss treatments.
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What About Tanning Beds For Psoriasis
Some people use indoor tanning beds as an alternative to natural sunlight, but these machines primarily use UVA light, not the more beneficial UVB light. The National Psoriasis Foundation does not support the use of tanning beds as a substitute for light therapy performed under a health care providers supervision. Read more about tanning beds and psoriasis.
Who Can Help Me With Light Therapy For Psoriasis
Although many patients begin their search for help with psoriasis with a primary care physician, light therapy is typically administered by a dermatologist who specializes in phototherapy treatment for psoriasis.
No matter whom you visit first, its important to seek help for psoriasis because if its left untreated, symptoms can worsen and cause problems well beyond the skin, such as psoriatic arthritis, an inflammatory form of arthritis that develops in about 30 percent of people with psoriasis. The biggest thing is to make sure that you see the doctor and get a diagnosis. Psoriasis can be debilitating, Kaffenberger says.
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What Is Puva Treatment
PUVA is a combination of UVA light and a chemical called psoralen . UVA is not beneficial in treating psoriasis on its own instead it must be combined with psoralen which makes the skin more sensitive to the UVA light. Psoralen can be taken as a tablet, applied to the areas of the skin being treated as a gel or cream, or added to bath water to soak the whole body. It will depend on what areas of the body are being treated as to which method is used.
PUVA is used to treat moderate to severe plaque psoriasis that has not responded to topical treatments, or UVB therapy. PUVA can be more successful on thicker plaques of psoriasis than UVB, as the UVA is absorbed deeper in the skin. For the same reason, hand and foot psoriasis is often treated with PUVA therapy.
Like UVB, PUVA is given in a phototherapy unit and administered by a team of health professionals. A Dermatologist calculates precisely how much UVB light each persons skin should be subjected to, and will increase the exposure as appropriate over the course of the sessions. Treatment is usually given twice a week, for a period of five to eight weeks. The individual stands in the PUVA cabinet for a period of a few seconds to several minutes at a time.