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Home Uv Light For Psoriasis

Treatment Protocols And Follow

Psoriasis UVB Light Treatment From Home – Vlog #3

Although minimal erythema dose determination and subsequent dose calculation is the formal method of establishing initial dose, this process is often cumbersome and labor intensive. Therefore, most phototherapy centers have now adopted the use of initial dose determination based on patients Fitzpatrick skin type. Increments of dose increase are also determined by skin type in addition to response to previous treatments. The underlying principle is to increase the UVB dose gradually until the MED is reached and then try to maintain the UVB dose just below the MED . This approach eliminates the need for formal MED testing in most patients. It is also simpler and more efficient than methods using incremental dosages calculated as a certain percentage of the previous dosage.

A standard protocol for UVB phototherapy is treatment three times per week with a minimum of 24 hours between sessions. Treatment every other day is effective for most patients. Patients should be instructed to dose phototherapy as per treatment protocol and use proper technique as taught during outpatient phototherapy and home phototherapy orientation. Moisturizer should be immediately applied following treatment to prevent excessive dryness and subsequent itching.

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.

Users Manual & Treatment Method

A comprehensive Users Manual is a critically important part of the 500-Series Hand/Foot & Spot device. The SolRx Users Manuals have been continuously developed for over 25 years by Solarc employees that are also patients actually using SolRx devices, and vetted by a variety of dermatology experts. The information provided allows you to safely maximize your treatment results. Most importantly, it includes detailed exposure guidelines with treatment times for psoriasis, vitiligo, and atopic dermatitis . The Exposure Guideline Tables shown provide a complete treatment protocol based on your skin type , the power of the device, and the UV-waveband. The 500Series Users Manual is available in English, French, and Spanish. It is printed on 8 1/2 x 11 paper and bound in a 3-hole folder, so you can easily photocopy pages as needed.

The Users Manual also includes:

  • Warnings about who should not use the device
  • General warnings about UVB phototherapy and equipment safety
  • Installation considerations, assembly and setup
  • Exposure guidelines including skin type determination, positioning and other tips
  • Usage guidelines & treatment procedure
  • Psoriasis long term maintenance program
  • Device maintenance, bulb replacement & troubleshooting
  • Several years of Solarcs uniquely useful Phototherapy Calendar

Spot Treatment: The following pictures show some of the many possible Spot Treatment positions:

Back

Side of lower leg & knees

Back with partial blockage using clothing

Side of leg

Hands

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How Effective Is Uv Light Treatment For Psoriasis

UV light treatment has been very effective in a wide range of patients. Studies show that 60-75% of people that try phototherapy achieve at least a 75% improvement in around 20 sessions! This success rate has led to quite a few hand held NB-UVB units being made for home use.

These handheld units are great for treating scalp psoriasis as well as other areas of the body.

Excimer laser treatment is another light therapy that is showing a lot of promise. Its basically a high energy NB-UVB laser that can be very effective in treating areas with heavy plaques.

Since these areas need more light to effectively treat than other areas the laser is able to use more energy in these areas to get rid of psoriasis. The downside is that it isnt very effective over large areas of the body.

Remission from laser treatment is generally longer than with NB-UVB treatment but cannot be done at home.

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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.

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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Psoriasis Light Therapy Treatment

Light therapy treatment can use either artificial or natural sources.

Sunlight Careful exposure of the skin to very limited amounts of direct sunlight can assist in alleviating symptoms. However, very close monitoring of exposure time and intensity is required because too much sunlight may cause skin damage and actually worsen symptoms.

UV light An invisible light wavelength that is too short for our eyes to see. When skin is exposed to UV rays the activated T cells die off, resulting in a more normal skin cell replacement protocol. As well as less scaling and inflammation.

Patients should use sunlight treatment only under the supervision and advice of a medical professional.

UVB Normally given in a clinic, under the supervision of a dermatologist. This type of therapy can retard the production of skin cells. It is effective for the treatment of plaque psoriasis when the patient has not responded well to topical treatments.

We have written a very detailed article about the mechanism of red light therapy here.

TREATMENT WITH ULTRAVIOLET LIGHT B

Ultraviolet B is a natural component of sunlight and an effective treatment for psoriasis. UVB penetrates the epidermis and slows down the growth of affected skin cells. UVB treatment exposes the skin to an UVB light source for a calculated length of time on a regular schedule. This treatment can be administered in a medical clinic or at home.

COMBINATION LIGHT THERAPY

How Does Phototherapy Work

UVB Light Treatment for Psoriasis (before and after) – My Story

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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How Is Phototherapy Used To Treat Psoriasis

Both UVB and UVA can be used to treat psoriasis. UVB is used on its own, but UVA requires that the skin be sensitised by a plant-derived chemical called psoralen before it is effective. The treatment combining Psoralen and UVA is termed PUVA.

Both forms of phototherapy are given as a course of treatment over many weeks, where the time of exposure to the UV is gradually increased to prevent burning the skin and to allow the skin to acclimatise to the treatment. After a course of phototherapy the treatment is stopped in some cases improvements last for more than a year, while in other cases the psoriasis may start to recur after a few months or even weeks. Further courses of treatment may be given. It is not possible to predict how individuals will respond or how long their response will last after the phototherapy course ends. Psoriasis is the skin condition that responds best to phototherapy and in most phototherapy units 60-70% of the people attending are being treated for psoriasis.

Update: Home Phototherapy For Psoriasis Is Cost

In our article about psoriasis in the June 2010 issue of Harvard Women’s Health Watch , we mentioned phototherapy using ultraviolet B , a treatment that usually requires 30 sessions at a hospital or clinic. We noted that home therapy systems are available but did not compare them with clinic-based treatment. Now, a Dutch study in the medical journal BMJ has found that home phototherapy devices are as cost-effective as hospital-based treatment. An earlier study by the same group had shown that home phototherapy is at least as safe and effective as conventional outpatient phototherapy. The study involved about 200 people with psoriasis randomly assigned to receive phototherapy at home or at a hospital.

At the end of treatment, costs were roughly equal: $950 for hospital-based sessions and $1,000 for home devices . Therapeutic benefits were also similar: 82% of the home therapy patients and 79% of the patients treated at a hospital showed an improvement of 50% or more. Most patients in both groups said they would prefer home phototherapy if they needed treatment again in the future.

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Can Anyone Who Has Psoriasis Use Phototherapy

While dermatologists prescribe phototherapy for many people, it is not recommended for anyone who has:

  • Had a melanoma or any other type of skin cancer

  • A medical condition that makes you more likely to develop skin cancer, such as Gorlin syndrome or xeroderma pigmentosum

  • A medical condition that makes you sensitive to UV light, such as lupus or porphyria

  • To take medicine that makes them more sensitive to UV light, such as some antibiotics, diuretics, and antifungals

Choosing Patients For Home Phototherapy

UVB Phototherapy hand lamp

A thorough history and physical examination is the first step to identifying ideal patients for home phototherapy. UVB phototherapy is appropriate for psoriasis patients with widespread or generalized disease for whom topical therapy is impractical or ineffective. Phototherapy is contraindicated in patients who are photosensitive due to medications or an underlying photosensitive disease. Numerous medications can potentially photosensitize patients. Common offenders include thiazide diuretics, furosemide, tetracyclines, sulfonamides, amiodarone, diltiazem, and oral antifungal agents. Retinoids are also photosensitizing, but the oral retinoid acitretin is sometimes combined with phototherapy to augment the response. Such combination therapy should be closely supervised by a physician. Care should also be taken with the use of potentially photosensitizing antidepressants such as amitriptyline or desipramine, as well as antipsychotics like chlorpromazine, and hypoglycemic agents including glyburide and glipizide. Therefore, if possible, alternative medications should be substituted to prevent phototoxicity. Examples of photosensitive diseases include lupus, rosacea, porphyria, polymorphous light eruption, and vitiligo. Other relative contraindications to UVB phototherapy include current or past history of melanoma or a history of recurrent non-melanoma skin cancers.

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What Is Home Phototherapy

is the use of light or other forms of non-ionising electromagnetic radiation in treatment. The light or radiation is produced by a medical device commonly referred to as a phototherapy unit.

The most commonly used medical lamps in phototherapy units emit a narrow band of ultraviolet radiation, which reduces or eliminates various skin diseases, at least temporarily.

Home phototherapy is a relatively safe and effective non-drug option for the self-treatment of skin disorders in the privacy and convenience of a patient’s home. Phototherapy should be controlled and supervised by an experienced physician. However, not all dermatologists agree to oversee home phototherapy because of the potential for adverse reactions.

Treatment can be delivered to the skin of the whole body or it can be precisely targeted to affected areas to minimise exposure of uninvolved skin.

Home phototherapy

Home therapy is not suitable for all patients with these skin conditions and results vary.

What Are The Side Effects Of Uvb Treatment

The most common immediate side effect of UVB phototherapy is a mild sunburn reaction. This maybe more likely if the person being treated has been using other medications or herbal supplements which can cause sensitivity to light. It is, therefore, important, before starting any course of any treatment, to inform the healthcare professional or doctor of any products being taken. This sunburn reaction is usually not serious and the phototherapist will adjust the dose of the next treatment or postpone treatments until the redness has settled. Some people report itchiness in the early stages of treatment, but this should soon settle.

The long-term effects of phototherapy include increased ageing of the skin and an increased risk of certain skin cancers. In the 30+ years of the medical use of narrowband UVB phototherapy, increased skin cancer has not been reported. UVB causes very little photoageing. Nevertheless, if someone has had 500 or more UVB treatments it is recommended that the risks and benefits of further UVB are re-evaluated and their skin checked for signs of skin cancer.

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Uv Light Therapy For Moderate To Severe Cases

, also known as UV light therapy, is one of the most effective treatments for psoriasis. It involves exposing the skin to controlled amounts of ultraviolet radiation similar to that from the sun. It is usually prescribed with other treatments when conservative therapies fail to provide relief and is especially useful for moderate to severe psoriasis covering large portions of the body.

Phototherapy is performed in a dermatologist’s office under controlled conditions. Side effects tend to be mild. In addition to psoriasis, phototherapy may also be used to treat eczema, vitiligo, lichen planus, and cutaneous T-cell lymphoma.

Treatments With Uvb And Uva

UVB Lamp for Treatment Psoriasis Vitiligo Eczema Atopic Dermatits HOME Phototherapy
  • Psoralen and UVA light therapy , which combines UVA exposure and a medicine that makes your skin more sensitive to light.
  • The Ingram regimen, which combines dithranol, tar products, and UVB phototherapy.
  • The Goeckerman treatment, a combination of tar products and UVB phototherapy.

Your body is exposed to UV light from banks of light tubes that give off either UVB or UVA light in a booth. Booths come in several designs. Some look like phone booths and you can stand in them. Others look like tanning beds and you can lie down during treatment. The booth will record the total amount of light you are exposed to.

In general, your entire body is exposed to the light. You will wear sunglasses that block UV light and goggles or a blindfold to protect your eyes from getting cataracts. Men may also need to shield their genitals to protect them from an increased risk of genital cancer.

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