Gary W. Cole, MD, FAAD
Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Psoriasis facts
- What is psoriasis?
- What causes psoriasis?
- What does psoriasis look like? What are psoriasis symptoms and signs?
- Can psoriasis affect only my nails?
- Can psoriasis affect my joints?
- How do health-care professionals diagnose psoriasis?
- How many people have psoriasis?
- Is psoriasis curable?
- Is psoriasis contagious?
- Can I transmit the gene for psoriasis to my children?
- What kind of doctor treats psoriasis?
- What is the treatment for psoriasis?
- What creams, lotions, and home remedies are available for psoriasis?
- What oral medications are available?
- What injections or infusions are available for psoriasis?
- What about light therapy for psoriasis?
- Where can people get more information on psoriasis?
- Is there a national psoriasis support group?
- What is the long-term prognosis with psoriasis? What are complications of psoriasis?
- What does the future hold?
- Pictures of Psoriasis - Slideshow
- Take the Psoriasis Quiz
- Psoriasis FAQs
- Find a local Dermatologist in your town
What about light therapy for psoriasis?
Light therapy is also called phototherapy. There are several types of medical light therapies which include PUVA (an acronym for psoralen + UVA), UVB, and narrow-band UVB. These artificial light sources have been used for decades and generally are available in only certain physician's offices. There are a few companies who may sell light boxes or light bulbs for prescribed home light therapy.
Natural sunlight is also used to treat psoriasis. Daily short, controlled exposures to natural sunlight may help or clear psoriasis in some patients. Skin unaffected by psoriasis and sensitive areas such as the face and hands may need to be protected during sun exposure.
There are also multiple newer light sources, including UV lasers (XTRAC) that produce light at a wavelength beneficial for psoriasis and photodynamic therapy (use of a light activating medication and a special light source), that have been used to treat psoriasis.
PUVA is a special treatment using a photosensitizing drug and timed artificial-light exposure composed of wavelengths of ultraviolet light in the UVA spectrum. The photosensitizing drug in PUVA is called psoralen. Both the psoralen and the UVA light must be administered within one hour of each other for a response to occur. These treatments are usually given in a physician's office two to three times per week. Several weeks of PUVA is usually required before seeing significant results. The light exposure time is gradually increased during each subsequent treatment. Psoralens may be given orally as a pill or topically as a bath or lotion. After a short incubation period, the skin is exposed to a special wavelength of ultraviolet light called UVA. Patients using PUVA are generally sun sensitive and must avoid sun exposure for a period of time after PUVA. Narrow-band UV is now a very popular approach for patients with extensive disease who wish to avoid systemic medications. It is frequently given daily or two to three times per week. UVB is also a component of natural sunlight. UVB dosage is based on time and exposure is gradually increased by as tolerated. Potential side effects with UVB include skin burning, premature aging, and possible increased risk of skin cancer. The relative increase in skin cancer risk with UVB treatment needs further study.
Common side effects with PUVA include burning, aging of the skin, increased brown spots called lentigines, and an increased risk of skin cancer, including melanoma. The relative increase in skin cancer risk with PUVA treatment is controversial. PUVA treatments need to be closely monitored by a physician and discontinued when a maximum number of treatments have been reached.
Sometimes UVB is combined with other treatments such as tar application. Goeckerman is a special psoriasis therapy using this combination. Some centers have used this therapy in a "day care" type of setting where patients are in the psoriasis treatment clinic all day for several weeks and go home each night.
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