What is Psoriasis?
Psoriasis is a common, chronic, genetic disease of the immune system, effecting nearly 7.5 million Americans today. Most commonly, psoriasis effects the skin causing red patches with silvery white scales, called plaque psoriasis. Often psoriasis is seen on the scalp, elbows, legs, trunk and sacrum, but can occur anywhere on the body, including the palms, soles, genitals, and skin folds. In some people, only a small portion of the skin surface area is effected, in others, it may be extensive. Additionally, there may be itching, pain, nail changes including pitting and discoloration, and arthritis symptoms.
Although the cause of psoriasis is still not fully understood, it is thought to involve the immune system’s response to the environment in people who have a genetic susceptibility. In patients with psoriasis, T cells, a type of white blood cell that usually fight off infection, mistakenly become overactive, attacking healthy skin cells and triggering other immune responses. As a result, there is an increased production of blood flow to the skin, and excess production of both healthy skin cells and white blood cells. This causes an ongoing cycle in which new skin cells are forced to the outermost layer of the skin surface much too soon in a few days rather than weeks. Unable to slough off quickly enough, dead skin cells and white blood cells form the thick scaly plaques commonly seen with psoriasis. Without treatment, this cycle will likely continue.
Anyone may develop psoriasis, but risk factors include: a family history of the disease, decreased immune function, stress, obesity, and smoking. Psoriasis may be triggered or worsened by: injury to the skin, stress, cold weather, smoking, infection, and certain medications.
For some people psoriasis is merely a nuisance, for others it may be a debilitating disease that inhibits a person’s daily activities, is a source of chronic itching and pain, and leads to stress, anxiety, depression, and social isolation.
There is no cure for psoriasis, but current treatments can significantly reduce and control psoriatic plaque formation, and in some cases, lead to remission. The aims of these treatments are to: remove scales and smooth the skin, disrupt the cycle that causes increased cell production, inhibit DNA synthesis locally, promote self-destruction of excess T cells, and reduce inflammation. Methods include topical medications, systemic medications, and in-office narrowband (NB)-UVB phototherapy.
Treatment of Psoriasis
NB-UVB phototherapy is a highly effective, popular, and easy therapy option for the treatment of psoriasis, vitiligo, atopic dermatitis (eczema), and many other skin disorders that respond to light therapy. It emits only a narrow spectrum of specific wavelengths of light (311-313nm). Unlike broadband UVB treatment or natural sunlight exposure, the wavelengths are concentrated in an optimal therapeutic range, achieving the best medical results without the risk of sunburn.
Phototherapy is specifically tailored to meet each patient’s needs and typically entails 3 treatment sessions per week for 8-12 weeks, then tapering as symptoms improve. Therapy sessions are convenient and quick (generally lasting under 2-3 minutes), and available throughout the day.
NB-UVB phototherapy is a great treatment option for patients who have not reached treatment goals with topical therapies alone, who are unable to take immunosuppressant medications, or who prefer alternatives to topical and oral medications. Additionally, NB-UVB phototherapy is safe to use in children, adults, and during pregnancy.
Depending on each patient’s individual condition, overall health, and personal treatment goals, our providers will develop a customized treatment plan to suit your needs.