Psoriasis / Light Therapy / Excimer laser
What is psoriasis?
Psoriasis is a hereditary disorder characterized by itchy or painful thick, red, scaly patches of skin. It often affects the scalp, elbows, knees, groin, hands and feet, but may occur anywhere on the body. The disease goes through cycles, worsening for months or years and sometimes going into remission for a period of time. Typically, psoriasis begins in young adulthood, but may begin at any age. One percent of the population is affected. Psoriasis is not contagious. Multiple family members may be affected due to the hereditary nature of the disease.
What causes psoriasis?
There is much research dedicated to discovering the cause of psoriasis, but it is still unknown. It is thought that something in the environment triggers a genetically susceptible individual to develop psoriasis. Some people develop psoriasis after an infection, particularly with Streptococcal bacteria.
How is psoriasis treated?
New treatments for psoriasis are being developed every year, but there is no cure. Topical treatments include moisturizers, corticosteroids, crude coal tar preparations, Tazorac® (a vitamin A derivative), and Dovonex® (a vitamin D derivative). Some people benefit from light therapy (see below). Severe psoriasis may require therapy with oral medications such as acitretin (a vitamin A derivative), methotrexate (a chemotherapy agent), sulfasalizine (a sulfa medicine) and cyclosporine (an immunosuppresant).
What is light therapy?
Ultraviolet light, in the form of natural sunlight or light administered in a special light box at the dermatologists office, has healing properties for many people with psoriasis. There are three types of controlled light available: UVB, narrow-band UVB, and PUVA. UVB is the type of light responsible for much of the tan people get outdoors. Narrow-band UVB is a very focused type of UVB that has been found to be more effective than standard UVB for controlling psoriasis. This type of light is more expensive to administer, and thus not widely available. PUVA treatment involves receiving UVA light and taking a pill (Psoralen) to enhance the effect of the light. This method of light treatment is highly effective but carries the highest risk of future skin cancer. It has recently been found that PUVA and narrow-band UVB are probably equally effective.
An exciting technology in our practice is the Excimer Laser. With the Excimer laser, higher doses of narrowband UVB can be directed to individual plaques, shortening the time to clearance without exposing the entire body to the UVB rays. This is best for stubborn plaques on elbows, knees and scalp and is covered by most insurance plans.
How can Cary Dermatology help my psoriasis?
The physicians at Cary Dermatology are experienced in the diagnosis of psoriasis and in a wide variety of psoriasis treatments. We offer the latest narrow-band UVB treatment. We are active in the National Psoriasis Foundation and encourage patient membership.