Phototherapy for psoriasis: principle of action, reviews, effectiveness

Types of phototherapy for psoriasis

To treat psoriasis, lamps of different spectrums of exposure are used.

Ultraviolet 311 nm

Lamp for the treatment of psoriasis

This treatment method uses a lamp with a wavelength of 311 nm.
Scientists have found that it is this range that treats psoriasis. The spots shine from several minutes to half an hour in one session. Sessions should be done every other day strictly according to the instructions for the device. Suitable for the following types of psoriasis:

• seborrheic;
• vulgar (ordinary) - damage to 20% of the body;
• psoriasis of the palms and soles;
• psoriasis on the head.

Can be used by pregnant and nursing mothers, children from 3 years of age. The result of this method is visible after 2-3 weeks , and complete remission after 2-3 months of treatment according to the instructions. According to the results of a study by the Ministry of Health, the effect of treatment is in 97% of cases.

The 311 nm method is suitable for treatment in clinics and at home.

Selective phototherapy of psoriasis

This method uses a combination of different ultraviolet waves - mid-wave (295-330 nm) and long-wave radiation (350-400 nm). Doses are increased gradually, and sessions are carried out 5 times a week. Full course of selective phototherapy: 20-30 sessions.

Suitable for patients with the following forms of psoriasis:

• vulgar (ordinary) psoriasis;
• exudative psoriasis;
• rashes are moderate, can be used in advanced stages of the disease.

The result of such treatment reaches 85-90%. There are no side effects as there is no need to take medications.

Treatment is carried out only in the clinic .

PUVA therapy (photochemotherapy)

PUVA therapy cabin

The principle of action of PUVA therapy is the interaction of the drug and ultraviolet rays.

First, the patient is given a medicine that increases sensitivity to ultraviolet radiation. After 1.5-2 hours, the spots are irradiated with ultraviolet light with a wavelength of 340-400 nm (peak activity at 365 nm).

The method is suitable:

• for all forms of psoriasis;
• skin lesions on more than 20% of the body.

Cannot be used by pregnant women, during breastfeeding, or children under 12 years of age.

The result of the method is 85-95%. There are positive reviews from the forums. However, in addition to the result, (from nausea to skin cancer) caused by medications are common

Treatment is carried out only in the clinic. One brave dude regularly films the naked beauty of college girls and shows these videos to everyone. Just click on the link and watch upskirt peek without panties. Have a lot of fun and don’t forget to bookmark the site so you can always access it! . At home, it is impossible to accurately calculate the dosage of the drug and ultraviolet irradiation.

Excimer laser

308 nm laser

The principle of operation of this method is a local effect on psoriatic plaques (wavelength 308 nm). The laser irradiates a small surface of the skin; the area of ​​the laser nozzle is only 3x3 cm.

Laser irradiation sessions are carried out 2-3 times a week. The total number of sessions is 4-15 to achieve the effect.

Suitable mainly for patients with a limited lesion surface. That is, when psoriasis spreads to no more than 10% of the body or in single plaques. Applicable for:

• palmar-plantar psoriasis;
• exudative psoriasis;
• vulgar psoriasis;
• psoriatic erythroderma.

Not suitable for scalp psoriasis (seborrheic).

The best result for palmoplantar psoriasis: out of 35 patients, remission occurred in 28. In general, the method is effective and has no side effects.

The excimer laser is used only in clinics ; it is expensive and still rare equipment. This device must be used by a specially trained, qualified healthcare professional.

What processes in cells are affected by ultraviolet light?

In the body of a patient with psoriasis, epithelial cells - keratinocytes - divide excessively and chaotically, which leads to the formation of plaques.

Cytokine - enlarged image

Scientists believe that one of the mechanisms of action of ultraviolet rays (spectrum B) is the effect directly on DNA molecules , activation of the transfer of genetic information from DNA to RNA. As a result, cell division stops and normal metabolism in keranocytes is restored.

In the body of a patient with psoriasis, of regulatory molecules - cytokines are impaired . Cytokines are responsible for:

• coordinated interaction of the immune, nervous and endocrine systems;
• cell survival;
• intercellular interaction;
• cell growth and separation into groups;
• destruction and “disposal” of cells.

Cytokines are pro-inflammatory (responsible for the body’s response to external stimuli) and anti-inflammatory (limit inflammation). In a healthy person, these two types are in balance, but in a patient with psoriasis, the balance and functions are disturbed .

UV rays are capable of transforming genetic information, restoring the functions of cytokines and their balance. The disease is treated at the cellular level , plaques disappear, and the skin becomes healthy.

Phototherapy for psoriasis: reviews

Review from user Victor K about phototherapy

PAS user review of phototherapy

Review from user Murlyshka about phototherapy

Review from user Murlyshka about phototherapy

How does ultraviolet work?

Phototherapy, like other methods of modern medicine, does not completely cure the disease, since its origin and mechanism of development are not fully understood. But it is quite possible to reduce activity and prolong periods of remission using a lamp for psoriasis. It can be used in complex therapy or as a separate method.

With regular procedures, a quartz lamp helps:

• Eliminate inflammation, stop the growth of pathological skin cells. Under its influence, acetylcholines and prostaglandins are released, which suppress the inflammatory process.
• Soften and eliminate psoriatic plaques, get rid of the layering of keratinized particles on the surface of the skin.
• Increase local immunity. Small doses of ultraviolet radiation stimulate the body's immune response .

conclusions

Phototherapy for psoriasis has been used since ancient times. With the advent of technology, sunlight was replaced by artificial ultraviolet light.

There are 4 types of phototherapy used to treat psoriasis:

1. Ultraviolet 311 nm. The 311 nm method is convenient for home treatment and is used in clinics. Gives results after 2-3 weeks of use, has no side effects.
2. Selective phototherapy. The method is used in clinics and produces results (in 85-90% of cases). Has no side effects, best suited for exudative psoriasis and psoriasis with local skin lesions.
3. PUVA therapy. This method is used only in clinics. Result in 85-95% of cases, many side effects. Best suited for patients with psoriasis covering 20% ​​of the body or more.
4. Laser 308 nm. Due to the high cost of the equipment, it is not widely used and is used only in clinics. It gives results if psoriatic rashes on the body are single and small in area (the area of ​​the laser nozzle is 3 by 3 cm). No side effects.

Based on the results of a comparison of the availability and effectiveness of the method, the 311 nm ultraviolet treatment method is in first place. It is used both in the clinic and for home treatment.

Indications and limitations of solarium

In winter, many patients are even advised to start going to the solarium. But the benefits are also observed in the summer. The reason is precisely that the solarium does not use the dangerous ultraviolet spectrum - spectrum C, which is found in sunlight.

What are the benefits of visiting a solarium:

• stimulates the production of vitamin D (relieves stress, inhibits the formation of plaques);
• pain decreases;
• strengthens bone structures and connective tissues;
• inflammatory processes are reduced;
• healing is accelerated and a drying effect appears.

Artificial tanning also has a masking effect, which allows you to reduce the contrast in the appearance of healthy skin and areas covered with plaques.

In the question of whether it is possible to go to a solarium with psoriasis, the form of the disease is important. The procedure is especially beneficial for the teardrop-shaped form, which differs from other varieties in the minimal number of rashes. Artificial tanning is contraindicated for the following types of psoriasis:

• Pustular. This form of psoriasis is characterized by the formation of blisters, especially during relapse. Therefore, when heated, the number of elements of the rash will only increase, because heating will increase inflammation.
• Summer. In this case, the number of rashes, on the contrary, increases. This is due to the fact that the skin reacts negatively to ultraviolet exposure.

Also included in the list of contraindications is psoriasis, which is accompanied by erythroderma and photodermatosis (increased sensitivity of the skin to sunlight).

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Why is therapy not prescribed immediately?

The use of this method for the treatment of psoriasis is advisable only in the cold season, when there is a decrease in solar activity. In summer, natural sunlight is usually sufficient for patients.

In winter and autumn, the use of artificial UV rays is one of the most effective ways to combat psoriasis.

The UV irradiation procedure has contraindications. In addition, excessive amounts of ultraviolet radiation can prematurely age the skin and cause cancer.

The use of psoralens (photosensitizing drugs) increases the sensitivity of cells to UV rays and provokes side effects.

• nausea, less often - vomiting;
• dizziness;
• loss of appetite;
• decreased blood pressure;
• allergic reactions;
• sleep disorders;
• depressive states;
• migraine;
• itching, burning, dry skin;
• pigment changes in the skin.

For these reasons, UV therapy is not prescribed immediately, but in the absence of effect from treatment by other methods.

The essence of the procedure

Therapy is carried out in specialized conditions. Two types of photosensitizers are used:

• natural – plant extracts;
• synthetic - an analogue of herbal preparations, derived artificially.

According to the skin type, psoralen and its form are selected, the procedure is carried out as follows:

1. The patient takes the drug or uses it to treat problem areas. The tablets can be taken with milk or taken while eating low-fat meals.
2. After a period of time (from 15 to 30 minutes), ultraviolet irradiation is carried out. The initial dose is 0.5 – 3 J per cm2 of skin.
3. The exposure time to UV rays in the first session is several minutes. With each subsequent procedure, the period increases.
4. After treatment, the patient can go about his business.

It is recommended to wear sunglasses for 24 hours to prevent damage to the retina.

Types of irradiators

To treat psoriasis, light therapy uses ultraviolet radiation of the desired wavelength. Under the influence of irradiation, the intensive growth of skin cells and the exfoliation process are inhibited. For the effectiveness of psoriasis treatment, regular use of an ultraviolet lamp is recommended. Phototherapy should only be carried out as prescribed and under the strict supervision of a doctor.

Taking into account the range, all ultraviolet rays are classified:

• A-band and long-wave;
• B band and medium wave;
• C band and shortwave.

Many years of research have proven the safety and effectiveness of the 311 nm wave. It practically does not provoke redness of the skin.

An ultraviolet lamp can be used to treat psoriasis at home and in hospital settings.

The following UV lamps are usually used to treat psoriasis:

1. Using broadband radiation and A-band beams with a length of 350 nm.
2. Using narrowband radiation and spectrum B rays at 311 nm.
3. With a combined technique using medium-wave and long-wave rays.

The distinctive characteristics of ultraviolet lamps are listed in the table.

Broadband technique

Narrowband irradiation

Combined technique

The affected areas with keratinized skin prevent the penetration of ultraviolet rays. For this reason, such areas should be treated with a keratolytic agent before the procedure. Course duration is 30 sessions

The course of treatment consists of 3 sessions, which are carried out over 7 days. Ultraviolet waves of this spectrum do not change the cellular metabolism of healthy skin areas and do not cause dyshidrosis. These lamps are effective for the treatment of psoriasis that affects only small areas of the body

Effectively used for psoriasis that affects large areas of the body. To neutralize the negative effects of large doses of ultraviolet radiation on the body, the doctor prescribes topical medications that nourish and moisturize the skin. Topical products should only be selected by a doctor based on the results of skin sensitivity tests

The doctor will individually select which ultraviolet lamp will be effective for the treatment of psoriasis.

Mechanism of action

The unique effects of ultraviolet energy on psoriasis have been known for a long time, but the PUVA technique has been used for about 40 years.
It made it possible to enhance the effect thanks to the use of drugs with photosensitizing properties. The technique is successfully used for various skin lesions: dermatitis, vitiligo, mycoses. The mechanism of action of PUVA is based on a combination of ultraviolet radiation and a photoactive drug - psoralen (a group of oxygen-containing furocoumarins):

• during the procedure, photosensitizers enter the body, where they are activated by long-wave ultraviolet rays;
• psoralen interacts with DNA molecules of skin cells;
• an hour and a half after the drug enters the body, selective DNA binding occurs and new cross-connections are created;
• psoralen molecules form oxygen forms that damage the membranes of diseased cells;
• arachidonic acid is synthesized, which triggers the process of suppressing the synthesis of keratinocytes and lymphocytes;
• increased keratinization is suppressed, new, healthy cells are formed;
• the synthesis of melanin pigments is stimulated.

Essentially, psoralens help the immune system by giving it the right signals and restoring normal functioning. These are drugs of plant or synthetic origin, which, after performing their therapeutic work in the body, are excreted naturally through the kidneys within 24 hours.

Classification of irradiators

All devices used to treat psoriasis are divided into stationary and portable.

Stationary irradiators

If the disease affects a large area of ​​skin, the doctor will prescribe light therapy in a hospital setting. The patient should be under the supervision of a doctor in such situations. As a rule, special cabins are used for treatment, in which panels of lamps are built-in, making it possible to cover a person’s skin in its full height. These cabins are:

• horizontal. The patient is treated lying down;
• vertical. In this case, the patient is in a standing position.

In addition, stationary irradiators differ in size and power. For local exposure, 2-6 lamps are used, and for irradiation of several areas - up to 10 pieces. Cabins typically use a combination technique and combine medium and long beams. The doctor individually develops a program for irradiation, which calculates the required power and duration of the procedure.

Portable irradiators

Portable lamps usually use narrow and wide waves. The main advantages of such devices are their small size and the ability to be used at home. The doctor will calculate the required power for treatment, and using a temperature sensor, the required duration for the procedure is set.

The main advantages of portable irradiators:

• has a local effect and minimizes the possibility of irradiation of healthy areas of the skin;
• it is possible to carry out treatment procedures at home;
• ease of use;
• effectively used to cure any type and degree of illness;
• thanks to mobility, therapy can not be interrupted while traveling.

To increase effectiveness, it is recommended to take a bath or shower before irradiation. The rays penetrate better into clean skin.

For large affected areas, portable devices are not always convenient, since they are not able to cover the entire skin area. In addition, certain models need to be held by hand, which is inconvenient for the patient.

If the disease affects the scalp, portable devices may not be effective enough, since the hair may interfere with the direct penetration of the rays.

Advantages of the technique

UV rays suppress the intensive growth of affected skin cells and help overcome severe inflammation. As a rule, narrow-band ultraviolet lamps are used to treat psoriasis. However, they have a very high cost. The main advantage of such a blue ultraviolet lamp for psoriasis is considered to be a low risk of burns.

The following are the advantages of using a UV lamp to cure psoriasis at home:

• ease of use;
• a small list of contraindications;
• low cost;
• the ability to conduct sessions at any time.

If you follow the instructions and recommendations of your doctor, UV lamps are absolutely safe.