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Patients prefer NB-UVB over other PUVA treatments because they do not have to wear protective eyewear, take medications, or experience unpleasant side effects such as nausea. NB-UVB is also safe for pregnant women and children.
Combinations with topical medications, such as tazarotene or psoralens, may help NB-UVB therapy work more effectively.
Laser Treatments
Laser UVB Treatment. A variation of a device called an excimer laser (Xtrac) delivers a precise UVB wavelength of 308 nanometers. The laser is more effective than narrowband UVB for localized psoriasis, because it allows very specific areas of skin to be targeted. (Note: The therapy is not suitable for the scalp.) Generally, 8 - 10 treatments given twice a week will clear psoriasis. Remission rates are similar to those of NB-UVB, but the excimer laser can clear the psoriasis faster and at lower doses. It also spares the healthy skin around it. Blistering is a common side effect. More comparison studies are needed to determine risks and benefits compared to NB-UVB, particularly any long-term risk for skin cancer.
Pulsed-Dye Lasers. Pulsed-dye lasers give off high-intensity yellow light, which destroys the tiny blood vessels that make up psoriatic plaques. This treatment has been used for years to remove birthmarks, such as port wine stains and unsightly blood vessels on the skin. Some studies have reported significant (but not complete) improvement of psoriasis, and remissions that have lasted up to 13 months. Treatment sessions can take up to 30 minutes and can feel uncomfortable (similar to being repeatedly snapped with a rubber band). It typically takes up to six sessions to clear the target areas. Bruising is common, and there is a small risk for scarring.
Commercial Tanning Units
Home tanning devices and tanning salons are not usually recommended, but they may be helpful for patients who do not have access to a medical facility. Many patients have achieved a significant reduction in symptoms after taking acitretin and being exposed to a UVB commercial tanning unit (specifically, a Wolff tanning bed).
However, UV outputs can vary widely among tanning beds and salons. Some units emit UVA radiation, which poses a higher risk for skin cancers. Adverse effects of tanning salons that use UVA or UVB radiation are the same as with any UV phototherapies, including a risk for skin cancer.
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Review Date: 10/21/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine,
Harvard Medical School. Also reviewed by David Zieve, MD, MHA,
Medical Director, A.D.A.M., Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
