Light therapy for psoriasis

How does light therapy work

Light therapy is also known as phototherapy and is a physical method to treat psoriasis (Psoriasis vulgaris) to treat. It is used for moderate to severe or extensive psoriasis. In light therapy, the affected skin is irradiated with ultraviolet light (UV light).

The irradiation can take place alone or in addition to a drug or local therapy. Narrow-spectrum UVB light is used, whereby light with a wavelength between 311 and 331 nanometers hits the skin.

Another light therapy is the so-called PUVA therapy (psoralen UVA therapy), which works with a wavelength between 320 to 400 nanometers. In addition to treating the affected skin with UVA rays, the skin is also treated with the drug psoralen, which makes the skin more sensitive to UVA rays.

The light therapy with UVB or UVA rays should generally eliminate the inflammation in the skin affected by psoriasis by suppressing the overactive immune system and slowing down the cell division, which is increased in psoriasis.

Read more on the topic:

• Treatment of psoriasis
• UV radiation

Can you do light therapy at home?

Professional light therapy cannot be carried out at home, but takes place in dermatological practices or in hospitals. The light therapy is carried out with UVB or UVA rays. For this purpose, special devices with light tubes are used that emit light in certain wavelengths.

Since it is important before treatment how high the dosage and wavelength of the UV light should be, as well as how long the treatment should last, treatment should only be carried out by dermatologists who are familiar with light therapy.

In addition, the setting of the light irradiation depends on the skin type, the use of medication that makes the skin more sensitive to light, and previous illnesses such as skin cancer. Previous skin cancer is not only a therapy restriction, but must also be considered with regard to the side effects of light therapy, as this increases the risk of skin cancer.

This is especially important when irradiating with UVB radiation devices, which are available over the counter. These are handy devices, for example a UVB light comb that can be used independently for psoriasis on the scalp or other parts of the body. This treatment, if carried out, should only be carried out after consulting a dermatologist.

What is the cost of light therapy

If light therapy is justified, the costs for the person affected are usually covered by the health insurance fund. How much a practice or hospital then earns from light therapy depends on the respective health insurance company. If the light therapy is not covered by the health insurance fund because the severity of the disease is too low, the price must be requested from the practices and hospitals. UV light devices for private use cost over € 200. In general, the costs for a patient with only local therapy (creams) and light therapy amount to over € 1000 per year.

The health insurance pays the treatment costs for a light therapy

If the indication - i.e. a therapy justified - is given for light therapy, the costs can be covered by the health insurance. However, this is not always the case, especially if the psoriasis is not severe enough.

The severity of psoriasis is determined by what is known as the PASI score (Psoriasis Area and Severity Index) certainly. A PASI score above 10 is moderate to severe psoriasis, and the costs are usually covered by your health insurance. If the indication for so-called balneophototherapy (PUVA therapy, where psoralen is administered as a bath) exists, the health insurance companies have had to cover the costs since 2008. The extent to which the costs will be covered and the prerequisites for the therapy should, however, be clarified individually with the health insurance company before the therapy.

Use on the scalp

Psoriasis on the scalp is also called Psoriasis capitis designated. Light therapy can also be used if the scalp is affected. The light therapy is carried out exactly like when the rest of the skin is affected by irradiation with ultraviolet light.

Practices and hospitals that offer light therapy also have, in most cases, devices with which partial irradiation is possible. Light therapy on the scalp can also be done using smaller, handy devices. This is a light comb, also known as a UV or psoriasis comb. The attachment of the device resembles a comb and is therefore very suitable for the scalp. The comb-like attachment is used on the one hand to part the hair so that the UV light also reaches the scalp and on the other hand as a spacer to prevent burns to the skin. A light comb can also be purchased over the counter. However, it should only be used after consulting a dermatologist who is familiar with light therapy, as the treatment entails an increased risk of skin cancer.

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Duration of light therapy

The light therapy should ideally be carried out three times a week for about 15 minutes. Usually between 15 to 24 treatments will be performed in a row. A series of treatments therefore lasts up to eight weeks. The attending physician must determine whether there are 24 treatments or less. Another series of treatments can take place after six months.