Psoriasis Phototherapy

Psoriasis is a complicated and unpredictable disease that affects over two million people in the United States. Although most individuals are mildly affected and are easily controlled with simple topical therapies, some experience periods of increased activity or become poorly responsive to topical treatments. Such individuals require a more proactive therapeutic approach. Phototherapy is a well understood, time proven method of achieving remission in a majority of cases.

The Psoriasis Phototherapy Program at Dermatology Associates of Morris

Dermatology Associates of Morris is a full service practice of medical and surgical dermatology with expertise in the many treatments of psoriasis. Through our Psoriasis Phototherapy Program we offer many years of experience in the ultraviolet light treatment of psoriasis. Our physicians are certified by the American Board of Dermatology, have trained in dermatology at university centers that include the University Hospitals of Columbia and Cornell in New York City and Jefferson Medical College in Philadelphia, and continue to maintain academic teaching affiliations.

Phototherapy for Moderate to Severe Psoriasis

Our phototherapy program consists of the in-office treatment of persistent psoriasis by the administration of increasing increments of ultraviolet light to the skin in a precise computer controlled fashion. As ultraviolet light rays penetrate into the skin, they produce changes which slow down the rapid growth of cells that is characteristic of psoriasis. Plaques flatten and become less scaly, and often, within a 7 to 8 week period, complete or nearly complete remission is achieved.

Phototherapy is a proven, relatively safe method for the treatment of:

Types of Ulstraviolet Light Treatments

Utraviolet B (UVB) Light

Ultraviolet B light is usually our first line of light treatment. We administer two types of ultraviolet B light - Broad Band (BB) and Narrow Band (NB).

Broad Band
This is the time tested older type of treatment. It consists of the controlled administration of a variety of ultraviolet B (sunburning) light rays emitted by high energy light bulbs. Treatments are initially administered three or more times per week and are progressively decreased in frequency once remission is achieved, usually after 20-30 treatments, in about 70% of patients.
Narrow Band
This is a relatively new type of treatment. It consists of the administration, by specialized bulbs, of a high concentration of the specific type of ultraviolet B rays that are most effective in reversing the changes of psoriasis. Treatments are initially administered three times per week and are likewise progressively tapered once remission is achieved, usually after 20-25 treatments.

PUVA - Psoralen plus Ultraviolet A (UVA) Light

PUVA is our third available treatment choice. It consists of the ingestion of an oral medication (Psoralen) followed by the administration of UVA (sun tanning) light rays, hence the name PUVA. The psoralen becomes deposited in the skin and is activated by the UVA light that is administered 1 - 2 hours later. Treatments are initially given 2-3 times per week and are tapered upon remission, usually after 20-25 treatments.

Topical PUVA for the Palms and Soles

Localized psoriasis of the palms and soles is a difficult therapeutic problem as it often does not respond well to topical medications. The administration of psoralen, usually by ingestion, but occasionally by topical absorption through the application of an ointment or a 15 minute soak, followed by UVA light exposure, can prove to be helpful in many instances.

Any of these treatments can be, and often are administered in combination with topical corticosteroids, vitamin D or retinoid preparations and/or ingested medications, such as retinoids, methotrexate and cyclosporine or various injected "biologic" medications.

Our Treatment Facility

The Psoriasis Phototherapy Program occupies a private wing of Dermatology Associates' suite of offices. Modeled after the outpatient phototherapy department at Columbia Presbyterian Medical Center, it consists of two full body light changers, two smaller units for localized hand and/or foot treatment, three private changing rooms with sinks and mirrors for grooming and a nursing station. We feel that it provides a complete and user friendly atmosphere for our patients.

Our Staff

Our phototherapy nursing staff consists of a dedicated team of friendly and approachable individuals who are well attuned to the concerns and needs of psoriasis patients. They are willing and able to provide assistance while they monitor patients' treatments and progress. A phototherapist is present during the entire treatment session and communication between staff and patients is encouraged.

Initiating Treatment

Before initiating phototherapy, each patient is carefully evaluated by one of our physicians. Past history is reviewed and alternative treatment options are considered. Once phototherapy is recommended, its administration is thoroughly discussed with the patient, and an individualized treatment protocol is set up. An informative manual is dispensed that describes the specific type of light treatment that will be administered. Prior to initiating actual treatment sessions, each patient will receive a thorough orientation by a member of our nursing staff. This provides an excellent forum for discussion of the many questions that undoubtedly arise.

Treatment Hours

In an attempt to fit most individual's busy schedules, treatments are administered during late afternoons, early evenings and usually one or more mornings each week. They are initially short, lasting less than one minute, but may eventually approach 10 - 20 minutes. They are usually administered in a timely fashion with little waiting.

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