Psoriasis is a chronic inflammatory and non-infectious skin disease. Dandruff formation and inflammatory redness are characteristic features of the skin changes. Accordingly, psoriasis is also called psoriasis.
Depending on the size, type and location of the occurrence (localization), different manifestations of the skin changes are distinguished. About 20% of those affected suffer joint problems at the same time.
The course of psoriasis is very different individually: On the one hand, the clinical picture can be uniform over long periods of time. On the other hand, the symptoms can occur in batches, i.e. phases with high inflammatory activity (thrust) alternate with largely symptom-free intervals.
It is also the normal sun that brings healing to the psoriatic, but it is not always available and controllable. However, certain wavelengths of radiation are more efficient and have anti-inflammatory effects by inhibiting the activity of certain cells of the immune system.
Most psoriasis patients see their dermatologist’s practice three to four times a week if they choose a radiation series.
Treatment at home offers more leeway: You can irradiate when you have time, regardless of the opening time of the practice. But: Such self-treatment should not be carried out uncontrolled, but under the precise guidance of a specialist. Because: Like almost every treatment, the radiation has side effects. Light damage such as sunburn or itching and skin aging processes are among the risk factors – if the treatment is too strong or takes too long. Slight erythema or slight itching can be accepted as side effects.
It is important that the doctor has experience with the different phototherapy options. There are different forms of therapy depending on the different effects of UVA and UVB radiation. Therefore, depending on the skin type and severity of psoriasis, it must be decided which therapy is used, with which dosage and at what interval it is increased.
Phototherapy alone is recommended for mild to moderate psoriasis and especially if the plaques are large.
Baths with saline water are combined with the radiation – either baths or shower baths are taken. The salt in the water is different – sometimes it is brine, sometimes simple table salt or salt from the Dead Sea. Salt and “sun” recreate the natural conditions of beautiful beach days that are beneficial for psoriatic patients. In the past, the treatments at the doctor were not paid for by the health insurance companies because there were allegedly doubts about the effectiveness. However, 30 years of practice meanwhile have shown that the success rates are between 60 and 90 percent, which is higher than that of UV treatments alone. Therefore, the treatment of psoriasis vulgaris has been health insurance again since July 01, 2008 – but not for pustular psoriasis, as no efficacy has been determined here so far.
PUVA is particularly suitable for the treatment of severe psoriasis. This therapy comes in three forms. In any case, psoralens are used before the radiation begins. These substances sensitize the skin to UV-A radiation. The medication is available in the form of tablets, as a cream for application to the skin or as a bath additive. PUVA uses UV-A radiation, which is used to treat two to four times a week. Experience shows a comparable effect of oral PUVA and bathing PUVA and a somewhat lower effect of cream PUVA. The therapy is contraindicated during pregnancy or breastfeeding and is also unsuitable for patients suffering from light-related skin diseases or skin cancer or for patients receiving immunosuppressive agents. Possible unpleasant side effects are erythema, itching, nausea.
UV-B broadband spectrum
This therapy is the oldest form of phototherapy. The entire spectrum of UV-B radiation is used here (280 – 320 nm). According to the results of various studies, half to three quarters of the patients achieved a PASI improvement of 75%. The more often a week, the faster this improvement was achieved. Of course, attention must be paid to the increased risk of erythema formation.