For some people, over-the-counter or prescription creams are enough to manage psoriasis. However, if your skin remains itchy, scaly, and red, you can try phototherapy. It’s also known as light therapy.
光疗是一种牛皮癣治疗，可能使病情的疼痛和瘙痒消失。它通常使用紫外线（UV）光，这减少了炎症并减慢了皮肤细胞的产生。
光疗也用于其他皮肤病s, such as eczema. However, it’s not as simple as just going out in the sun.
存在各种不同类型的UV光处理。如果您有兴趣尝试这种方法，则关键是确定哪一个最适合您。
To be safely treated with phototherapy, it’s best to talk to yourdoctorabout your options. Your doctor will make sure it’s safe for you.
你知道吗？Phototherapy is considered safe for both children and women who are pregnant.
如果你准备尝试光疗,考虑范围h treatment will be best for you. Your doctor may recommend combining UV therapy with a prescription cream.
Narrowband ultraviolet B (NB-UVB) light therapy
Narrowband ultraviolet B (NB-UVB) is the most common form of phototherapy. It can be used to treat plaque or guttate psoriasis.
NB-UVB灯和灯泡发出光波长在311和313纳米之间（nm）之间根据最近的光疗法临床指南。
Your starting dose will depend on your skin type and how easily you burn or tan.
However, NB-UVB light therapy is most effective when performed two or three times a week. An emollient such as petroleum jelly may be applied before each session.
根据2002年
一旦皮肤清晰，可以每周进行维护课程。
A 2017studyshowed that around 75 percent of people receiving NB-UVB treatments found it cleared their psoriasis or led to minimal symptoms. They used fewer prescription creams for their condition, too.
NB-UVB treatments may prove more effective when combined with topical treatments, such as vitamin D analogues and corticosteroids.
Broadband ultraviolet B (BB-UVB) light therapy
Broadband ultraviolet B (BB-UVB) light therapy is an older form of phototherapy than NB-UVB. The two treatments are similar.
但是，BB-UVB灯和灯泡发出光波长between 270 and 390 nm.
As with NB-UVB, your starting dose will depend on your skin type.
According to a small 1981study, 90 percent of people had clear skin after having sessions three times a week and an average of 23.2 treatments.
一hundred percent of people had clear skin after having sessions five times a week and an average of 27 treatments.
BB-UVB is considered less effective than NB-UVB and is more likely to cause side effects. It should be reserved for instances where NB-UVB isn’t a treatment option.
BB-UVB is most effective for plaque psoriasis, although it can also be used for guttate psoriasis.
It can be prescribed as a monotherapy or alongside retinoid acitretin (Soriatane). In combination therapy, the skin clears up faster, and lower doses of UVB can be used.
Targeted ultraviolet B (UVB) light therapy
Targeted ultraviolet B (UVB) light therapy is applied to small areas of the body. It often involves the use of an excimer laser, excimer light, or NB-UVB light.
If you have psoriasis over less than 10 percent of your body (known as localized psoriasis), this treatment might work for you.
This approach exposes you to fewer UV rays overall, which will reduce side effects and health risks. It also results in faster clearing of the skin.
For best results, it should be performed two to three times a week.
Targeted UVB therapy can be used to treat:
- plaque psoriasis
- 头皮牛皮癣
- psoriasis on the soles or palms (palmoplantar psoriasis)
准分子激光比准分子闲逛更有效hts or targeted NB-UVB lights. Adults with plaque psoriasis can combine excimer laser therapy with topical corticosteroids.
Psoralen plus ultraviolet A (PUVA) therapy
This approach uses ultraviolet A (UVA) light with psoralen, a medication that increases your sensitivity to light. Psoralen can be:
- 口服
- mixed in bathwater
- 局部应用
In general, PUVA is highly effective but not widely used or available.
Oral PUVA comes with the highest risk of drug interactions and side effects (such as nausea). It’s most effective when combined with an oral retinoid.
Bath PUVA works best for adults with moderate to severe plaque psoriasis.
它在欧洲更常见于美国。这主要是因为它使用Trimethylpsoralen，一种食物和药物管理局（FDA）的脂肪醛形式没有批准。
Topical PUVA may be of particular benefit to adults with palmoplantar psoriasis or palmoplantar pustular psoriasis. It can also be used for localized psoriasis.
Other types of phototherapy that either aren’t as effective, widely recommended, or widely used are described below.
Sunshine therapy
You can also go outside and expose the areas of your body affected by psoriasis to the sun’s UV rays. This works best from May to October when there are more UV rays coming from the sun.
If you live farther south, that period is even longer.
You need to cover your unaffected areas with sunscreen and slowly increase your time of exposure to the sun. Start with periods of only 5 to 20 minutes.
这种治疗可能比紫外线灯更长的工作，也增加了患皮肤癌的风险。您应该只使用这种方法与您的医生的支持和指导。
Tanning beds
Be aware that tanning salons are no substitute for doctor-supervised light therapy. TheNational Psoriasis Foundation (NPF)reports that tanning devices can’t stand in for phototherapy treatments.
那是因为晒黑床使用uva，除非结合某些药物，否则没有帮助牛皮癣。
此外，这些机器的使用具有比医学监督的治疗更高的皮肤癌风险。
Climatotherapy
Climatotherapy is relocation, either temporary or permanent, to a place with a more suitable climate as well as natural resources that can be used for symptom relief.
These favorable locations include:
- the Dead Sea (with its low altitude)
- 加那利群岛
- Iceland’s Blue Lagoon
高潮疗法通常涉及组件，如：
- consultations with medical professionals
- a personalized sun schedule
- psoriasis education
Although people practicing climatotherapy typically see improvements in their skin and mental health, some研究shows that the positive effects tend to fade after a few months.
Studies are needed on remission.
Goeckerman therapy
Goeckerman therapy combines coal tar with UVB light therapy. It’s used for people with severe or recalcitrant psoriasis. Recalcitrant disease is resistant to treatment.
It’s highly effective but rarely used, in part because of its messiness.
脉冲染料激光（PDL）疗法
脉冲染料激光（PDL）疗法may be used for nail psoriasis.
A 2014studyfound that monthly PDL treatments were more effective than twice-weekly excimer laser treatments.
PDL.causes only mild side effects.
Grenz ray therapy
Grenz ray therapy uses radiation. A typical treatment plan consists of weekly sessions for four or five times, a 6-month break, and then up to 6 more months of treatment.
Research on it is limited.A small surveyfound that only around half of respondents deemed it useful. It may be recommended for people with recalcitrant psoriasis that hasn’t responded to other treatments.
Visible light therapy
Visible light therapy may use blue or red light. Smallstudies已经表明承诺，但需要更多的研究。
A version of visible light therapy known as intense pulsed light (IPL) therapy has led to great results when used in the treatment of nail psoriasis.
Hyperpigmentation is common, but side effects are generally minimal.
Photodynamic therapy (PDT)
In PDT, photosensitizing agents (such as acids) are applied to the skin. When activated by blue or red light, these photosensitizing agents can help destroy premalignant or malignant cells.
Research已经表明，包括严重疼痛的风险通常超过益处。一
It’s more effective at treating nail psoriasis than palmoplantar psoriasis or other types of localized psoriasis. However, experts don’t currently recommend it for any form of the disease.
For best results, you should undergo at least 20 phototherapy sessions, according to a 2016study.
PUVA是the most effectiveof the major forms of phototherapy, with some studies showing that over 70 percent of people who received oral PUVA achieved a PASI 75.
PASI 75 represents a 75 percent improvement in the Psoriasis Area and Severity Index score.
它之后是Nb-UVB和有针对性的UVB治疗。
While BB-UVB can still relieve your symptoms, it’s the least effective of these four. Most BB-UVB studies have resulted in around 59 percent of people achieving a PASI 75.
Despite the fact that PUVA is more effective overall, NB-UVB is generally recommended instead because it’s less expensive, easier to use, and causes fewer side effects.
To boost its effectiveness, NB-UVB is often used with additional medications.
best ADMINISTRATION METHODSA 2013文献评论found that oral administration of PUVA is more effective than bath PUVA.
就靶向UVB疗法而言，准分子激光是最有效的给药方法，其次是准分子光，然后靶向NB-UVB光。
最合适的疗法还取决于正在治疗哪种类型的牛皮癣。例如：
- Topical PUVA is the preferred treatment method for palmoplantar psoriasis, although BB-UVB has been proven effective.
- Targeted UVB therapy with excimer lasers is the preferred treatment method for adults with scalp psoriasis.
- PDL.is the preferred treatment method for nail psoriasis.
Certain people shouldn’t try light therapy. This includes people with lupus, a history of skin cancer, or the skin condition xeroderma pigmentosum, which makes people very sensitive to sunlight.
此外，某些药物 - 包括一些抗生素 - 让你对光线敏感。光敏感性会影响这种处理。
光疗法可以：
- make your skin sore and red
- leave blisters
- change the pigment of your skin
它增加你的风险对于某些类型of skin cancer, so your doctor will watch for warning signs during and after treatment.
The different forms of phototherapy, climatotherapy aside, also come with their own unique risks:
- BB-UVB.BB-UVB increases your risk of genital skin cancer, so genital shielding is recommended. Eye protection, such as goggles, is also recommended. Practice caution if you have a history of skin cancer, arsenic intake, or exposure to ionizing radiation (such as X-rays). Arsenic and ionizing radiation are both carcinogenic.
- NB-UVB.This therapy can cause the same side effects as BB-UVB, although they’re less likely to occur with NB-UVB.
- Targeted UVB therapy.Common side effects include redness, blistering, burning, itching, hyperpigmentation, and swelling.
- OralPUVA.Risks of oral PUVA include phototoxicity, nausea, and itching. It’s not recommended for children under 10 years old, women who are pregnant or nursing, or people with certain skin conditions. Older children should practice caution if they take immunosuppressive medications, have had certain skin conditions, or have been exposed to carcinogens.
- 浴Puva和局部Puva。These methods may also cause phototoxicity.
- Sunshine therapy.Sunshine therapy increases your risk of skin cancer.
- Tanning.The use of tanning beds carries a much higher risk of skin cancer than medically supervised treatments.
- Goeckerman therapy.The coal tar used in this form of phototherapy may cause skin burning.
- PDL..Side effects are mild and may include hyperpigmentation of the cuticles, minor pain, or small spots known as petechiae.
- Grenz ray therapy.If not administered properly, it can cause painful marks. This side effect is known as radiation dermatitis or radiation burns.
- 可见光疗法。Side effects are mild, and hyperpigmentation is the most common one.
- PDT.Side effects are common. They include burning sensations and severe pain.
Home NB-UVB phototherapy is recommended for certain people with plaque psoriasis as an alternative to in-office NB-UVB phototherapy. It can be used for mild, moderate, or severe disease.
Many people who use phototherapy as a long-term treatment like the ease and lower cost of doing it at home.
您通常首先有几轮办公室疗法，以确保它有效。您仍然需要定期查看皮肤科医生来监控您的皮肤并在使用家用设备上获取建议。
A 2009 Dutchstudywas the first randomized controlled trial to compare the treatments.
The researchers concluded that home NB-UVB phototherapy and in-office NB-UVB phototherapy are equally effective and result in similar side effects.
Study participants who used home treatments had a slightly higher chance of developing severe redness. Those who used in-office treatments had a slightly higher chance of blistering and burning.
大多数数据显示，光疗通常每年花费几千美元。
Medicaid和Medicare - 以及许多私人保险政策 - 办公室封面封面。
At-home treatments are不太可能被保险覆盖。标准的家庭NB-UVB单位成本$ 2,600一般。需要每3到6年更换灯泡。
at--home治疗的启动成本比办公室处理更重要。
However, after the initial equipment has been purchased, at-home phototherapy has a lower per-treatment cost than in-office treatment.
A small 2018studyestimated that the 3-year cost of at-home phototherapy was $5,000. In addition to the lamp itself, this estimate also factored in the cost of a warranty, shipping, setting up the lamp, and technical support.
It didn’t factor in the cost of co-payments and doctor’s visits.
Some 2012研究found that adults undergoing phototherapy had yearly costs of $3,910.17.
By comparison,大多数生物治疗方法costtens of thousands of dollarsper year.
如果您对作为治疗选项的Phototherapy感兴趣，请与您的医生交谈，了解您是否是一个好候选人。
Also, see how much your health insurance will cover and take care to budget accordingly for this effective but sometimes costly treatment.
确保在决定治疗适合您时，请务必与医生讨论风险和福利。