Can I Do Phototherapy at Home for My Psoriasis?
Phototherapy is one of the many treatment options available for psoriasis. Also referred to as light therapy, it involves repeated exposure to specific wavelengths of ultraviolet light. It’s also one of the oldest and safest dermatological treatments. Phototherapy works very well to reduce skin inflammation and help make psoriatic plaques disappear, sometimes putting patients into remission for months, or even longer. Plus, it doesn’t interfere with other medications and doesn't require pills or injections, says Scott Paviol, M.D., a board-certified dermatologist in Charlotte, North Carolina. When patients ask for natural treatments for psoriasis, this is one of the most evidence-based options out there.
In phototherapy, the success of treatment requires regular sessions and consistency. Usually, at a dermatologist’s office, treatment is administered three times a week for several months, and then slowly tapers in frequency over several more weeks. The entire process can be expensive and time-consuming. So you might wonder: How does an at-home phototherapy machine compare? Here, we explain the options, safety, and efficacy of at-home phototherapy units.
Many people assume that using a tanning bed may offer similar benefits as phototherapy. But it’s really not a good idea.
“I never recommend tanning beds as a light source for psoriasis treatment because it dramatically increases skin cancer and melanoma risk,” says Paviol. “Tanning beds utilize full-spectrum UV light (UVA and UVB) which is very carcinogenic.” According to the American Academy of Dermatology (AAD), one indoor tanning session can increase the risk of developing skin cancer (melanoma) by 20 percent, squamous cell carcinoma by 67 percent, and basal cell carcinoma by 29 percent.
On the other hand, medical UV phototherapy uses a very specific wavelength of UV light, often narrowband UVB (311-312 nm wavelength), which can dramatically reduce the risk of skin cancer and DNA mutations. So it’s considered much safer.
Over-the-Counter (OTC) Phototherapy Machines
Some phototherapy units are available to purchase without a prescription, but you’re much better off seeing your doctor before buying one.
“At home, non-doctor-prescribed UVB units do work,” Paviol admits. “But I always recommend visiting your doctor, because there are specific protocols to use light units. If you don't have the instructions from a doctor, you can burn your skin or have suboptimal treatment.” Important instructions, such as slow increases in the energy between treatments, can be explained by your doctor.
In fact, your doctor may be able to prescribe you an at-home unit instead. And even if you’re set on using the OTC unit, you can at least receive advice from your doctor about how different units compare and which might fit your prescribed treatment plan better.
“If light therapy is right for you, establish a long-term plan of care that is safe, efficacious, and designed by a physician who has done extensive training in treating psoriasis,” says Paviol. “Often insurance can cover [prescription] UVB light therapy for patients, so it is nice to explore that option first.”
Prescription At-Home Units
If you’re set on trying phototherapy at home, prescription options are likely going to better meet your needs. Plus, there’s a better chance they’re covered by insurance.
Prescription home units are very similar to the ones found in doctors’ offices, says Anna H. Chacon, a board-certified dermatologist at the Cleveland Clinic Florida, Weston Hospital.
“They are more convenient in the sense that they can be used at home,” says Chacon. “However, the drawback is that you won’t have anyone monitoring your safety while you are getting the treatment done.”
In a physician’s office, she says, you would have medical professionals on hand in case you start feeling unwell, fall asleep, or something unexpected happens. Still, many doctors, researchers, and the National Psoriasis Foundation seem to agree that prescription at-home phototherapy can be a viable alternative to in-office treatments.
Not only are prescription at-home units more convenient to use, they can save medical costs for some people. “In the past, we would treat people in the office with light therapy three times a week,” Paviol says. “But if you have an insurance co-pay, you had to pay a co-pay for each treatment, which can get expensive.”
As a result, he often prescribes at-home light units. “These are advantageous because you can prescribe different size light boxes to treat just the hands, trunk, scalp, or the total body, with a stand-up unit.”
Aside from size, most prescription units are pretty similar, as they’re almost all distributed by a single, reputable company known as National Biological Corporation, says Chacon.
Some people opt to try in-office phototherapy for a short time, and then, if the treatment is effective, decide to continue treatment with a prescription home phototherapy unit. That way, they get accustomed to getting regular treatments and have the opportunity to ask their doctor or nurse questions before doing it on their own.
Keep Your Doctor in the Loop
Remember: While an at-home unit can provide similar treatment success as receiving phototherapy in your doctor’s office, that doesn’t necessarily mean it’s the right treatment for you. It’s always important to get the guidance from a medical professional before trying it.
“Let your physician do the thinking—it’s what we are trained to do—and get you on a treatment plan that works,” says Paviol. “You should be evaluated first, see what options are right for you—creams versus light versus systemic medication—and get a long-term treatment plan.”
If it turns out phototherapy is a valuable treatment option for your needs, that’s when you can begin talking to your doctor about getting a prescription for an at-home unit.
“Establish a relationship with a dermatologist, so you can be set up for long-term success for your condition,” says Paviol.
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