Psoriasis (psoriasis) is one of the common dermatological diseases. The affected people can range from children to the elderly. The symptoms and characteristics of psoriasis are different at different ages, so you need to pay attention to each age when choosing treatment methods. Based on the characteristics of the disease, choose the appropriate treatment method.
At present, the main treatments for psoriasis include topical drugs, oral drugs, ultraviolet phototherapy, and other auxiliary treatments. Among them, ultraviolet phototherapy is a treatment method that is relatively unfamiliar to everyone. Some patients may feel that ultraviolet phototherapy is similar to the usual sun exposure, so they feel that the phototherapy effect is not very good. So what kind of treatment method is ultraviolet phototherapy and whether this method is reliable? Today I will take you to learn more about it.
Types and treatment characteristics of ultraviolet phototherapy
First of all, we need to know what parts of the ultraviolet rays we usually irradiate are composed of, which are UVA (low frequency long wave), UVB (intermediate frequency medium wave), UVC (high frequency short wave), and EUV (ultra high frequency). The main ones used clinically are PUVA (long-wave ultraviolet light), NB-UVB (narrow-band mid-wave ultraviolet light) and the 308 excimer laser commonly used in hospitals. So, what are their characteristics?
PUVA (ultraviolet rays):
UVA is suitable for local plaque psoriasis and usually needs to be used in combination with the photosensitizer psoralen. The treatment method is generally a progressive system, which is adjusted according to the skin tolerance and requires continuous treatment for more than 6 months. Among all ultraviolet phototherapies, its adverse effects are relatively large. It can be considered as a second-line treatment when other ultraviolet phototherapy is ineffective. If the patient is under 12 years old, use must be prohibited to avoid stunting.
NB-UVB (narrowband mid-wave ultraviolet):
NB-UVB is currently the main phototherapy method and is safer than PUVA. There is no need to use photosensitizers during treatment, and it is suitable for moderate to severe stubborn guttate and plaque psoriasis. Usually the initial treatment frequency is 3 times/week, and the frequency and time can be adjusted according to skin symptoms. During the treatment process, at least 20 to 30 treatments are needed to judge the efficacy. Therefore, the treatment time is usually more than 3 months, during which adverse reactions such as erythema, blisters, and dry skin may occur. However, this phototherapy method already has home-based equipment and can be used for treatment at home. It reduces the trouble of going to the hospital and saves money at the same time.
308 excimer laser:
It is an advanced version of NB-UVB, which has the characteristics of long remission period, fewer treatments, and less adverse reactions for psoriasis treatment. It is suitable for mild to moderate stable plaque psoriasis and facial psoriasis. It is currently the most commonly used ultraviolet phototherapy in hospitals. It can adjust the initial dose according to different skin lesions, and it usually takes 6 to 8 weeks to evaluate the treatment effect. Since the instrument is only used within the hospital, it requires traveling back and forth to the hospital.
These three types of ultraviolet phototherapy have been widely used and also occupy a place in the treatment of psoriasis. The main principle is to exert biological effects by inhibiting the antigen presentation of Langerhans cells and activating T cell function, inducing T lymphocyte apoptosis, and inhibiting the impact of abnormal protein expression on cytokines. Simply put, it pulls abnormal cells back to their normal state and remodels the skin.
Combined application of ultraviolet phototherapy
Ultraviolet phototherapy is a safer treatment method because the treatment process only occurs on the surface of the skin, causing less damage to the body. However, this treatment method will have certain limitations and will also bring some side effects. Therefore, it is often combined with other drugs for clinical treatment to improve the therapeutic effect and reduce adverse reactions. Commonly used drugs include the following two.
1) Moisturizer:
Currently, auxiliary treatment drugs with higher safety can be used in all processes of psoriasis treatment. It is generally recommended to apply it multiple times a day to cover the surface of the skin. This reduces water loss and avoids worsening of psoriasis symptoms.
2) Vitamin D3 derivatives:
This is an old medicine that has been used for decades, and most skin friends should have used it before. Drugs such as tacarbinol are more effective in improving mild to moderate plaque psoriasis vulgaris. Generally used once a day in the morning and evening. Since it is less irritating, it can be used on thin and tender skin such as the face and inner thighs. According to the Chinese Psoriasis Diagnosis and Treatment Guidelines, when combined with tacarbinol and NB-UVB in the treatment of plaque psoriasis vulgaris, it is suggested that the improvement effect is better. The main factor may be synergistic or additive effects in treatment, resulting in differences between combination therapy and single therapy.
So how do you choose the right treatment plan? It depends on the severity of psoriasis
Mild psoriasis (skin lesion area within 3 palms): According to the Chinese Psoriasis Diagnosis and Treatment Guidelines, mild psoriasis can be treated individually with topical drugs, ultraviolet phototherapy, etc.
Moderate psoriasis (skin lesion area between 3 to 10 palms): There are many skin friends at this stage, and there are relatively many treatment methods. Such as topical drugs, ultraviolet light therapy, oral drugs, etc., can be used as the first choice for treatment. However, attention needs to be paid to the treatment of some special parts, such as the face, inner thighs, external genitalia, etc. Because the skin is relatively thin and tender, most treatment drugs are less irritating. For example, tacalcitol can be applied to the above-mentioned areas for treatment, and the adverse reactions are relatively low.
Severe psoriasis: Oral medications or biological agents are usually required to control the progression of the disease in the short term.
Summarize:
Among the treatments for mild to moderate psoriasis, ultraviolet phototherapy is relatively reliable. However, it is also necessary to pay attention to stopping the drug during the progression stage of psoriasis to prevent the disease from getting worse. During this period, it is more appropriate to choose a moisturizer, which is less likely to cause irritation to the skin and can protect the damaged skin from further aggravation.
