Laser Treatment for Psoriasis

If you're living with psoriasis, you know how uncomfortable and embarrassing the red, itchy, scaly skin can be. Treatment options for psoriasis include steroid cream or other medicated creams, oral medications, and light therapy.

All of these treatments work well, but medications can have side effects and light therapy requires a regimen of three sessions a week for two to three months.

Today, there is another option for treating psoriasis: excimer lasers, which deliver ultraviolet light to localized areas of the skin. This treatment uses intense, focused doses of laser light to help control areas of mild to moderate psoriasis without harming healthy skin around them. Targeted laser therapy is similar in effectiveness to traditional light therapy, but it works in fewer sessions with stronger doses of light that can reach deeper into the affected skin. The handheld laser wands are also good for reaching psoriasis in hard-to-treat areas, such as the elbows, knees, palms of the hands, soles of the feet, and scalp.

How do laser treatments for psoriasis work? Can they really clear up your skin? Here's what the research shows about this new treatment for psoriasis.

Psoriasis Laser Treatment: How It Works

Excimer laser treatments are performed in the dermatologist's office. Each session takes only a few minutes. During the treatment, the doctor aims the laser directly at patches of psoriasis. You might feel some warmth at the site or a snapping sensation against the skin.

Laser treatments for psoriasis use one of two types of lasers: a pulsed dye laser (PDL) or an excimer laser.

Pulsed dye lasers create a concentrated beam of yellow light. When the light hits the skin, it converts to heat. The heat destroys the extra blood vessels in the skin that contribute to psoriasis, without harming nearby skin.

Excimer lasers aim a high intensity ultraviolet B (UVB) light dose of a very specific wavelength -- 308 nanometers -- directly at the psoriasis plaques. Because the laser light never touches the surrounding skin, it reduces the risk of UV radiation exposure. Excimer lasers are used to treat mild-to-moderate psoriasis.

With excimer laser therapy, patients usually have two treatments lasting 15-30 minutes each week for three or more weeks, with at least a 48-hour break between treatments. With pulsed dye laser therapy, sessions go for 15-30 minutes every three weeks.

Your doctor will determine your dose of laser light based on the thickness of your psoriasis plaques and your skin color (a lower dose is used on lighter skin). During the procedure, you will be given dark goggles to protect your eyes.

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How Well Do Psoriasis Laser Treatments Work?

Psoriasis laser treatments work well on people with mild-to-moderate psoriasis. But because the light is concentrated, it's not effective for people with psoriasis on large areas of the body.

Because laser treatment for psoriasis is still a relatively new therapy, research is still underway to confirm its effectiveness. Some studies find that most people who are treated with lasers see real improvements in their skin that can last anywhere from several months to a year. Results are usually seen within 8 to 10 sessions.

What You Should Know Before Starting Laser Treatment

Laser treatment for psoriasis can produce dramatic results in some people -- but this therapy isn't for everyone. To make sure you're a good candidate, have a complete health history and exam done before starting treatment.

Avoid laser treatments if you have:

  • Lupus
  • Sun sensitivity
  • Xeroderma pigmentosum (an inherited disease that causes sensitivity to sunlight)
  • Risks for, or a history of, skin cancer
  • A condition that requires you to take medications that make you sensitive to the sun
  • A weakened immune system

Are There Any Risks to Laser Treatments for Psoriasis?

Laser therapy is generally safe, but some people have reported side effects after treatment, including:

  • Temporary redness, itching, burning, and stinging
  • Blistering
  • Purple-colored spots (purpura) on the skin
  • Darkening or lightening of the skin (hyperpigmentation or hypopigmentation)
  • Scarring

More research is needed to determine whether exposure to UVB light from the excimer laser might increase the long-term risk for skin cancer.

WebMD Medical Reference Reviewed by Stephanie S. Gardner, MD on May 31, 2015

Sources

SOURCES:

National Psoriasis Foundation: "Phototherapy."

de Leeuw, J. Journal of the American Academy of Dermatology, February 2006; vol 54: pp 266-271.

News release, American Academy of Dermatology.

Hruza G.J. Journal Watch, 2005; vol 4.

Talbjee, S.M. British Journal of Dermatology, November 2005; vol 153: pp 960-966.

Brubb B. Journal of the American Academy of Physician Assistants, December 2008.

Gerber, W. British Journal of Dermatology, December 2003; vol 149: pp 1250-1258.

Trehan, M. Journal of the American Academy of Dermatology, November 2002; vol 45: pp 701-708.

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