What is Psoriasis?
Approximately 2% of adults have psoriasis. Often appears between the ages of 15 and 35, but can develop at any age. Psoriasis is a chronic inflammatory skin disorder, which typically consists of red plaques covered by silvery-white scales. These red scaly plaques are usually found on the elbows, knees, lower back and scalp. When psoriasis involves the underarms, genital area and beneath the breasts it tends to be less scaly and have a glazed appearance. Psoriasis infrequently affects the face and it can involve the nails and bones. Its exact cause is unknown but the result is skin, which grows about seven times more quickly and thickly than usual. It is thought to be due, at least in part, to an abnormal immune reaction and genetic factors play a part. The rash often seems to start after some sort of trigger factor. This may be emotional stress, skin injury (cuts and scratches for example), a streptococcal sore throat, hormones (it often first occurs at puberty), or rarely, certain medications. Psoriasis is not an allergy, nor is it infectious to others.
How Does Psoriasis Affect Quality of Life?
Individuals with psoriasis may experience significant physical discomfort and some disability. Itching and pain can interfere with basic functions, such as self-care, walking, and sleep. Plaques on hands and feet can prevent individuals from working at certain occupations, playing some sports, and caring for family members or a home. The frequency of medical care is costly and can interfere with an employment or school schedule. People with moderate to severe psoriasis may feel self-conscious about their appearance and have a poor self-image that stems from fear of public rejection and psychosexual concerns. Psychological distress can lead to significant depression and social isolation.
How is Psoriasis Treated?
Dermatologists at the Advanced Dermatology PC generally treat psoriasis in steps based on the severity of the disease, size of the areas involved, type of psoriasis, and the patient's response to initial treatments. This is sometimes called the "1-2-3" approach. In step 1, medicines are applied to the skin (topical treatment). Step 2 uses light treatments (phototherapy). Step 3 involves taking medicines by mouth or injection that treat the whole immune system (called systemic therapy).
Over time, affected skin can become resistant to treatment, especially when topical corticosteroids are used. Also, a treatment that works very well in one person may have little effect in another. Thus, doctors often use a trial-and-error approach to find a treatment that works, and they may switch treatments periodically (for example, every 12 to 24 months) if a treatment does not work or if adverse reactions occur.
- Combination Therapy
There are many approaches for treating psoriasis. Combining various topical, light, and systemic treatments often permits lower doses of each and can result in increased effectiveness. Therefore, doctors are paying more attention to combination therapy.
- Laser Therapy
Advanced pulse dye laser technology, successfully used to treat a wide variety of skin lesions in adults and children, now is proving to be a remarkably powerful weapon in the battle against psoriasis and no one knows more about pulse dye lasers than Cynosure.
Psoriasis Before & After treatment Photos with Phototherapy (nb UVB)
| Psoriasis on the back
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| Psoriasis on the chest and abdomen
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| Psoriasis on the back
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| Psoriasis on the legs
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| Psoriasis on the chest and abdomen
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| Psoriasis on the back
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Before and After photographs courtesy of Daavlin Company
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Before you decide on laser treatment for your psoriasis, here are some things you should know about the Cynosure pulse dye laser.
How does the laser work?
Cynosure pulse dye laser technology is particularly suited for the treatment of psoriasis because it provides for the selective elimination of the small blood vessels that support the growth of the psoriatic plaque. With these vessels gone, the growth of the plaque should be significantly slowed or discontinued.
Does it work on all types of psoriasis?
The Cynosure pulse dye laser is ideal for treating stable, localized psoriatic plaques typical in mild to moderate psoriasis.
How many treatments are required?
Results are seen within three to four weeks. Typically, five to six monthly treatments are recommended.
Does it work on everyone?
Initial clinical studies demonstrated that 73% of patients experienced more than 70% clearance of their psoriatic plaques. Of the remaining patients, some 15% obtained about 50% clearance. 5% minimal clearance and 7% experienced no change, which is consistent with other, more time-consuming procedures.
Is the treatment difficult?
Not at all. In fact it's a simple, two-step process.
- Step One - Your physician will prescribe a lotion, which you will apply on the areas to be treated for one week prior to treatment.
- Step Two - On the treatment day your physician will coat the designated areas with a special fluid to enhance their receptivity to the laser. Then the physician or medical assistant will treat the areas with the laser. A typical four-inch square area will require several minutes.
Is the treatment painful?
There is some minor discomfort associated with the treatment. Most patients describe the treatment as a series of rubber band snaps to the skin. Your physician can reduce or eliminate this discomfort by providing you with a topical anesthetic or by cooling the treated area with ice or an air-cooling device.
Will pulse dye laser treatment be more effective than PUVA, narrow band UVB, creams or drugs?
While your results should be comparable to other types of treatment pulse dye laser technology frees you from the potential undesirable side affects commonly associated with other treatments. For example:
- Pulse dye laser treatment requires fewer treatments and less time than PUVA, or narrow band UVB, and will not cause aging of your normal skin as is the case where the entire body is exposed to UV.
- Pulse dye laser radiation is not UV, which is typically mentioned in conjunction with skin cancer.
- Pulse dye laser treatments are less messy than the daily application of creams and lotions.
- Unlike drugs, pulse dye laser treatments are non-systemic.
Will pulse dye laser treatment be more effective than other laser treatments, such as with excimer lasers?
At publication of this pamphlet data from initial studies were available using excimer and pulse dye lasers. These initial studies indicate a significantly longer remission time with pulse dye using a similar number of treatments. In addition, pulse dye treatment uses light at a wavelength proven safe enough to use on newborns, not ultraviolet (UV) light which has been associated with skin cancer and aging.
Will insurance cover my treatments?
You will most likely be charged a flat fee for the complete series of treatments. Since the treatment is specific to eliminating the plaque vasculature or vessels, some insurance companies may cover it as they do other vascular lesion conditions such as warts or port wine birthmarks. A lot may depend on whether your request is for medical or cosmetic purposes, or a combination.
How safe are pulse dye lasers?
Pulse dye lasers have been used since 1983 to treat port wine birthmarks and hemangiomas in infants as young as two days old. Today pulse dye lasers are routinely used in thousands of medical and cosmetic treatments in more than 80 countries. More than 100 peer-reviewed articles have been published on pulse dye laser treatments, including several on psoriasis treatment.
New Treatment Options for Psoriasis
We at Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery are pleased to share with you some exciting news about a new treatment option for your psoriasis. If your psoriasis is not responding well to topical creams and/or conventional phototherapy, we would like to offer a new and exciting laser therapy.
Using a new special pulsed vascular laser, our physicians are able to target only the involved skin with a high dose of laser energy for faster clearing and allow you to have longer periods without the plaques.
If your psoriasis is not responding to other treatments and would like to visit one of our offices for a consultation regarding this technology, please call the office nearest you. This treatment may be covered by your insurance carrier especially if alternative therapies have not helped. Also feel free to look at our website for our physicians "In the News" about new developments.
Laser Treatment for Psoriasis?
As a psoriasis sufferer you know how debilitating this disease can be. You’ve tried a variety of treatments but none has delivered relief from the redness, scaling, and itching you experience. Now there is an effective alternative to topical creams, ultraviolet phototherapy and oral drugs. A treatment that will allow you quickly to resume a normal, active lifestyle.
Advanced pulse dye laser technology, successfully used to treat a wide variety of skin lesions in adults and children, now is proving to be a remarkably powerful weapon in the battle against psoriasis and no one knows more about pulse dye lasers than Cynosure.
Before you decide on laser treatment for your psoriasis, here are some things you should know about the Cynosure pulse dye laser.
How does the laser work?
Cynosure pulse dye laser technology is particularly suited for the treatment of psoriasis because it provides for the selective elimination of the small blood vessels that support the growth of the psoriatic plaque. With these vessels gone, the growth of the plaque should be significantly slowed or discontinued.
Does it work on all types of psoriasis?
The Cynosure pulse dye laser is ideal for treating stable, localized psoriatic plaques typical in mild to moderate psoriasis.
How many treatments are required?
Results are seen within three to four weeks. Typically, five to six monthly treatments are recommended.
Does it work on everyone?
Initial clinical studies demonstrated that 73% of patients experienced more than 70% clearance of their psoriatic plaques. Of the remaining patients, some 15% obtained about 50% clearance. 5% minimal clearance and 7% experienced no change, which is consistent with other, more time-consuming procedures.
Is the treatment difficult?
Not at all. In fact it's a simple, two-step process.
Step One - Your physician will prescribe a lotion, which you will apply on the areas to be treated for one week prior to treatment.
Step Two - On the treatment day your physician will coat the designated areas with a special fluid to enhance their receptivity to the laser. Then the physician or medical assistant will treat the areas with the laser. A typical four-inch square area will require several minutes.
Is the treatment painful?
There is some minor discomfort associated with the treatment. Most patients describe the treatment as a series of rubber band snaps to the skin. Your physician can reduce or eliminate this discomfort by providing you with a topical anesthetic or by cooling the treated area with ice or an air-cooling device.
Will pulse dye laser treatment be more effective than PUVA, narrow band UVB, creams or drugs?
While your results should be comparable to other types of treatment pulse dye laser technology frees you from the potential undesirable side affects commonly associated with other treatments. For example:
- Pulse dye laser treatment requires fewer treatments and less time than PUVA, or narrow band UVB, and will not cause aging of your normal skin as is the case where the entire body is exposed to UV.
- Pulse dye laser radiation is not UV, which is typically mentioned in conjunction with skin cancer.
- Pulse dye laser treatments are less messy than the daily application of creams and lotions.
- Unlike drugs, pulse dye laser treatments are non-systemic.
Will pulse dye laser treatment be more effective than other laser treatments, such as with excimer lasers?
Initial studies indicate a significantly longer remission time with pulse dye using a similar number of treatments. In addition, pulse dye treatment uses light at a wavelength proven safe enough to use on newborns, not ultraviolet (UV) light which has been associated with skin cancer and aging.
Before & After Photographs with Laser Treatment |
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