The chemicals that reside in our skin and are responsible for making the skin sensitive towards light there are substances known as psoralens which are also found in plants is used to treat psoriasis. the potential of this substance medically is no new fact as there have been finding indicating its use in ancient Egypt but it is only for the last 25 years that it has been started to be used for treating psoriasis.
It is due to psoralens that the skin becomes sensitive to the (UVA) ultra violet light’s longer wave lengths. The procedure of PUVA involves giving psoralens preparations initially and later on after a period of two hours exposure to UVA is made through special PUVA treatment lamp. The quantity of psoralens and the duration of UVA exposure should be calculated and regulated carefully so as to produce an effect of photo chemotherapy to produce healing effects.
Although there is no solid explanation as to how PUVA therapy is effective against psoriasis the best guess made up to now is that through increasing the effects of UV rays, the psoralens reduce the accelerated rate of cell growth within the epidermis which is the a main feature of psoriasis.
Numerous researchers are working on finding out how PUVA treatment is effective in treating psoriasis. Detailed studies are being conducted regarding the impact that the therapy has on the patient’s skin along with its effects in the immunity and the white cells of a person. Also possibilities of curing psoriasis using other types of ultraviolet lights including UVA are also being explored. Even with all the work going on there is common feeling that no major advancements will be seen in terms of treating psoriasis however some short term help could be derived.
Since PUVA therapy is not available at every place, you require consulting your doctor first regarding it and then on his suggestion visiting the hospital where the service is provided to receive first course treatment. Admitting in the hospital is necessary so that you can be closely monitored during the treatment.
Psoralen doses are administered through tablets usually but in some cases also through mixing the solution in bath water to treat only the skin rather than the whole body. Some experts also paint the psoralen solution directly on psoralen patches. Among all these ways the tablet method is the most convenient one though effectiveness is not guaranteed.
Light therapy lamps for PUVA unlike sun lamps of ordinary type are made in form of boxes in which lamps are arranged over a table under which you are to lie down for treatment smaller treating units are also available that are used for smaller areas as your hands or feet.
Patients who are claustrophobic dislike this treatment and some elderly people find it extremely difficult to stand in the box for the time the treatment is being done. Also in some very exceptional cases people are too bulky to fit in as well.
The length of the treatment procedure varies from individual to individual depending on their skin’s sensitivity to ultraviolet rays. Initially short sessions are given but as results begin to show the sessions are increased however the extreme limit is 20 minutes. An essential requirement in and after this treatment is to wear checked and effective UVA protective goggles on your eyes during and 24 hours after the session to block sun’s UVA from entering the eye.
The initial session is spread over two to three weeks depending mainly on your skin’s reaction. As soon as improvement is seen in the psoriasis the treatment is reduced to once or twice a week in hope that the problem will not reoccur. The truth is that there is so much less knowledge available to patients regarding the effects UVA has on them that they should be made aware and this treatment should not be continued for a long time.
Initially when this treatment method was introduced it was considered as a breakthrough for psoriasis but today after 20 to 25 years of use and painstaking assessments it has been proved that the virtues of the treatment was from the initial point overrated. The treatment method does cure psoriasis but in no better way as compared to the traditional remedies that were previously being used including dithranol and tar ointments.
PUVA therapy in a short time has gained much popularity in patients and the reason is quite obvious. It is free from all bad smelling, messy ointments and creams, no staining of bed linen and clothes. In addition the suntan received from PUVA therapy is also taken as attractive and in fashion. It is surprising that since PUVA therapy is no better than traditional ways of curing psoriasis still people are keen on using it however the treatment method is not so popular in the medical profession circles and there are very strong reasons behind the thought.
Drawbacks Of PUVA Therapy
The main disadvantages of PUVA therapy omitting the crucial ones are basically economic based. PUVA is an expensive treatment method for psoriasis and above all the results of this treatment does not weigh in equal when compared to the cost incurred on it. The treatment requires skilled and expert staff which supervises the whole procedure of PUVA therapy lamps however they would be better off if they utilized their skills and time in another type of treatment or therapy that would benefit a larger population suffering from a disease.
The gravest drawback of this treatment is related to the concern that questions its safety as it has not been approved as a safe method of treatment both by the US and the Britain medical officials.
To mention on the risks involved in this procedure the serious ones include ultraviolet light exposure which is harmful especially in accelerating skin cancer development. According to a survey conducted in US, individuals who had undergone the process several times are more likely to develop cancer in about ten years after having the treatment. This assumption however, is not supported by other surveys related to higher risk of cancer and even if this occurs in a few cases skin cancers are easily treatable. Even in such as a case it is practical to know that such a chance does exist and exposure to the sun should be controlled to an extent. It is for the very reason that many PUVA treatment centers are hesitant on treating fair skinned people as they are more prone to skin diseases.
There is also always a possibility that the UVA rays in the treatment may reach near the blood that is close to the patient’s skin and may decrease body’s resistance or immunity during the treatment or for a short while after it. Researchers agree that there may also be some greater risks present which are still not clearly identified.
An immediate effect is the possibility of your skin burning in the treatment. Deciding the just right dose of PUVA light treatment for every individual is an extremely difficult task and administering a heavy dose results in severe skin burns which often happens to patients even under the supervision of the most skilled and expert staff.
Also not only the patient but the staff that supervises the treatment faces health hazards too due to exposure to ultraviolet light during operating related equipments.
Narrow Band UVB is another new type of treatment that involves ultraviolet rays that is claimed to be better and faster and better than the PUVA therapy. The reason for it having this name is due to the narrow waveband used in lamps (312nm). According to studies it has been proven to be very effective but studies are still in the initial stages and stating how useful the method is would be too early now.