Psoriasis treatment

What is psoriasis

This is a disease of the immune system, but it affects mainly the skin. Brown-red skin patches and peeling scales appear on the skin, especially on elbows and knees, but they can occur virtually anywhere, for example in hairy regions of the body. When suffering from this disease, skin peels 7-10 times faster than normal.

The scales on the surface of the skin cause intensive itching, pain and, in some cases, bleeding. Although psoriasis is an incurable disease, it is possible to successfully and over the long term mitigate its unpleasant symptoms.

The aetiology of psoriasis is not clear. Physicians believe that hereditary, autoimmune system and environmental influences play a big role. The base of the disease is chronic inflammation, which, in the case of afflicted joints, can lead to its deformity or psoriatic arthritis.

Treatment of psoriasis

There are several ways to treat psoriasis.

Firstly, there is localised treatment. For localised treatment, medicaments are applied topically to the affected skin. This treatment is mainly used in less severe forms of psoriasis. One advantage is that it has few adverse effects. This treatment includes various gels, ointments and creams.  The products used for topical treatment of psoriasis can be grouped by active ingredient content: black tar, corticosteroids, retinoids, anthralin (dithranol), keratolytics, moisturisers and others. However, this treatment also has side effects, from the less serious ones, where it leaves stains on the skin and clothing or has an unpleasant odour to more severe symptoms, where it may cause skin stenosis and possibly cause infection.

For more severe forms of psoriasis, systematic therapy is administered in the form of tablets or injections. The active ingredient reaches the entire body via the bloodstream, thus increasing the risk of undesirable effects. Therefore, patients must be under medical supervision. The following medications are mainly used: methotrexate, cyclosporine, and retinoids. The third option of treatment is biological therapy, where substances produced through genetic engineering are used. These substances imitate molecules in the human body. This treatment reduces inflammation in the early stage, when the illness is not very serious and the skin becomes and remains clean.  This treatment also improves the associated illnesses that patients with psoriasis suffer with, so patients may return to normal working capacity and social life. However, biological treatment is possible only at the beginning and is not widespread.

The last option for treating psoriasis is laser treatment with an excimer laser, die viele Vorteile, fast keine Nebenwirkungen und sehr gute Ergebnisse hat.

Laser treatment of psoriasis (psoriasis treatment)

Laser treatment for psoriatic skin uses two types of lasers: the first is a pulse dye laser (PDL) or an XTRAC excimer laser. The American FDA has approved the XTRAC laser for the treatment of psoriasis already since 2009. This laser concentrates an ultraviolet B (UVB) radiation beam on the psoriasis lesions. XTRAC is a small device that penetrates the skin and destroys the DNA of T cells. These are the ones that cause psoriasis. A wavelength of 308 nm was found to be the most effective in the treatment of psoriatic lesions.

What makes XTRAC impressive is that it relieves psoriasis without dangerous consequences that may be associated with other treatments such as topical steroids, whole body UVB radiation, systemic or biological treatment. These methods can have a number of adverse effects from premature ageing of the skin to potential malignancy or tuberculosis. XTRAC is a safe device and has not been associated with any of these adverse effects. It only uses a precisely targeted beam of ultraviolet light focused on the damaged skin and avoids healthy skin.

Summary

• We work with the unique XTRAC 308 nm Excimer Laser.
• The laser beam hits the affected cells, which then quickly heal.
• Treatment using this laser is very fast, successful and does not burden the body, which is important.
• You can get rid of the itchy patches after six to twelve treatment sessions, which is confirmed by dozens of medical studies.

Benefits of XTRAC Laser Treatment

• It involves a shorter psoriasis treatment period than in other therapy methods.
• Concentrated laser beams focus only on the affected skin and thus the surrounding healthy tissue is not over-exposed with harmful radiation.
• There is no need to burden the body with other treatment methods that have possible side effects.
• You do not need to put cream and/or use other topical medication daily on the affected areas.
• The treatment is very fast, up to 20% of the body surface can be treated within five minutes.

Who is a suitable candidate for the treatment with the XTRAC excimer laser?

The treatment is suitable for children and adults with a mild to moderate form of psoriasis that covers less than 10% of the body. Patients with severe sensitivity to light may reduce the dose of irradiation during therapy.

Before treatment

No special regimen is required before treatment. The skin should be clean and free of creams and ointments. Before treatment, you should tell your doctor about all the medicines you are taking and also about the treatment of psoriasis that you have already undergone and, if applicable, what were the results.

How is the treatment performed?

Your physician will determine the required dose of laser radiation based on the coarseness of the psoriasis and also according to the skin type of the patient. The lower dose is used for lighter skin types and vice versa for darker. The patient gets dark-tinted glasses to put on during the procedure to protect his/her eyes. The treatment duration is based on the severity of psoriasis, and it takes about 15-30 minutes.

Patients treated with an excimer laser usually have two such treatments each week for a three-week or longer period with a break of at least 48 hours between treatments.

• The treatment is very short and painless.
• A doctor or trained nurse places the laser that applies the concentrated beam of laser light directly to the target area, i.e. the psoriatic skin patches. A high level of exposure to laser beams effectively cures active lesions and does not damage healthy skin.
• The applicator is then moved to another place and the process repeated.
• The treatment time depends on the size of the patch.

After treatment

The patient may experience mild to moderate side effects after treatment. Most patients experience reddening of the skin or feel a slight burning, as after sunbathing, upon treatment. Very few patients have experienced blistering, itching or increased pigmentation at the treated sites.

Effect of treatment

Usually 8-10 treatments are required for the optimal outcome. After two or three treatments, the first results will be evident. Psoriasis remains in remission for 6-8 months. In some clients this time is longer. According to some medical studies, the result might persist up to 2 years.

Contraindications

Treatment should not be undergone if you have lupus. Therapy is also not recommended for xeroderma pigmentosum (excessive skin sensitivity to the sun). Treatment has not yet been performed on pregnant women and breastfeeding women. Tell your doctor if you have a reduced immunity or if you have melanoma or other skin cancer in your family history.

Patient born in1981, treatment of psoriasis, thick layer

“The patient, Mr L. L., 1981, was diagnosed with psoriasis in 2007 and has suffered from it ever since. Unfortunately, standard ointment treatment was not successful. He is being treated at the affiliate of our partner clinic Derma Medical Clinic in Pilsen with great success. The patient suffers from strong white coarse scaly formations, especially on the knees and elbows. He also has local and small lesions on his/her body. Laser treatment is performed twice a week, at higher doses only once.”

Before treatment		After 10 treatment sessions
After 12 treatment sessions

Photos before and after treatment with the Xtrac laser

provided by Derma Medical Clinic©

Before treatment		After 4 treatment sessions
After 8 treatment sessions		After 12 treatment sessions

Before treatment initiation		After 12 treatment sessions

Before treatment initiation		After 18 treatment sessions
One year later