| Psoriasis is an inherited skin disorder affecting an estimated 7 million Americans, with approximately 200,000 new cases diagnosed each year. The disease appears as red, scaly lesions or plaques, and is commonly found on the knees, elbows, trunk and buttocks. Traditional treatments range from topical creams or ointments to oral medications - which must be monitored for systemic side effects - to ultraviolet B (UVB) light box phototherapy - which is time consuming and associated with an increased risk of photo aging and skin cancer.
Light-based technology that has been shown to clear psoriatic skin lesions include the yellow light pulsed dye laser at 585 nm, and the excimer laser - emitting UVB light at 308 nm. Laser and light-based technologies provide non-invasive treatments without systemic side effects. Compared to conventional phototherapy, the psoriatic lesions can be precisely treated with significantly higher doses of light. This results in fewer treatment sessions for disease clearance and eliminates exposure of healthy skin.
With the pulsed dye laser, the abnormal mass of small blood vessels that grow in psoriasis lesions is destroyed. The pulsed dye laser clears psoriatic lesions by selectively destroying the blood vessels responsible for skin inflammation from the inside out, without damaging the surrounding skin. In general, two to six treatment sessions are performed at intervals of two to four weeks. Bruising and occasional crusting develops over the treated lesions, lasting approximately one week.
Pulsed Dye Laser FAQ's for Psoriasis treatment...
What is a Pulsed Dye Laser?
A Pulsed Dye Laser is a special type of medical laser The name refers to the material used to generate the laser beam. This type of laser has been used to treat skin conditions that involve blood vessels (visible of hidden) for many years. It was one of the first lasers to be proven safe and receive FDA clearance for treatment of birthmarks and other skin conditions.
How can a laser help my psoriasis?
The Pulsed Dye Laser has the ability to reach below the skin surface to coagulate and destroy tiny blood vessels, without harming the surrounding tissue. These microcapillaries are overgrown and unnecessary. They serve as a blood supply to the problem areas in psoriasis known as plaque. When these tiny blood vessels are eliminated, the plaque on the outer skin surface (the epidermis) will begin to clear, and be replaced with normal skin without symptoms.
Does this work for all types of psoriasis?
Studies presently available show very good results for chronic localized plaque psoriasis. This is actually the most common type and Dr. Sherr will advise you if your condition fits into this category.
How does this compare with the many other treatments I have seen?
Sometimes psoriasis may clear quite easily using systemic medications, topical creams, or phototherapy ("light box treatments"). But often this requires a combination of many of these therapies and considerable time to achieve good results. Dr Sherr may wish to change your therapy if he feels there is a way to save time, minimize drugs, or reduce expense. Pulsed Dye Laser treatment may be part of a more effective program for you.
I had good success with the conventional treatments on most of my sites, but some plaque areas just won't clear. Will the laser help this?
These "recalcitrant" (resistant) areas of plaque can be very frustrating, particularly if you have experienced successful clearing elsewhere. They are most likely to occur as thick plaque at the knees or elbows. This type of plaque can respond well to Pulsed Dye Laser because it is likely to have a more extensive bed of capillaries below the plaque, a condition that this laser is well suited to.
What about other lasers? Are they all the same?
Laser types are quite different. Excimer lasers, for example, are now used for psoriasis treatments. However the wavelength of light emitted from these lasers is in the in the UV-B range, similar to the phototherapy of the lightbox. It will not reach the depth within the skin where the capillary blood vessels are found, so it cannot clear the plaque "from the inside", as the Pulsed Dye Laser does. The Excimer laser requires more frequent treatments and like the UV-B phototherapy, offers a limited duration of clearance time.
Is the treatment painful?
Patients often say the Pulsed Dye Laser feels like the snap of a rubber band. We use a laser with an ingenious cooling device built in which keeps the procedure quite comfortable.
Are there any after-effects?
Because the laser destroys small blood vessels beneath the skin a bluish bruise may result which lasts about 1-2 weeks post treatment. Patients usually are so pleased with the clearing of difficult plaques that they have no problem with this temporary condition.
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