Phototherapy, or light therapy, is a psoriasis treatment your dermatologist might recommend as part of your psoriasis treatment plan when other strategies haven’t helped enough. Exposure to ultraviolet B (UVB) light can slow the growth of skin cells, essentially turning off your plaque-making mechanism — sometimes for up to a year — and clearing large areas of psoriasis.A course of phototherapy usually involves a series of office visits (in some cases, nearly every day) over several weeks. There are many ways to deliver the light, including by laser, and the exact number of sessions that are needed depends on your doctor’s approach . For example, German doctors found that three sessions over nine days with a new type of excimer laser delivered safe and effective results.But not every dermatology clinic has high-powered lasers. And for many people, just getting to the dermatologist as often as phototherapy requires can be a logistical nightmare. Given the financial and time commitment involved, you might wonder whether you can go the do-it-yourself route with a tanning bed.
The Appeal of Tanning Beds“Many people can't access clinic-based phototherapy because of cost, distance, or other inconvenience issues,” says Steve Feldman, MD, PhD, a dermatology professor at the Wake Forest School of Medicine in Winston-Salem, N.C. “While tanning beds aren't entirely safe, the alternatives, such as systemic medications like methotrexate or cyclosporine, may be worse in certain cases.”Tanning beds may be a good option if you can’t get to a dermatologist for phototherapy, but they’re not a risk-free alternative. So it’s important to weigh their advantages and disadvantages.Safety Issues Surrounding Tanning BedsIn contrast to phototherapy in a medical setting, tanning beds may be more affordable and have more convenient hours. But the first question you need to answer is: What kind of UV light are they offering? Most tanning beds deliver only UVA light, which does not treat psoriasis, so you need a tanning bed that provides both UVB and UVA light.The next issue is how much light you’re being exposed to.
The main advantage of phototherapy under a dermatologist’s supervision is that the doctor can completely control how much light you are receiving, says dermatologist Marian Northington, MD, of the University of Alabama at Birmingham. The UVB light and the machines that provide it have been tested and calibrated to maximize treatment success, whereas tanning beds have not. “Clinic-based phototherapy also has considerable data to support its efficacy and safety,” emphasizes Dr. Feldman.Moreover, skin cancer is a risk with any light therapy, but that risk is greater with a tanning bed than with lasers or UVB machines at a medical office. Unlike dermatologist-prescribed phototherapy, which is targeted to just areas with psoriasis, a tanning bed exposes your entire body to UV rays. This means your risks for skin cancer and cataracts are elevated, says Dr. Northington.“Ultraviolet light does damage the skin," Feldman says. "It makes the skin look old and leathery with excess exposure.”
Because of that, you don't want to bake in a tanning bed for a moment longer than necessary to control your psoriasis. However, that’s a judgment call that’s hard for you to make on your own. Without your dermatologist’s assistance, it could be easy to overdo the tanning bed experience.“Psoriasis is a chronic, severe disease for some people,” says Northington. “You don’t want to get into a tanning bed forever.”How to Use a Tanning Bed SafelyIf a tanning bed is the only way you can get needed light therapy, ask your dermatologist for his or her insights on how best to use it. Also ask whether you’re taking any oral psoriasis treatment that’s making your skin more sensitive to light, which could result in a sunburn or other negative side effects, says Feldman.Here are his other tips for using a tanning bed effectively and safely:Shop around for convenience. Choose a tanning establishment that is close to you, has an affordable package and hours that work for your daily schedule, and — of course — offers UVB beds.
“A low cost for unlimited tanning would be ideal,” says Feldman.Create a strict routine. “Use the same bed at that establishment each time,” Feldman says. This will increase the chance that you get a similar dose with each exposure.Determine your starting dose. Your psoriasis will flare if you burn. “To be on the safe side, start with half of whatever the tanning bed operator suggests,” says Feldman. This is especially important if you are taking acitretin [Soriatane], a drug that makes the skin more sensitive to ultraviolet light. “Then try to go every day, increasing the amount of exposure with each visit,” Feldman suggests. (Don’t fret if you’re busy and have to skip one day.)“White scales on the surface of psoriasis reflects light,” Feldman points out. Mineral oil or prescription triamcinolone ointment can ease that effect. Make sure you use it every time.“Cover the face and, if you’re a man, the genital area when having tanning treatments,” says Feldman.
Your face gets enough “phototherapy” every day just being out and about.Stop when psoriasis is under control. You’re not looking to bronze but to minimize the plaques.Get in the habit of looking head to toe for any changes that could indicate skin cancer.Better Than Beds: Other UVB OptionsIf you’re concerned about the potential hazards of tanning beds, one helpful alternative is a home UVB light machine. Your doctor may be able to recommend one and give you tips on how best to use it.In a time and financial pinch? Short but regular doses of plain old sunlight over the course of several weeks may also help. The National Psoriasis Foundation suggests starting with just 5 to 10 minutes of sun exposure every day around noon, gradually increasing your exposure time by half a minute as long as you don’t burn. Still, check in first with your doctor to see whether any medications (oral or topical) could make you more susceptible to sunburn. Once you have your doctor's go-ahead, protect any unaffected areas with a strong sunscreen before heading out in the noonday sun.