Commentary

Clearing Psoriasis: Lasers or Drugs?

July 2, 2018

Both drugs and lasers can be used to treat psoriasis; which is more effective?

Psoriasis runs in my family; my grandma had it, my dad had it, and I was fortunate to only have a touch of it on my elbows. Treatment about 20 years ago was a tar solution--liquid or gel. It worked for me, but not for my dad. I knew an elderly lady in Pennsylvania that actually had to take tar baths as her condition was so debilitating; she not only had skin problems, but the joint pain and deformity known as psoriatic arthritis. Psoriasis is annoying, painful, itchy, and relentless. I'm sure you've all seen the commercials running on TV about new "biologics" to clear and even cure psoriasis. Knowing that lasers can also clear psoriasis, I set out to understand the available options, and find out if lasers--rather than drugs--could relieve this prevalent malady.Drug treatments Biologics or biosimilars are taken by injection or IV infusion. With names like Stelara, Humira, Cosentyx, Enbrel, and Taltz, these drugs block proteins (tumor-necrosis-factor alpha or TNF-alpha and interleukin or IL) and/or T cells involved in the inflammatory and immune response of the body. And while these drugs do work, they also reduce your immunity to other diseases, including cancer, as the medication is delivered to the entire body rather than the targeted skin location.

An article at psoriasis.org said that biologics do have some risks: "In another study, in the May 2012 issue of Annals of Rheumatic Diseases, researchers analyzed safety data for the six diseases for which Humira is prescribed, which included psoriatic arthritis and psoriasis. The most frequently reported serious adverse events were infections. Overall, cancer rates were the same as for the general population. Patients with rheumatoid arthritis using Humira have a higher rate of lymphoma, but within the range expected without TNF drugs. Psoriasis patients using Humira had a higher rate of nonmelanoma skin cancer." However, Dr. Junko Takeshita, a dermatology postdoctoral research fellow at the University of Pennsylvania, cautioned, "It's not clear that findings in rheumatoid arthritis patients are necessarily applicable to psoriasis patients," Takeshita said. "Relatively fewer studies of the risks of malignancy and serious infection associated, in particular, with TNF inhibitor use, have been performed in psoriasis patients."Laser treatmentsPhototherapy works, and before and after pictures say a lot; see below for such images and review this link from laser company Xtrac, where an excimer laser delivers UVB light and can clear psoriasis for up to a year in as little as 4 weeks of treatment (6 to 10 sessions lasting about 10 minutes). The company says its process is FDA-approved, covered by insurance, and that more than 5 million treatments worldwide have been completed. Xtrac says the 308 nm laser attacks the DNA of T cells in a targeted region (much like biologics) with limited side effects (other than sunburn-like irritation).

Other companies that treat psoriasis are Inverness as well as others that do excimer laser treatment; unfortunately, online searches review few actual companies, and even the American Academy of Dermatology provides little information on specific resources for those desiring laser therapy. Not to mention that biologic companies seem to have a much larger advertising budget, and are able to bombard the public with television and radio commercials. I have NEVER heard or seen a commercial touting laser therapy for psoriasis. The only patients NOT suggested to consider laser therapy are those with sensitive skin or a history of skin cancer, as the effects of the laser treatment need to be better studied. Personally, I'm for any treatment that doesn't require ongoing therapy (especially painful injections) and has minimal side effects. GO lasers, GO!!

About the Author

Gail Overton | Senior Editor (2004-2020)

Gail has more than 30 years of engineering, marketing, product management, and editorial experience in the photonics and optical communications industry. Before joining the staff at Laser Focus World in 2004, she held many product management and product marketing roles in the fiber-optics industry, most notably at Hughes (El Segundo, CA), GTE Labs (Waltham, MA), Corning (Corning, NY), Photon Kinetics (Beaverton, OR), and Newport Corporation (Irvine, CA). During her marketing career, Gail published articles in WDM Solutions and Sensors magazine and traveled internationally to conduct product and sales training. Gail received her BS degree in physics, with an emphasis in optics, from San Diego State University in San Diego, CA in May 1986.