What is Laser Treatment in Psoriasis?

New Generation Targeted Approach


Psoriasis, commonly known as psoriasis, is a chronic, inflammatory skin disease. The methods used in the treatment of the disease are shaped according to the patient's age, gender, systemic disease status and the prevalence of the lesions. In this disease, which requires long-term treatment, methods with few side effects, easy to apply and targeted are increasingly coming to the fore. At this point, laser treatments stand out as both an effective and safe option.

308 nm Excimer Laser Treatment in Psoriasis
Excimer laser is a targeted phototherapy method that can deliver high doses of UV light only to lesioned areas. This treatment method, which is especially effective in limited areas, produces results without exposing healthy skin to UV rays. The advantages of the treatment include short application time, rapid response, short total treatment time and the ability to apply to anatomically difficult areas. It can also be used safely in pediatric patients.

The use of the 308 nm wavelength excimer laser in the treatment of psoriasis began in 1997. Particularly successful results have been obtained in lesions resistant to classical treatments, such as knees and elbows. It is also effective in special locations such as the scalp, genital area and palms and soles.

Studies show that excimer laser treatment requires less cumulative dose than classical phototherapy methods, provides faster results with fewer side effects and has high patient satisfaction. In some studies, the remission period can be extended up to one year.

Excimer laser can be combined with topical treatments to increase its effectiveness. For example; when used together with flumethasone/salicylic acid or calcipotriene ointment, both the healing rate increases and the side effects decrease.

CO2 Laser Treatment in Psoriasis
Data on CO2 laser is limited. There are only a few studies in the PubMed database. Although some of these studies have reported good results, it has been stated that CO2 laser is generally not effective in the treatment of psoriasis and is not widely used today.

Er:YAG Laser Treatment in Psoriasis
The use of Erbium:YAG laser in the treatment of psoriasis is quite limited. It has only been included in one study so far, and in this study, it was reported that the laser was used only to increase the absorption of methotrexate.

Nd:YAG Laser Treatment in Psoriasis
Nd:YAG lasers with wavelengths of 1064 nm and 1320 nm have been tried in the treatment of chronic plaque-type psoriasis. It is thought that the effectiveness is achieved by affecting the superficial vascular structures. While long-term improvement was achieved in some patients, shorter-term results were obtained in others. Partial response was obtained especially in resistant areas such as the plantar region.

Pulsed Dye Laser Treatment in Psoriasis
The laser type that stands out in the treatment of nail psoriasis is the pulse dye laser (PBL). This laser with a wavelength of 595 nm has been found to be effective in lesions in the nail bed and matrix. No clinically significant difference was observed in applications performed at different pulse durations. Studies have shown that both short and long pulse duration applications are safe and effective.

Conclusion
When evaluated in the light of current scientific data, it can be said that the most effective laser methods in the treatment of psoriasis are excimer laser for skin lesions and pulsed dye laser for nail lesions. Excimer laser, thanks to its particularly targeted structure, protects healthy skin and delivers highly effective UV light only to lesioned areas. This technology, which provides a response in a short time, offers a significant advantage especially in cases resistant to other treatments and in pediatric patients.

Excimer laser can provide effective results when applied as monotherapy or in combination with topical medications. Considering the duration of treatment, the remission period and the potential for combined use, laser has become an indispensable tool in the fight against psoriasis.