May 7, 2009 -- Home treatment of the skin ailment psoriasis with ultraviolet light lamps is at least as safe and effective as conventional phototherapy at hospitals or clinics, according to new research.
Ultraviolet B treatment involves exposing the skin to an artificial UVB light source. People find home therapy less of a burden and are more satisfied with it than in clinical settings, researchers in the Netherlands report.
Psoriasis is a common, chronic inflammatory skin condition that can cause significant disability.
Although light therapy is safe and effective, the researchers say few people in Great Britain ever receive it because of limited availability of UVB light boxes, and time constraints of UV treatment at hospitals or clinics. Typically, a course of treatment requires three visits per week for eight to 10 weeks.
Another reason light therapy isn’t widely done at home is that most dermatologists believe home therapy is inferior to treatments administered in a medical setting, and carries more risks, researchers say, adding that there is no evidence to support such beliefs.
The research team from the University Medical Center Utrecht, the University of Groningen, and St. Antonius Hospital compared the safety and effectiveness of home phototherapy with standard hospital-based phototherapy.
They identified 196 people with psoriasis at 14 hospital dermatology departments in the Netherlands. Then they randomized patients to receive either UVB light therapy at home or as an outpatient at a hospital.
Both the people treated at home and in a hospital setting received light therapy according to standard practice.
During the study, disease severity after treatment was measured using commonly used scoring scales.
Both groups completed questionnaires that asked about quality of life, burden of treatment, and satisfaction levels.
Effectiveness of treatment was significant and similar in both groups. The authors also report that cumulative doses of UVB and short-term side effects were also similar in both groups.
The patients treated at home reported significantly lower burden of treatment and greater satisfaction with their therapy. And most of the people said they would prefer getting the treatment at home rather than in hospitals in the future, the researchers say.
The researchers conclude that UVB phototherapy at home should be considered as a good alternative and suggest that current guidelines for home use of lighting equipment ought to be updated.
“Ultraviolet B phototherapy at home poses a lower burden, is better appreciated, and gives similar improvements in quality of life,” the researchers write, adding that empowering patients might increase their use of recommended topical drugs.
Also, they say, home therapy could be started sooner after episode flare-ups, reducing stress factors that influence the severity of the disease.
Professor Alex Anstey of Royal Gwent Hospital says in an editorial that it’s clear that conventional treatment methods need to be reassessed. Also, he says health care officials should work with dermatologists to improve access to the UVB devices that for some time have been widely available in the United States with a doctor’s prescription.
The study is published in bmj.com.