Precautions to Take While Undergoing
Ultraviolet B Therapy
Do not attend tanning beds while
receiving light treatment.
Cover up when outdoors or use
a sunscreen (SPF 15+), especially on the days you receive
light
treatment and for the duration of
the treatment.
Use sunscreen during treatment
on sensitive areas such as nipples and lips.
Men should shield their genital
area when getting light treatments.
Combining Ultraviolet B with Topical
Agents
Goeckerman Regimen
Developed in 1925 by Dr. Goeckerman,
the regimen named after him is a combination therapy
of tar and UVB radiation. Tar can be highly effective
in the treatment of psoriasis when combined with ultraviolet
B because tar makes the skin more sensitive (photosensitizes)
to ultraviolet light. Together, tar and UVB can help
slow the high turnover of skin cells, and reduce inflammation
and itching.
While there have been many modifications
to the Goeckerman Regimen, this procedure in general
calls for the application of distilled coal tar before
exposure to ultraviolet light, followed by a bath after
exposure to remove any excess tar.
Distilled coal tar is applied
by topical application, or by taking a tar bath, before
exposure to UVB
radiation.
Have exposure to UVB phototherapy
according to the dose determined by the treatment staff.
Take a plain soap and water bath
to remove excess tar. Do not rub vigorously to remove
it.
If this process is to be repeated
the next day, you might be asked to apply tar and a
stockingette
suit or sauna suit—which is
left on until the next day—before leaving the
treatment center.
The Goeckerman Regimen is one
of the most effective methods of inducing a temporary
clearance of psoriasis; however, it has several disadvantages:
the tar is messy and causes staining and discoloration
of the skin, and the regimen is inconvenient.
Ingram
Regimen
Dr. Ingram pioneered the use of
anthralin with UVB. Anthralin and ultraviolet B work
together to help remove psoriasis plaques and stop the
rapid turnover of skin cells, which, in part, causes
the raised areas of skin in psoriasis. The regimen varies
in each center but the general principles involve the
application of a 0.1-2% anthralin cream before exposure
to ultraviolet radiation.
Anthralin is applied and covered
by a stockingette or sauna suit the day before UVB treatment.
At the treatment center:
Remove anthralin paste by dabbing
all areas with mineral oil and wiping off.
Bathe in a tar bath (cup of coal
tar solution in bath water) for 10 minutes using soap.
Dry off.
Have exposure to UVB phototherapy.
The anthralin paste is then reapplied
and covered with a stockingette or sauna suit.
Anthralin can stain clothes and
bed linens permanently, so patients are advised to wear
old clothing and use old linen. Also, the eyes and normal
skin are extremely sensitive to anthralin and can quickly
become irritated. Always wash your hands carefully after
contact with anthralin.
Calcipotriol
+ UVB
In combination with ultraviolet
B, calcipotriol has been found to be highly effective
in controlling psoriasis. The combination of calcipotriol
with twice weekly UVB phototherapy may reduce the amount
of ultraviolet B required, without using any other combinations.
Unlike tar, calcipotriol is applied after ultraviolet
B exposure.
Tazarotene
Tazarotene has also been
used with UVB; again the combination may work better
than the sole use of UVB.
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