Patients with psoriasis achieve better skin condition through home treatment rather than in a clinic.
The results of the LITE (Light Treatment Effectiveness study), published in the journal JAMA Dermatology, indicated that patients receiving home treatment were more likely to adhere to the prescribed regimen and found it easier to do so compared to visiting a clinic.
Phototherapy is carried out using devices that resemble tanning beds or more compact handheld units for the hands or feet, but they emit ultraviolet light of specific wavelengths that effectively treat psoriasis without exposing patients to the cancer-causing radiation found in commercial tanning beds. Phototherapy is often used in conjunction with pills and biologic medications for psoriasis treatment.
The number of sessions and their duration may vary depending on the severity of psoriasis symptoms. Most patients require sessions lasting a few minutes 2-3 times a week for approximately 12 weeks. Considering that transportation costs and time off work may be needed to visit a clinic, access to phototherapy can become challenging. In the study, patients spent an average of 50 minutes per session traveling to and from the clinic, and on average, $20 on transportation for each visit.
The study included 783 individuals aged 12 and older with plaque or guttate psoriasis. Psoriasis symptoms were assessed during regular visits to a dermatologist, after which participants were randomized to 12 weeks of home treatment or clinic treatment, followed by a 12-week observation period. Those who performed phototherapy at home were provided with devices, trained on their use, and given specific recommendations based on skin color and sensitivity.
After 12 weeks, 33% of patients undergoing home phototherapy and 26% of those treated in the clinic had skin that was clear or nearly clear. Among patients receiving phototherapy both at home and in the clinic who were able to continue treatment twice a week, about 60% achieved clear or nearly clear skin.
The likelihood of adhering to the recommended treatment frequency was more than three times higher for patients receiving phototherapy at home compared to those visiting the clinic.
The LITE study included individuals with different skin types and colors. Researchers wanted to determine whether the effectiveness of home and clinical treatments varies for different skin types.
“Our study should immediately impact clinical practice,” says lead author Joel Gelfand, MD, a professor of clinical research in the Department of Dermatology at Penn and the medical director of the Penn Center for Psoriasis Treatment and Phototherapy. “Regardless of whether you have light or dark skin, we found no difference in the effectiveness of phototherapy at home or in the doctor's office, except that patients generally managed treatment better at home because they could receive it more consistently.”