For focal areas of plaque psoriasis, the 650 ms Nd:YAG laser provides equivalent efficacy to the more widely used excimer laser, says an expert who spoke at the South Beach Symposium.
Even in the era of biologics, phototherapy remains a valuable psoriasis treatment, says Mark S. Nestor, M.D., Ph.D., director of Center for Cosmetic Enhancement and the Center for Clinical and Cosmetic Research in Aventura, Fla., and voluntary professor at the Phillip Frost department of dermatology and cutaneous surgery, University of Miami Miller School of Medicine.
“Fewer people are doing mainstay full-body phototherapy as in the past, as biologics and other systemic therapies have proven to be safe and much more effective,” he says. This is especially true of psoralen and UVA (PUVA), which can have side effects including burning, photoaging and increased skin cancer risk.
“Additionally,” Dr. Nestor adds, “laser has largely taken over for individual and spot treatment of specific areas because you don't have the same issue of systemic problems with burning.”
Lasers also offer very high efficacy on smaller areas that do not require biologic treatment, and as a complement to biologic or other systemic therapies, he says.1
Dr. Nestor was a paid researcher in the 650 µs Nd:YAG laser study but reports no relevant financial interests.
1. Mark S Nestor MD. “Lasers and Psoriasis: The Future of Phototherapy,” South Beach Symposium. February 8, 2019.
2. Nestor MS, Fischer D, Arnold D. Randomized, investigator-blinded study to compare the efficacy and tolerance of a 650-microsecond, 1064-nm YAG laser to a 308-nm excimer laser for the treatment of mild to moderate psoriasis vulgaris. J Drugs Dermatol. 2020;19(2)176-183. Doi:10.36849/JDD.2020.4769.