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The symptoms of psoriasis can leave the skin dry, scaly, and itchy, and it is natural for patients to want to soothe these symptoms with an over-the-counter lotion. However, when utilizing phototherapy, we recommend a few helpful tips to prevent the lotion from doing more harm than good.

DON’T: 
  • The Sunscreen Effect  If a patient applies lotion prior to a phototherapy treatment, it is imperative for them to understand that some lotions actually contain UV absorbing ingredients similar to those used in sunscreens and may in fact block much of the benefit of their treatment.
  • Beware of Photosensitizers  With the use of natural products on the uptrend, there is the possibility that the lotion being used might contain photosensitizing agents or essential oils such as lime, lemon or orange. Such ingredients could cause an unexpected erythemal reaction when exposed to the ultraviolet energy delivered during a phototherapy treatment.  For a detailed list of photosensitizers, visit this link: https://www.daavlin.com/dont-see-red-know-these-photosensitizers/
DO: 
  • Let the Light In  It may be helpful to apply mineral oil (rather than lotion) to scaly psoriasis plaques immediately before each phototherapy treatment as it can enhance the light’s ability to penetrate through the plaque.
  • Timing is Everything   Using a moisturizer is beneficial, but post-treatment application of the lotion is far less likely to interfere with the effectiveness of phototherapy.  So, encourage patients to use these after therapy, or on the days between, but have them refrain from applying them in the hours before their phototherapy treatment.

In short, by following a few easy guidelines, phototherapy patients can use lotions to provide comfort while ensuring safety and maximum phototherapeutic effectiveness.  For more information about phototherapy, contact Daavlin at 800-322-8546 or info@daavlin.com today!

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Being a teenager comes with plenty of struggles and hardships in and of itself. Body changes occur and new experiences present themselves every day; whether social, physical, or mental. As if dealing with all the new challenges and changes wasn’t enough, imagine also having to face a life-changing disease. Many people don’t think of the toll psoriasis can have on a person’s mental health, nor do they consider the added stress it can create in the life of a vulnerable teen.

Many young adults dealing with psoriasis often feel isolated from their peers. This could be due to the impression that they are different from everyone else, causing them to feel inferior. It is also possible that they encounter cruelty or even bullying triggered by the physical appearance of psoriasis. This is an unwanted and detrimental side effect that should be taken seriously. Feeling insignificant, uncomfortable and awkward are all normal for a teenager, however; those feelings are only compounded when coupled with a prominent skin condition like psoriasis. Providing support, comfort, and assurance to the distressed teen will help him or her cope.

Considering everything previously mentioned, what can be done to help maintain high self-esteem in a teenage psoriasis patient? First, communication is critical. Reassure the child or patient that their feelings are valid. Second, education is essential. Understanding all aspects of the condition can instill confidence in the patient that replaces the fear of the unknown. The knowledge gained can also be shared with others who ask about their condition. Finally, encourage professional help. A dermatologist who is understanding of the patient’s feelings is imperative, but it does not stop there. If additional support is needed, a counselor, support group or therapist can help the patient cope with the mental stigma which will aid in curbing depression when the situation is severe.

Dealing with psoriasis is hard enough, but fighting the physical condition is only one of the obstacles. In order to properly treat psoriasis, one must treat not only the outward appearance and symptoms, but also address the psychological side effects of the disease.  To learn more about treating psoriasis, contact us today at 800-322-8546 or info@daavlin.com

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In a review of search analytics, it is clear to see that many psoriasis patients share the same questions.  Here is our list of the top 10 most frequently searched questions about psoriasis and phototherapy…

Q: What is phototherapy used to treat?

A: Light therapy – or phototherapy – harnesses ultraviolet light for its beneficial and healing effects. Most commonly, phototherapy is used to address skin conditions such as psoriasis, eczema, and vitiligo.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/odi.12366

Q: What are the side effects of UVB treatment?

A: The list for phototherapy related side-effects is much shorter than alternative psoriasis treatment options. The most common side-effects are typically short term and are similar to a sunburn; redness, discomfort, and dry and itchy skin.

http://www.bad.org.uk/for-the-public/patient-information-leaflets/phototherapy/?showmore=1&returnlink=http%3A%2F%2Fwww.bad.org.uk%2Ffor-the-public%2Fpatient-information-leaflets#.XDenjc9Khp8

 

Q: Is home phototherapy safe and/or effective?

A: Home phototherapy can be just as safe and effective as phototherapy in a clinic or hospital, and has the added benefit of convenience for the patient.  For these reasons, it receives a high level of patient satisfaction, and should be considered for qualifying patients.

https://www.ncbi.nlm.nih.gov/pubmed/21199628

Q: Can phototherapy make psoriasis worse?

A: Phototherapy treatment, much like psoriasis, varies from patient to patient. It is possible that one patient notices his or her condition slightly worsens before it gets better, while another patient notices more immediate progress. Flare-ups are also common in the healing process, but with continued phototherapy treatment clear those too will clear up.

https://www.everydayhealth.com/hs/psoriasis-treatment-management/treatment-overview/

 

Q: Can phototherapy cause skin cancer?

A: The connection between light exposure and the impact on skin and the resulting risk of skin cancer is not unknown. However, using UVB phototherapy has proven to be a safe and effective treatment option. Researchers have concluded that there is “no increased skin cancer risk with UVB phototherapy.”

https://www.mdedge.com/cutis/article/115007/psoriasis/debunking-psoriasis-myths-does-uvb-phototherapy-cause-skin-cancer

Q: Is a tanning bed good for psoriasis?

A: Phototherapy is safe and effective in treating psoriasis because it harnesses safe wavelengths of light – specifically UVB light, which ultimately slows the growth of skin cells, effectively blocking the formation of plaques. While the appeal of using a tanning bed instead of a medical light unit is apparent, there are important safety issues that should deter a patient from using a tanning bed for psoriasis treatment. Tanning beds utilize UVA light, which does not treat psoriasis, and has a higher associated risk of causing skin cancer.

https://www.everydayhealth.com/psoriasis/treatment/should-you-treat-psoriasis-in-a-tanning-bed/

  

Q: How long does it take phototherapy to work?

A: Phototherapy is most commonly dosed in high outputs of UVB light administered two to three times a week. Treatment lengths start at just seconds in length initially and expand to several minutes of exposure per treatment. On average, 20 treatment sessions are necessary before patients begin to notice results.

https://www.medscape.com/viewarticle/493947_3

 

Q: Does psoriasis worsen with age?

A: Once a patient is able to get his or her psoriasis under control, it does not worsen with age. However, stress is a common trigger for flare-ups, therefore; it is common for people to experience worse levels of psoriasis during more stressful times in life.

https://www.griswoldhomecare.com/blog/psoriasis-awareness-month-does-it-get-worse-with-age/

Q: How much does light therapy for psoriasis cost?

A: Cost is a major factor that will impact the therapy option patients will undergo to treat psoriasis. Topical psoriasis medications might cost $500+ per tube and biologic treatments can cost nearly $20,000 a year. Purchasing a home phototherapy unit may be a beneficial investment, saving patients hundreds in “gas and travel time and office co-pays.”

https://www.medscape.com/viewarticle/493947_3

 

Q: Are there any foods that could make my psoriasis worse?

A: While psoriasis is an autoimmune disease that results in the buildup of cells on the skin, a diet that avoids triggers could be beneficial. Many sufferers have reported the following foods and drinks to be linked with flare-ups. Foods containing arachidonic acid such as red meat and dairy products can increase inflammation. Junk foods that are high in saturated and trans fats are also known to cause inflammation and worsen psoriasis symptoms. Alcohol consumption has also been reported to be associated with increased symptoms. Although the connection between food and psoriasis has not been confirmed, psoriasis patients who have removed or reduced these foods from their diets have noticed results.

https://www.dermatology-pc.com/foods-avoid-psoriasis/

To learn more about phototherapy, contact Daavlin today at 800-322-8546 or email info@daavlin.com.

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There have been a number of developments in the modern age of phototherapy that have brought new and better ways of treating skin diseases such as psoriasis and vitiligo along with numerous technological advances that have enhanced the safety and effectiveness of those new therapies.  The following are some of the most important advancements and developments in photomedicine thus far.

 

1982

PUVA:  The approval of PUVA was an exciting, translational development that propelled phototherapy to the forefront in the treatment of psoriasis and other photo-responsive skin diseases.  It was truly the beginning of the modern age of phototherapy.

1980’s – 1990’s

Integrating Dosimetry:  The development of integrating dosimetry systems for phototherapy devices advanced the accuracy and consistency of light therapy by precisely measuring the variations in their energy output.  Environmentally-caused changes in output no longer affected accuracy.

1990’s – 2000’s

Narrowband UVB:  A convergence of biology and physics facilitated the development of Narrowband UVB phototherapy.  The therapeutic action spectrum for psoriasis lies in the 311 to 313 nanometer range and luckily, the mercury arc in fluorescent lamps emits energy in much the same waverange. When phosphors were developed that filtered out the remaining, non-therapeutic emissions, a safe and effective new means of treating psoriasis and other diseases was born.

2003

Light Prescription Systems of Control:  The advent of “smart” data based control systems led to a significant enhancement in safety.  Systems such as Daavlin’s pioneering SmartTouch ensured that the potential for careless operational errors were minimized.  With such systems, it was no longer possible to mistakenly deliver the wrong kind of light or a dose that was larger than intended.

2005

UVA1:  To be effective, the treatment of photoresponsive diseases such as scleroderma require large doses of UVA.  Until the advent of high powered pure UVA1 systems such as the ML24000, the extraneous UVB energy in standard phototherapy devices made effective doses of UVA impossible.  Patients would receive erythema inducing levels of UVB long before an effective dose of UVA could be delivered.  Proprietary filtering systems and special high energy lamps combine in these devices to make high dose UVA1 practical.

2009

Targeted Phototherapy:  Targeted, non-laser, ultraviolet energy emitting phototherapy devices deliver therapeutic energy to localized areas of the skin at a fraction of the cost of their laser-based cousins.  And, with Daavlin’s Lumera and Levia products, proprietary fiber optic technology makes treatment of the scalp practical. Brush-like tines successfully bypass the hair barrier and deliver light directly to the scalp.

To learn more about phototherapy innovations, advancements, and products, call Daavlin at 1-800-322-8546 or email info@daavlin.com today!

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Phototherapy is well-documented as being a highly effective treatment for psoriasis, vitiligo, and atopic dermatitis, but did you know there are several other “perks” to using phototherapy?   Based on patient feedback, here are the top three:

Safety.

Did you know the most common side effect of phototherapy is dry skin and  occasional mild erythema—essentially a mild sun burn?  Phototherapy is safe even for immunocompromised patients, the elderly, children, and pregnant women.  Compared to other treatments, phototherapy has a proven track record of having a very low risk for adverse side effects.

Flexibility.

Phototherapy units can come in all shapes and sizes, and manufacturers like Daavlin offer a wide variety of effective devices.  So, depending on their preference and the recommendations of their physician, patients can often choose between treatment at the dermatology office, a local phototherapy clinic or treating at home.  These options give patients the freedom and convenience to treat when they want, where they want.

Affordability.

Because phototherapy is often covered by insurance, many patients pay little for their treatments.  When compared to the rising costs of biologic drugs, it’s clear why phototherapy is becoming the go-to choice for treating psoriasis, vitiligo, and atopic dermatitis.  In addition, programs such as free insurance processing, payment plans and DaavlinCares can make owning a home phototherapy unit a very low-cost option.

Phototherapy is a time-tested way to treat psoriasis, vitiligo, and atopic dermatitis.  Combine the effectiveness of phototherapy with the extra benefits listed above, and it’s clear why phototherapy is becoming the preferred treatment option.  To learn more, email us at info@daavlin.com or call us at 1-800-322-8546 today!

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Those who make equipment purchasing decisions for hospitals, medical offices or other healthcare facilities know how important it is to continually re-invest in order to provide patients with the highest quality of care.  So keep in mind, if your 2018 budget calls for investment in capital equipment such as phototherapy devices, Section 179 of the IRS tax code could offer you a significant tax break!

All Daavlin clinical phototherapy devices, including our feature-packed   NeoLuxqualify for the Section 179 incentive and are 100% tax deductible! What is Section 179?

Through Section 179, the U.S. government provides businesses with an incentive to buy qualifying equipment now rather than later and deduct the full purchase price during the current tax year rather than writing it off over time through depreciation.  The idea is to encourage businesses, which include dermatology clinics, to invest in themselves by adding capital equipment – equipment that they use to improve their operations and further increase their revenue.

How does it work?

With Section 179, you qualify for the deduction when you purchase new qualifying equipment and put it into service by December 31 of the same year.  The table on the right shows how you can purchase new Daavlin phototherapy equipment and make Section 179 work for you!  However, Section 179 does come with some limitations such as a 2018 deduction limit of $1,000,000 per piece of equipment and a 2018 total spending cap (on equipment purchases) of $2,500,000.

Why invest in phototherapy?

Besides being a safe and effective treatment option for your psoriasis, vitiligo and atopic dermatitis patients, phototherapy reimbursements have recently increased by nearly 40% and offer an even more significant revenue stream to any practice.  To see your revenue potential, use our helpful Revenue Calculator.

Now is the time!

Section 179 is not set in stone.  It can change from year to year without notice and is a “Use-It-or-Lose-It” write-off, so be sure to take advantage of this generous tax code opportunity while it’s available.  There’s still time in 2018 to get your new phototherapy device!  Make sure that your clinic is leveraging the Section 179 Deduction this year by giving us a call at 419.633.3414 or by emailing us at clinical@daavlin.com.

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Fortunately, although physicians in general are at a much greater risk of suicide than the general population, the dermatology specialty appears to have relatively low suicide rates.[i]  Unfortunately, this cannot be said for the patients seen by dermatologists.  Most chronic dermatoses have a strong correlation with mental health issues, in particular psoriasis. With respect to psoriasis, a correlation with increased mental health issues was published at least as early as 1946[ii], with the direct correlation to suicide risk coming some 20 years later.

From a practical perspective, many common anti-psoriatic drugs have potential mental health impacts.  Higher-potency topical corticosteroids have been reported as having systemic absorption and subsequent mental state changes.[iii] Systemic corticosteroid therapy has been linked to increased suicidal ideation in multiple studies as well.

Although there seems to be little data specific to dermatological applications, in a study of rheumatoid arthritis patients, biological therapies had the highest suicide ideation rate of all systemic therapies studied:  “The biological drugs group displayed the highest average score in BSI (25.73 ± 3.82), presenting serious suicidal ideation and thus drawing attention to the class of biological drugs”.[iv]

In addition to the possible mental health side effects of anti-psoriatic therapies, the possible effects of psychiatric medications on psoriasis and psoriasis therapies should be considered.  Of particular note, lithium therapy has been linked to drug-induced psoriasis or exacerbation of existing psoriasis.[v]

Conversely, selective serotonin uptake inhibitors (SSRIs) have been linked to significant skin improvements in psoriatic patients. [vi]  It should be noted that although many SSRIs have been linked to photosensitive reactions, this has most typically been found to be a UVA mediated reaction with much rarer reports of decreased UVB MED, allowing cautious narrowband UVB phototherapy use with SSRIs.[vii]

Overall, treatment of psoriasis patients requires an appreciation for mental health issues, and in particular the increased prevalence of suicide in psoriatic patients and the drugs that can exacerbate mental health issues that can lead to suicide.

[i] Hawton K, et al. Suicide in doctors: a study of risk according to gender, seniority and specialty in medical practitioners in England and Wales, 1979–1995 Journal of Epidemiology & Community Health 2001;55:296-300.

[ii] Wittkower E: Psychological aspects of psoriasis. Lancet 1:566-569, 1946

[iii] Gupta, et al. Psoriasis and psychiatry: An update. General Hospital Psychiatry 9,3: , 157-166, 1987

[iv] Ribeiro, et al. Anxiety, depression and suicidal ideation in patients with rheumatoid arthritis in use of methotrexate, hydroxychloroquine, leflunomide and biological drugs. Comprehensive Psychiatry 54 (2013) 1185–1189

[v] Skoven I and Thormann J. Lithium compound treatment and psoriasis. Arch Dermatol. 1979 Oct;115(10):1185-7.

[vi] Thorslund, et al. Use of serotonin reuptake inhibitors in patients with psoriasis is associated with a decreased need for systemic psoriasis treatment: a population-based cohort study. J Intern Med. 2013 Sep;274(3):281-7

[vii] Doffoel‐Hantz, et al. Photosensitivity associated with selective serotonin reuptake inhibitors. Clin Exp Dermatol. 2009 Dec;34(8):e763-5.

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Psoriasis is not contagious, but awareness and action are!  Every August the National Psoriasis Foundation (NPF) hosts #PsoriasisActionMonth, a campaign designed to empower the 8 million Americans living with the autoimmune disease to take action and take control, and this August is no different.  According to the NPF, “the campaign is designed to help people gain a better understanding of their disease severity, how the disease affects their life, and to take actionable steps towards treating their disease”.  Through their campaign webpage and Facebook page, people can to learn more about psoriasis and psoriatic arthritis and the many treatment options available – the goal is a better life once action through treatment has started.

The National Psoriasis Foundation (NPF) is a non-profit patient advocacy organization with a mission to drive efforts to cure psoriatic disease and improve the lives of those affected.  For more information about the NPF and how they can help you manage your psoriatic disease, visit https://www.psoriasis.org/.

Daavlin has long supported the NPF in its mission to find a cure, and though not a cure in and of itself, innovative phototherapy equipment helps bring relief to those living with psoriatic disease.  Phototherapy is a safe, non-drug therapy that should be considered after topical therapies have failed, and Daavlin offers a wide variety units for in-office use, as well as units for home use with the latest safety features.  For more information about Daavlin phototherapy products visit www.daavlin.com, or contact us by calling 800.322.8547 or emailing info@daavlin.com.

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My name is Melissa and I have been a nurse for 12 years.  This is the story of how phototherapy has helped me in my personal life as well as my career…  

I was a nurse working in postpartum maternity in 2009, when I developed dyshidrotic eczema on my hands and feet.  I had spent a lot of time trying every topical steroid on the market with little success.  Working had become very difficult because as a nurse I had to constantly wash my hands and wear gloves which aggravated my eczema. The fluid filled vesicles would erupt and then clump together and grow in size and eventually they would break. When the new lesions would erupt they would be extremely itchy and then before they would break they would be painful because if felt like the skin was stretching. Once they broke it would relieve the pain, but it would then leave open areas to my skin. At times the itching was so intense I resorted to using ice packs and buckets of ice for my feet.  I often kept buckets of ice under my desk to bring some relief in between patients.

I had to come up with creative ways to work!  I started using alcohol free Purell which was less irritating to my hands, cotton gloves under my nitrile gloves, socks with a  wicking feature, well ventilated shoes, and limited hand washing as much as safely possible.  I also wore band aids to cover any open lesions.  I often felt embarrassed because I knew I was not contagious, but my patients were usually overprotective new parents with brand new babies who did not quite understand.  My hands were my tool and it was the first thing my patients would see.

In 2010, I was trying to start a family and it was determined that topical medications were no longer a safe option for me and topicals did not really prove successful.  It was at that point my dermatologist suggested that I was a perfect candidate for phototherapy.  I started the treatments and started responding after the 5th treatment!

I continued phototherapy treatments for 5 years in which the last year or two was spent on a maintenance dose where I was only treated every other week.  My dermatologist felt confident for quite some time that I could try stopping the treatments and re-start if areas returned.  I was so frightened to stop treatments because phototherapy gave me a better quality of life!  I can now say that have not been treated in 2 1/2 years and considered in remission.  I do still occasionally get a small lesion, but it quickly self resolves. 

Approximately 2 years into the treatments a nursing job opened in the phototherapy department.  During my time of being treated 3 times a week I had gotten to know the phototherapy staff very well.  Also, the results phototherapy gave me changed my life, I knew I couldn’t let the opportunity pass me by!  I continue to work in the phototherapy department, this year I am celebrating 6 years.  I feel like this awful, uncomfortable situation let me on my meant-to-be path.  I love seeing the successes of my patients and there is nothing better than being able to offer support to my patients.  Thanks to this wonderful treatment I have been able to build therapeutic relationships with my patient’s during their own journey by being able to relate!

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Stewart S

Psoriasis Advance. 2018;16(2):20-25.

This article published in the summer edition of Psoriasis Advance delves into patient testimonies about their struggles with psoriasis. Melissa Leeolou, age 26, who was diagnosed with psoriasis when she was just one year old. The past 25 years have not been an easy battle for Leeolou and her parents, the article states. Through many failed treatment attempts and limited treatment options because of her age, hope for a cure was quickly diminishing. That was until a trip to the Israeli desert provided in an unexpected result. The point of the trip was to visit the Dead Sea with hopes that the mineral rich water would provide healing, or at least some relief. Instead, sunlight worked as a healing agent for Leeolou’s aggressive psoriasis.

While many patients worry about the effects of too much sun exposure, these fears can be put at ease with the use of prescription phototherapy. Providing “medically supervised exposure to UV light – which provides the benefits of sunbathing while minimizing its risks – can serve as a powerful tool in the treatment of psoriasis.” Doctor Joel Gelfand, M.D., a major proponent for phototherapy has found that the patients who undergo the proper treatment regimens of light therapy typically experience great results. He goes on to say that “light therapy is considered to be the safest way to treat psoriasis because you’re treating from the outside in.”

Conversely, biologic alternatives require intensive monitoring for side effects and increase patients’ risk of infection. The combination of phototherapy’s low risk safety profile, and the dangers associated with other forms of therapy make phototherapy “the most commonly favored first-line intervention for healthy adults.”

Nancy Renner shared about her scalp psoriasis and the emotional sacrifice she had to make in order to receive treatment. She had always had long hair, until the psoriasis plaques on her scalp started to make her hair fall out. Renner had also noticed improvements in the plaques on affected areas of her body after going on a sunny vacation. When her dermatologist recommended phototherapy, she was pleased to find that “after just 10 days and a few light treatments, her wounded scalp had healed of all lesions.”

Clearly, phototherapy can provide positive results and treat psoriasis with very few associated risks. However, there are limitations that come with clinical-based treatments, such as distance to and from the clinic, office hours, and missed time at work or school. To combat those restrictions, home phototherapy is growing in popularity as an option that provides the same results as treatments in a doctor’s office yet reduces the amount of time spent traveling to the doctor, the cost of co-pays for each appointment, and offers patients more convenience and flexibility in treatment schedules. Each patient case is unique, but “it’s great to have phototherapy as a first-line intervention.”

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