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Comparative Effectiveness Review of Laser Therapy for Psoriasis

April 25, 2019

Health Problem: Psoriasis is an immune-mediated disease of the skin that affects 7.5 million people in the United States and is characterized by the appearance of red, thickened, scaly patches on the skin.

Technology Description: Laser therapy typically involves passing a focused laser beam back and forth over the entire area of a psoriasis lesion. In some protocols, cool air is applied during laser exposure to prevent excess buildup of heat. Single or multiple treatments may be given at a fixed dose or escalating doses and a full course of therapy can take several months. The duration of treatment is often determined by the occurrence of adverse side effects (e.g., hyperpigmentation, blistering) or by a positive response such as complete plaque clearing.

Controversy: Multiple treatment options for psoriasis are available, including topical or oral medications, light therapy, and laser therapy. Medications may have side effects and light therapy requires multiple treatment sessions per week for 2 to 3 months, followed by maintenance treatments. Laser therapy is nonpharmacological and requires fewer treatment sessions than light therapy, but the comparative effectiveness and safety of laser therapy relative to other options is uncertain.

Key Questions:

  • Is laser therapy an effective treatment for psoriasis and, if so, does efficacy depend on type of laser utilized?
  • How does laser therapy compare with other treatments for psoriasis?
  • Is laser therapy for psoriasis safe?
  • Have definitive patient selection criteria been identified for laser therapy for psoriasis?