The U.S. Federal Drug Administration approved the XTRAC laser for psoriasis therapy in 2009. The XTRAC is a small handheld device that your dermatologist can use in the office.
This laser concentrates a single band of ultraviolet B (UVB) light on psoriasis lesions. It penetrates the skin and breaks the DNA of the T cells, which are what have multiplied to create psoriasis plaques. The 308-nm wavelength was found to be the most effective in clearing psoriasis lesions.
XTRAC laser therapy is said to clear up mild to moderate plaques from psoriasis faster than natural sunlight or artificial UV light. It also requires fewer therapy sessions than some other treatments. This reduces the cumulative UV dose.
Because it’s a concentrated light source, the XTRAC laser can focus only on the plaque area. This means it doesn’t affect the surrounding skin. It’s also effective on areas that are hard to treat, such as the knees, elbows, and scalp.
Treatment time can vary depending on your skin type and the thickness and severity of your psoriasis lesions.
With this therapy, it’s possible to have long remission periods in between outbreaks.
One 2002 study reported that 72 percent of participants experienced at least a 75 percent clearing of psoriasis plaques in an average of 6.2 treatments. About 50 percent of participants had at least 90 percent of their plaques clear after 10 or fewer treatments.
Although XTRAC therapy has been shown to be safe, more long-term studies are necessary to fully assess any short- or long-term effects.
Mild to moderate side effects are possible. According to the same 2002 study, almost half of all participants experienced redness after the treatment. Approximately 10 percent of the remaining participants had other side effects. Researchers noted that participants generally tolerated the side effects well and that no one dropped out of the study because of side effects.
You may notice the following around the affected area:
- a burning sensation
- an increase in pigmentation
Risks and warnings
No medical risks have been identified. The American Academy of Dermatology (AAD) recommends this treatment for both children and adults with mild, moderate, or severe psoriasis covering less than 10 percent of the body. Although no studies have been performed on pregnant or nursing mothers, the AAD regards this therapy as safe for women in these groups.
If you’re highly sensitive to light, your doctor may use a lower dose during treatment. Some antibiotics or other drugs can increase your photosensitivity to UVA, but the XTRAC laser operates only in the UVB range.
This treatment isn’t recommended for people who have lupus or xeroderma pigmentosum. If you have a suppressed immune system, a history of melanoma, or a history of other skin cancers, you should also proceed with caution and discuss your options with your doctor.
Another type of laser treatment, the pulsed dye laser (PDL), is also available to treat psoriasis lesions. The PDL and XTRAC lasers have different effects on psoriasis lesions.
The PDL targets the tiny blood vessels in the psoriasis lesion, whereas the XTRAC laser targets T cells.
For some people, PDL may be effective with fewer treatments and with fewer side effects.
Most medical insurance companies cover XTRAC laser therapy if it’s considered medically necessary.
Aetna, for example, approves XTRAC laser treatment for people who haven’t responded adequately to three months or more of topical skin cream treatments. Aetna considers up to three courses of XTRAC laser treatment per year with 13 sessions per course may be medically necessary.
You may need to apply for prior approval from your insurance company. The National Psoriasis Foundation can help with appealing claims if you have been denied coverage. The foundation also offers help in finding financial assistance.
Treatment costs can vary, so you should check with your doctor on the per treatment cost.
You may find that the XTRAC laser treatment is more expensive than the more common UVB treatment with a light box. Still, the higher cost may be offset by a shorter treatment time and longer remission period.
If your doctor recommends XTRAC laser therapy, it’s important to stick to your treatment schedule.
The AAD recommends two to three treatments per week, with at least 48 hours in between, until your skin clears up. On average, 10 to 12 treatments are usually necessary. Some people’s condition may improve after a single session.
The remission time after treatment also varies. The AAD reports that 55 percent of patients who had maintenance therapy for a month with the number of treatments and the dose tapering off were in remission after a year.