The Food and Drug Administration (FDA) approved the XTRAC excimer laser for psoriasis therapy in 2000. This laser is a handheld device that a dermatologist can use in their office.

XTRAC works by concentrating a single band of ultraviolet B (UVB) light on psoriasis lesions, penetrating the skin and breaking down the skin cells and T cells that create psoriasis plaques.

It emits a very focused light with a 308-nanometer wavelength, which has been found to be the most effective in clearing those lesions.


  1. Each treatment takes only minutes.
  2. The surrounding skin isn’t affected.
  3. It may require fewer sessions than some other treatments.

XTRAC laser therapy is said to clear up mild to moderate plaques from psoriasis faster than natural sunlight or artificial UV light. It targets specific plaque areas and doesn’t affect the surrounding skin.

It has also been shown to reduce lesions in areas that are harder to treat, including the knees, elbows, and scalp.

XTRAC requires fewer therapy sessions than other psoriasis treatments. This helps reduce the total UV dose administered to a patient, and decreases the possibility of damage to the skin.

The amount of time it takes to undergo full treatment with XTRAC varies depending on a person’s skin type and the thickness and severity of their psoriasis lesions.

With XTRAC, it’s possible to have long remission periods between outbreaks.

In a 2020 study published in the Journal of Drugs and Dermatology, the XTRAC laser (used with a new diagnostic tip) was found to be fast, safe, and more effective than most other existing options for treating psoriasis, including topical medications and traditional forms of phototherapy.

The study showed that XTRAC takes about 5 to 7 weeks to visibly reduce psoriasis plaques, compared to three months or more for some biologics and systemic treatments. With its laser, remission from psoriasis also lasts longer, stretching 2.5 to 6 months between treatments without requiring maintenance visits.

Another study conducted in 2020 concurred with the first finding. It showed that 92% of its subjects reduced the severity of their psoriasis plaques by at least 75% after 5 to 7 weekly sessions with the XTRAC laser when used at an optimal therapeutic dose.

If you choose to use the XTRAC laser as a form of treatment, ask a healthcare professional about ways to speed up healing after each session. Some people find that putting mineral oil on their psoriasis before treatments or using topical medications along with the XTRAC laser can help with healing.

Some people who use XTRAC will experience mild or moderate side effects. In a 2016 study, researchers described it as “well-tolerated with minimal side effects,” among them blistering and patches of tender, discolored, or hyper-pigmented skin.

These results agree with those of other studies, including an older one in which researchers noted that no participants dropped out of the study because of side effects.

When you receive XTRAC treatment, you may notice the following around affected areas:

  • darkening of the skin
  • blistering
  • itchiness
  • a sunburned sensation


  1. You shouldn’t use this treatment if you also have lupus.
  2. You shouldn’t try this therapy if you also have xeroderma pigmentosum.
  3. This may not be the best treatment for you if you have a history of skin cancer.

No medical risks have been identified. In their joint guidelines of care, the American Academy of Dermatology (AAD) and the National Psoriasis Foundation (NPF) have said this treatment is suitable for both children and adults with mild, moderate, or severe psoriasis covering less than 10% of the body.

Although no studies have been performed on people who are pregnant or breastfeeding/chestfeeding, the AAD regards “narrowband” UVB therapy such as XTRAC as safe for 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 UV light.

XTRAC 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 a healthcare professional.

Another type of laser treatment, the pulsed dye laser (PDL), is also available to treat plaque and nail psoriasis.

The PDL and XTRAC lasers work in different ways. The PDL targets the tiny blood vessels in the psoriasis lesion, whereas the XTRAC laser targets T cells.

For some people, PDL may be more effective with fewer treatments and with fewer side effects.

According to one study, XTRAC can cost between $1,027 and $6,934 for three treatment cycles per year. That’s much less expensive than the cost of many biologics and other forms of narrowband therapy.

While certain medications (like methotrexate) are more affordable, they may take longer to work.

Most medical insurance companies will cover XTRAC if it’s considered medically necessary.

Aetna, for example, approves XTRAC laser treatment for people who haven’t responded adequately to 3 months or more of topical skin cream treatments.

Assuming it’s deemed medically necessary, the company will cover up to three courses of XTRAC laser treatment per year, with 13 sessions per course.

You may need to apply for prior approval from your insurance company. The National Psoriasis Foundation provides a letter template that you can use to appeal claims if you’re denied coverage.

Treatment costs sometimes vary. Always check with a healthcare professional to find out how much you might need to pay before you begin treatment.

If your healthcare professional recommends XTRAC, stick to your treatment schedule.

The AAD and NPF guidelines recommend two to three treatments with an excimer laser per week. On average, 10 to 12 treatments are usually necessary. Newer iterations of XTRAC take less time to work.