The Excimer Laser offers a revolutionary new treatment for patients suffering from vitiligo, white stretch marks, white scars, lightening of the skin from previous laser treatments, trauma, or other causes. This laser uses a carefully focused beam of light delivered through a sophisticated fiber optic device. The Excimer system allows the practitioner to use high doses of UVB light necessary to only treat the lighter skin, while minimizing the risk of exposure to the healthy, pigmented skin. Remissions are expected to last months to even years.
- Treats vitiligo
- Treats white stretch marks
- Treats white scars
- Treats lightening of the skin from previous laser procedures
- Provides long-lasting relief
- Quick, easy treatment: sessions last only a few minutes
- Relief without messy creams and daily skin care regimen
- Other benefits include: reduction of psoriasis, eczema, atopic dermatitis
UVB Therapy, PUVA Therapy, Steroid Creams, and New Elidel and Protopic Creams.
The Excimer excimer laser system is light-years ahead of other vitiligo treatments. Using a carefully focused beam of laser light delivered through a sophisticated fiber-optic delivery system, the Excimer system is designed to repigment unsightly lighter skin tones. Because it concentrates light on active lesions, Excimer allows your doctor to deliver the high-exposure doses necessary, without risk of damage to healthy skin. On the first visit, your physician will test your skin to determine your optimum dosage level. Then the Excimer hand-piece is moved over the affected area, applying laser light at your determined dose. Depending on the area to be treated this only takes a few minutes.
Most skin tones.
Each case is unique, but patients who have experienced Excimer treatments have found that relief can last for extended periods of time. Remissions are expected to last at least as long as with conventional phototherapy, but you will probably need fewer treatments per year to remain free of symptoms.
The laser has been proven to be safe when used properly. The specific risks and the suitability of these procedures for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Blistering, change of pigmentation and scarring is very rare.
None Usually. Treated areas are often pink for a few days.
Most patients feel no pain or discomfort during the short Excimer treatment sessions. A few report feeling a warm sensation, like a mild sunburn, at the site of the lesion. No anesthesia is necessary. Not only is the Excimer treatment free of pain, it has few of the drawbacks often associated with other treatments, such as premature skin aging, skin thinning or resistance to medication. And the XTRAC system can be used successfully on hard-to-treat areas of the body or face.
None.
Avoid excessive sun exposure.
Dr. Berman, Physician Assistants and Registered Nurses.
Most PPO Insurance Considers Phototherapy a Covered Benefit: Call Us To Inquire.
Phototherapy for vitiligo is beneficial
because it can target large areas of skin without the side effects of oral or
topical medications. During phototherapy sessions, a machine emitting rays of
narrow band UVB (NB-UVB) light is directed at the area of the body being treated.
A session takes only a few minutes, and patients can receive treatment several
times a week. Other phototherapy options such as PUVA therapy have been well
described for vitiligo; however, its limitations include nausea and light sensitivity
reactions, as well as long-term skin cancer concerns. Today, NB-UVB phototherapy
is a wonderful alternative for patients with fairly extensive disease. NB-UVB
has proven to be one of the most effective treatment options for thousands of
patients all over the world.
- NB-UVB is a useful and well-tolerated treatment option for patients with
vitiligo. Over many treatment sessions, patients see reduction or complete
elimination of white patches.
- Clinical studies show the peak therapeutic effectiveness of UVB to be
within the range of 295-313 nm, but wavelengths below 300 nm can cause redness
or severe burning and increase the risk of skin cancer.
- NB-UVB virtually eliminates superfluous and harmful UV by emitting only
wavelengths 311-312 nm. (Conventional broad-band UVB lamps emit a variety
of wavelengths ranging from 280-330 nm).
- Eliminating UV in wavelengths below 311 nm permits higher intensities
and longer exposure times, so patients can derive the maximum benefit from
phototherapy.
- The increased effectiveness permits even more aggressive treatment approaches,
resulting in a shorter course of treatment.
- Published research papers confirm that patients not only avoid the danger
of serious burning from sub-erythemal exposure, they may also enjoy longer
remission periods after treatment.
- Remission periods are similar to those with PUVA therapy and markedly
superior to broad band or conventional UVB treatment. Studies show 38-40
percent of NB-UVB treated patients require no additional therapy for at
least 12 months.
Non-surgical first line options
include excimer laser treatment, topical corticosteroid creams, topical immunomodulators
(Protopic or Elidel), oral or topical psoralens plus ultraviolet A (PUVA), conventional
broad band UVB phototherapy. Surgical modalities consist of skin transplantation
from an unaffected area of the body to the affected area, including split-thickness
epidermal grafting, grafting of cultured melanocytes, and epidermal blister
grafting.
Patients stand in a phototherapy
unit (Houva 11) containing a bank of 48 fluorescent tubes with peak emission
at 311 nm. For limited hand or foot disease, patients sit with the affected
areas placed in a specific hand and foot device. Therapy is administered 2-3
times a week, on nonconsecutive days. Affected segments of the skin are exposed
during each treatment. A predetermined starting dose of light is administered,
with subsequent increases of approximately 10-15% for each treatment. If the
patient reports mild redness or itching, the irradiation dose is held constant
for the subsequent treatment, or until resolution of symptoms. If burning, pain
or blistering develops, the irradiation dose is decreased by 10-15%. Once 75%
repigmentation is achieved, the frequency of treatments is tapered to twice
a week for 4 weeks, then weekly for 4 weeks. Lesional photography is often performed
at the initial pretreatment visit and periodically thereafter.
All patients with vitiligo who
do not have a contraindication for light therapy, (such as lupus, or other photosensitizing
diseases) may undergo this therapy. Smaller areas of vitiligo can alternatively
be treated with the excimer laser.
Reduction or complete elimination
of white vitiligo patches.
Adverse side effects are rare.
Redness and itching can occur, and resolves spontaneously. Blistering, exaggerated
increased pigmentation and scarring are possible though rare. Proper eye protection
is required during treatments. The specific risks and the suitability of these
procedures for a given individual can be determined only at the time of consultation.
All procedures have some degree of risk. Minor complications that do not affect
the outcome occur occasionally.
Usually none. Many patients may
have some pinkness of the skin for a few days.
No.
None.
Avoid excessive sun exposure for
a few days after the procedure.
Physicians, Physician Assistants,
Registered Nurses and Medical Assistants
