My Experience Using Phototherapy to Treat Psoriasis

Psoriasis has a special talent: it shows up on the exact day you want to wear shorts, shake hands,
or pretend you’re “low-maintenance.” After years of playing treatment whack-a-moletopicals, lifestyle tweaks,
“maybe it’s this soap,” “maybe it’s that stress,” “maybe I should move to a humid rainforest”I finally tried
phototherapy (light therapy). Not “vibes-only” light. Medical, controlled, dermatologist-supervised ultraviolet
light.

Quick honesty check: I’m not your clinician, and this article isn’t medical advice. Think of it as a patient-style
story (with real-world details) based on how phototherapy is commonly prescribed and what many people report
experiencingplus the unglamorous logistics nobody mentions until you’re sprinting to an 8-minute appointment
like it’s an Olympic event.

Why I Chose Phototherapy (and What I Hoped It Would Do)

My psoriasis was the classic “plaque psoriasis” situation: stubborn patches that flared, calmed down, then flared again
like they were subscribed to a monthly newsletter titled Surprise! More Scaling.
I wanted something that could:

• Reduce the inflammation and itching without feeling like I was marinating in ointment 24/7
• Help larger areas (not just one tiny patch) without turning my whole routine into a chemistry lab
• Fit into real lifework schedules, errands, and the basic human need to not live at a doctor’s office

My dermatologist explained that phototherapyespecially narrowband UVBhas a long track record for psoriasis.
The “light” is delivered at specific wavelengths and doses, with careful increases over time based on how your skin reacts.
That “controlled dose” part matters. This is not the same as sitting in the sun until you resemble a tomato with regrets.

Phototherapy 101: The Options I Learned About

Narrowband UVB (NB-UVB)

This was the main option discussed for me. It’s commonly used for moderate-to-severe psoriasis, and it’s typically done
a few times per week in a clinic setting (and sometimes at home with the right supervision and prescription setup).
It doesn’t require taking a light-sensitizing medication.

Broadband UVB

Older-school UVB with a broader range of wavelengths. It can still be used, but narrowband is often preferred because it’s
more targeted and tends to be better tolerated.

Excimer Laser (Targeted UVB)

This is like phototherapy’s precision tool: targeted UVB for specific areas (think elbows, knees, scalp edgesthose “greatest hits”
zones). It can be especially useful if you don’t need full-body treatment.

PUVA (Psoralen + UVA)

PUVA uses UVA light plus a medication (psoralen, often methoxsalen) that makes skin more sensitive to light.
It can be effective, but it’s also more “rules-heavy” (timing, eye protection, sun avoidance afterward), and long-term risk considerations
are part of the conversation. For me, we started with NB-UVB first.

My Pre-Game: The Consultation That Made It Feel Real

The consult was where phototherapy stopped being an abstract “maybe someday” and became a plan with a schedule, expectations,
and a suspicious number of reminders about sunscreen.

We covered:

• My skin type and burn history: How easily I burn affects starting doses and ramp-up speed.
• Medications and photosensitivity: Some meds can make you more sensitive to UV light.
• My psoriasis pattern: Widespread vs. localized changes which light method makes sense.
• Realistic time commitment: “Short appointments” still require travel, parking, and being a functioning adult who shows up repeatedly.
• Safety rules: Eye protection is non-negotiable. Sensitive areas may require shielding. Follow the clinic’s instructions like they’re a recipe for not getting burnedbecause they are.

The clinician also made a point I appreciated: phototherapy is a treatment, not a personality. If it works, great.
If it’s a logistical nightmare or you’re not responding, there are other strategies (topicals, systemic meds, biologics, combination approaches).
That took some pressure off. I didn’t need this to be my “forever solution” to count as a win.

What a Phototherapy Session Actually Looked Like

The Setup

I expected something dramaticlike a sci-fi chamber where a robot dermatologist says “initiating epidermal reboot.”
In reality, it was a clean, private room with a tall light unit (think: vertical tanning booth’s responsible cousin).

The routine was consistent:

1. Check in (sometimes they ask about redness or sensitivity from the last session).
2. Remove clothing as instructed (privacy is respected; you’re not on display).
3. Put on protective goggles (yes, every time).
4. Stand in position. The staff sets the dose/time.
5. Light exposure for a brief periodstarting very short, then gradually increasing over weeks.
6. Done. You leave. No anesthesia. No downtime. Just a strong desire to moisturize.

How Long It Took

The exposure itself was surprisingly quickespecially early on. The first sessions felt almost comically short.
Like: “I drove here… for this?” But that’s the point: dosing starts low to avoid burns, and increases cautiously.

What It Felt Like

During the light exposure: mostly nothing. No pain. No heat wave. Occasionally a faint warmth.
The bigger “feel” came later that day: mild dryness, a little tightness, sometimes a subtle itch shift.
The sensations were less dramatic than I expected, which I consider a feature, not a bug.

My Timeline: When I Started Noticing Changes

Everyone’s response varies, but this was my pattern (and a pretty common one):

Weeks 1–2: “Is This Doing Anything or Am I Just Standing Around in Goggles?”

Early on, I didn’t see fireworks. What I did notice:

• The plaques looked a bit less “angry” after several sessions.
• Scaling started to soften in places where it usually stayed stubborn.
• My skin felt drier overall, which made moisturizing feel mandatory rather than “nice.”

Weeks 3–5: The Turning Point

This is where I started to believe it. My patches began thinningless buildup, less redness.
It wasn’t instant clearance; it was more like watching a storm move out gradually.
The itch also became more manageable, which honestly felt like getting hours of my brain back.

Weeks 6–12: Smoother Skin, Fewer “Bad Days”

By this stage, the change was obvious. Some spots were dramatically improved, others slower.
The most satisfying part wasn’t just appearanceit was the reduction in daily irritation and the way clothes stopped
feeling like sandpaper on certain areas.

The clinician explained that many people do phototherapy in a structured course and then either taper, pause,
or switch to maintenance depending on results and recurrence pattern.

Side Effects I Dealt With (and How I Handled Them)

Dryness and Itch

Dryness was my most consistent side effect. My solution was not glamorous:
thick moisturizer after showers, fragrance-free products, and applying it like I was paid by the ounce.
A simple routine mattered more than fancy products.

Redness (the “Did I Overdo It?” Anxiety)

Mild redness happened occasionally, especially as doses increased. The clinic asked about redness after each session
because it helps them adjust safely. If you get significant burning, blistering, or pain, that’s not a “push through it”
momentthat’s a “call the clinic” moment.

Life Logistics Side Effect: Scheduling Fatigue

Nobody lists this on the pamphlet, but it’s real. Going multiple times per week can feel like adding a part-time job
called “commuting to a box of light.” It helped when I:

• Booked standing appointments at the same times each week
• Kept a “phototherapy bag” ready (goggles were provided, but I kept my own moisturizer and lip balm)
• Stacked errands nearby so the trip felt worthwhile

What I Wish I’d Known Before Starting

1) Moisturizing Isn’t Optional

If you do phototherapy and keep your old “sometimes I moisturize” habits, your skin may stage a protest.
A consistent, gentle skincare routine made the whole process more comfortable and helped my plaques look better
as they cleared.

2) Consistency Beats Intensity

Phototherapy is not about “blasting” psoriasis into submission. It’s about controlled dosing and steady progress.
Missing sessions didn’t ruin everything, but I noticed the best results when I stayed consistent.

3) Don’t DIY With Tanning Beds

I had heard the “tanning helps psoriasis” myth floating around. The clinical version of light therapy is designed for treatment
and safety. Tanning beds are not. The risks and the radiation profile are different, and dermatologists routinely warn against
substituting indoor tanning for medical phototherapy.

Phototherapy vs. Other Treatments: How I Thought About the Tradeoffs

I didn’t see phototherapy as “better than everything.” I saw it as a tool with a specific best use case:
when topicals aren’t enough, you want a non-systemic option, and you can commit to the schedule.

The tradeoff is obvious: time. Biologics and other systemic medications can be life-changing for many people, especially with more severe
disease or psoriatic arthritis, but they come with their own monitoring needs and decision-making. Phototherapy felt like a middle ground:
clinic-based, structured, and relatively straightforwardif you can make the appointments.

Making It Work in Real Life: Practical Tips That Helped Me

Plan for the boring stuff

• Clothing: Easy on/off outfits saved time and stress.
• Moisturizer: I kept one at home, one in my bag, and one “backup” because I am apparently a squirrel now.
• Tracking: I snapped a quick photo every week in consistent lighting. It helped me notice progress when my brain insisted nothing was changing.
• Communication: If a session left me red for longer than usual, I told the staff. Dose adjustments are normal and smart.

Ask about home phototherapy if clinic visits are hard

If your schedule is tight, home phototherapy may be an option for some patients under a clinician’s guidance.
It’s not “buy a random lamp and freestyle.” It’s prescribed equipment, structured protocols, and safety checksdone at home for convenience.
Not everyone is a candidate, but it’s worth asking about.

Who Phototherapy Might Be Best For (Based on What I Learned)

In plain terms, phototherapy tends to make sense if:

• You have moderate-to-severe plaque psoriasis or stubborn flare patterns
• Topicals alone aren’t cutting it
• You want a non-systemic approach (or a combo plan)
• You can commit to repeated sessions for several weeks

It may be trickier if you have a history of skin cancer, certain photosensitivity conditions, or logistical barriers that make consistent attendance impossible.
That’s where individualized medical advice matters most.

The Bottom Line: Was It Worth It?

For me, phototherapy was worth itespecially once I got past the “weekly schedule grind” phase.
The improvements weren’t just cosmetic. Reduced itching and irritation changed my day-to-day comfort in a way that felt surprisingly emotional.
It’s hard to explain how draining constant skin discomfort can be until it eases up and you realize your brain has been running background noise
for months (or years).

Would I recommend it universally? Nobecause psoriasis isn’t a one-size condition and people’s lives aren’t one-size either.
But if you’re considering phototherapy and your clinician thinks you’re a good candidate, it’s a solid, evidence-based option that can deliver
meaningful relief with a safety-first approach.

Extra Experiences: 500 More Words I Wish Someone Had Told Me

If you’re reading this and thinking, “Okay, but what’s it really like to live through the weeks of light therapy?”here’s the part
that doesn’t fit neatly into medical descriptions.

First: phototherapy taught me patience in a very annoying way. Topical steroids can feel like you’re doing something dramatic right now.
Phototherapy is more like investing. Small inputs, repeated often, and the results show up slowly enough that your brain keeps asking,
“Are we sure this isn’t just… standing?” I had to stop looking for overnight miracles and start looking for trends: plaques thinning, edges
less inflamed, fewer flakes after showers, less itching when I wore tighter clothing. The wins were subtle before they were obvious.

Second: the routine reshaped my week. I started treating sessions like a non-negotiable appointmentsame way you’d treat picking up a kid from school
or showing up to work. I set recurring calendar reminders, kept a “go-bag,” and chose clothing that didn’t require a gymnastics routine to remove.
I also learned to schedule sessions at times when I wouldn’t be tempted to skip: either first thing in the morning (before excuses spawn)
or during a predictable lunch window. Phototherapy isn’t hard physically, but it’s easy to abandon when life gets loud.

Third: moisturizing became the unsexy hero. I thought the light was the star of the show. In reality, moisturizer was the supporting actor that kept
the whole production from collapsing. When my skin got dry, plaques looked worse even if they were improving underneath. When I moisturized consistently,
the same areas looked calmer, felt less tight, and shed less. It also helped me avoid scratchingbecause sometimes what feels like a “flare” is actually
dryness plus irritation plus stress making everything louder.

Fourth: I became weirdly protective of my progress. I started caring more about sleep, stress, and gentle skin care because I didn’t want to sabotage
the momentum. I wasn’t perfectstress is not a subscription you can cancelbut I noticed that when I was run down, my skin looked more reactive.
The therapy didn’t magically make me Zen. It just made me more aware of the patterns: big stress week, worse itch; consistent routine, steadier skin.

Finally: the biggest surprise was emotional. When the plaques softened and the redness faded, I felt lighterlike I’d been carrying an invisible backpack
of discomfort and self-consciousness. I stopped scanning my body before social plans. I stopped planning outfits around coverage. My skin wasn’t “perfect,”
but it was quieter. And quiet skin, it turns out, is a kind of peace.