Your Skin, Your Schedule: Why More Psoriasis and Eczema Patients Are Turning to Home Phototherapy

If you’re living with psoriasis or eczema, you already know how overwhelming treatment decisions can feel. Biologic medications are often presented as the “gold standard,” but they come with trade-offs: injections, possible immune suppression, high copays, and the stress of coordinating every dose.

Phototherapy, on the other hand, is not new; it’s a tried-and-true therapy that has stood the test of time. What’s exciting today is that it no longer requires two or three trips a week to the dermatologist’s office. Thanks to FDA-cleared home devices, you can now bring the same effective light treatments into your home, with your dermatologist guiding the process.

How Does Phototherapy Work?

Phototherapy delivers targeted light to the skin, reducing inflammation and symptoms like itching, redness, and scaling. It works by calming overactive immune responses and restoring balance in the skin.

The most common type—narrowband UVB (NB-UVB)—is the same light wavelength used in both office and home devices. Unlike biologics or oral medications, it works only on the skin, which means fewer risks for your whole body. And the research backs it up:

• The Light Treatment Effectiveness (LITE) Study—the largest trial of its kind—showed that home phototherapy is non-inferior to office-based treatment. In other words, treating your skin at home works just as well as sitting in the clinic chair.
• Real-world results mirror the trial data. Patients report high satisfaction, greater convenience, and in many cases, the ability to reduce or stop systemic medications.

NB-UVB is one of the safest long-term therapies we have in dermatology. Studies have confirmed effectiveness in children, pregnant patients, and older adults. Side effects of phototherapy are usually limited to mild redness, itching, or dryness—generally self-limiting. Most studies show no increased cancer risk for NB-UVB in patients treated for psoriasis and eczema.

Psoriasis: Evidence for Phototherapy

For psoriasis, phototherapy is considered a first-line treatment for moderate disease. NB-UVB is the most widely used and most effective type. Compared to older broadband UVB methods, it clears plaques faster and often leads to longer remission. Phototherapy can also be safely combined with topical or systemic treatments when needed.

Eczema: Where Phototherapy Fits

In eczema (atopic dermatitis), phototherapy is typically used when topical creams are not enough. NB-UVB helps calm inflammation, restore the skin barrier, and even reduce infections. In one study, children treated with NB-UVB improved by more than 60%. It is often combined with moisturizers and occasional short courses of steroid creams.

Why Patients Choose Home-Based Phototherapy (HBPT)

Home phototherapy not only addresses the time and access barriers of in-office care but also provides unique advantages compared with systemic drugs:

1. Freedom from the grind
In-office phototherapy means hours spent commuting, waiting, and rearranging your life around treatments. Home devices let you treat on your own time, in your own space.

2. Less burden than biologics
No needles, no immune suppression, no monthly pharmacy calls. Just light. That means fewer side effects and less stress over lab work or infection risks.

3. Lower costs
Biologics can cost $60,000–$70,000 per year. Home devices are a one-time investment—typically $700–$2,400 over several years. That’s a fraction of the cost, especially when insurance helps cover it.

4. Treatment flexibility
Psoriasis and eczema aren’t static. Home phototherapy can be your first step before starting biologics—or a way to take breaks from systemic drugs once your skin is under control.

Real-World Impact

Studies show that HBPT isn’t just clinically effective—it’s practical for everyday patients:

• At the University of Rochester, nearly 90% of patients using home phototherapy reported improvement—and most preferred it to biologics because it felt safer and easier to manage.
• A Kaiser Permanente study found that one-quarter of patients on systemic medications were able to discontinue them within 150 days of starting home phototherapy.
• Health plans that expand access to home phototherapy project hundreds of millions in savings from avoided drug spending, all while maintaining disease control.

Why Haven’t More Patients Tried It?

The biggest barrier isn’t effectiveness—it’s access. Insurance coverage is inconsistent, and too often patients are steered toward expensive biologics first.  Most dermatology clinics are optimized for starting patients on biologics but not for initiating home phototherapy. As a result, many patients never hear about it as a real option. Raising awareness and improving insurance support could help thousands of people find a safer, more sustainable path.

At Zest, we take a chronic disease approach that makes all treatment options accessible. That means walking you through your choices, helping you navigate insurance, and monitoring you closely to ensure your treatment plan works for the long haul. Raising awareness and improving coverage could help thousands of people find a safer, more sustainable path.