Psoriasis patients who practiced meditation-based relaxation while undergoing ultraviolet (UV) light treatments experienced quicker clearing of their skin lesions than did patients who received UV treatments alone, according to results of a small, randomized controlled trial.
Use of relaxation techniques could speed the rate at which psoriasis clears and cut the number of treatment sessions, potentially decreasing the risk of skin cancers associated with UV light therapy and reducing the total cost of treatment, Jon Kabat-Zinn, PhD, and colleagues at the University of Massachusetts Medical School report in the September-October issue of Psychosomatic Medicine.
The research team randomly assigned 19 psoriasis patients to listen to relaxation tapes during their UV light treatments and 18 patients to complete the UV treatments with no relaxation tapes. Patients received approximately 40 treatments, either with ultraviolet B (UVB) or the photosensitizer psoralen plus ultraviolet A (PUVA), over 13 weeks. The relaxation tapes were designed to increase patients' "mindfulness," an ancient Buddhist meditation practice described as moment-to-moment non-judgmental awareness.
Kabat-Zinn developed this clinical use of meditation 20 years ago at the Stress Reduction Clinic of the University of Massachusetts Medical Center. The approach, known as mindfulness-based stress reduction (MBSR), is now used by some 240 hospitals and medical centers as well as in schools, prisons and inner city clinics.
The tapes instruct patients to become more aware of their breathing and other body sensations and encourage them to visualize the UV light slowing down the growth and division of their skin cells. In previous research, the technique has been shown to reduce symptoms in patients with chronic pain and reduce anxiety levels in others.
Twenty-three patients completed the study; 19 achieved clearing of their psoriasis lesions and four did not. The researchers found that lesions were cleared significantly more rapidly for those who heard the relaxation tapes than for those who did not.
Among those who received UVB treatments, the median time for the lesions to clear was 84 days for those who heard the tapes and 98 days for those who did not. For those who received PUVA, the median time for the lesions to clear was 46 days for those who heard the tapes and 95 days for those who did not. Overall, the rate of skin clearing for those who listened to the tapes was 3.8 times faster than for those using the light treatment alone.
"These results must be interpreted cautiously in light of the small numbers of patients," Kabat-Zinn and his colleagues caution. "Nevertheless, the effect appears robust and attainable in a significant number of psoriasis patients practicing stress reduction exercises."
The precise mechanism for the relaxation techniques' ability to speed clearing of psoriasis lesions is unknown. Psychological stress has long been observed among patients with severe psoriasis and among those with flare-ups of the disease. Emotional stress has been shown to affect a number of immunologic factors, some of which may also be related to the development of the disease.
The research was partially funded by a grant from the Fetzer Institute.
Psychosomatic Medicine is the official peer-reviewed journal of the American Psychosomatic Society, published bimonthly. For information about the journal, contact Joel E. Dimsdale, MD, editor-in-chief, at (619) 543-5468.
Posted by the Center for the Advancement of Health http://www.cfah.org. For information about the Center, contact Richard Hebert rhebert@cfah.org, (202) 387-2829.
Journal
Psychosomatic Medicine