Home Phototherapy for Psoriasis: Evidence and Implementation.

INTRODUCTION

Home phototherapy for psoriasis is non-inferior to office-based care, yet adoption remains limited by implementation barriers, inconsistent patient selection, and underrecognized safety gaps. This narrative review synthesizes recent evidence to address these gaps and provide actionable clinical guidance.

METHODS

PubMed and Embase were searched for studies published between January 1, 2020, and March 1, 2026, yielding 12 included studies. Study types included randomized controlled trials (RCTs), observational studies, cost analyses, implementation reports, and technical device comparisons; findings are interpreted by study design without formal risk-of-bias assessment.

RESULTS

The LITE randomized trial demonstrates that home narrowband ultraviolet B (NB-UVB) phototherapy is non-inferior to office-based treatment in patients with plaque and guttate psoriasis, with high satisfaction, improved adherence, and reduced indirect costs. Erythema was the most common adverse event and rarely led to discontinuation; long-term safety data remain limited.

CONCLUSION

Home phototherapy is safe and effective for appropriately selected patients with plaque or guttate psoriasis and represents an underutilized, cost-effective alternative to office-based care. This review identifies three gaps that must be addressed to realize its potential: absence of long-term UV exposure and skin cancer data, equity barriers that may paradoxically limit access for the patients who stand to benefit most, and uncharacterized safety risks of over-the-counter devices. Closing these gaps through prospective safety studies, equity-centered implementation, and regulatory oversight will be essential to establishing home phototherapy as a widely accessible, evidence-based standard of care.