Goeckerman Therapy

About

Goeckerman Therapy is used to treat skin conditions such as psoriasis in an inpatient setting. This therapy is a safe and effective alternative for patients that have tried oral and topical medications with little to no clinical success. 

Traditionally, the therapy involved a combination of ultraviolet (UV) radiation (specifically Broadband UVB Phototherapy) and crude coal tar(CCT). However, over the years, various institutions like the Florida Academic Dermatology Center at Larkin have adapted the treatment to conform to the unique needs of each patient. For example, we’ve replaced the traditional CCT with liquid carbonis detergens (LCD) (a modified form of tar mixed with Vaseline and Petrolatum) and the Broadband UVB with Narrowband UVB Phototherapy which have led to effective clinical outcomes.

The therapy has a demanding treatment regiment but results in an extended period of remission, increased patient satisfaction and quality of life, decreased psychosocial distress, and long term cost-effectiveness. On average the patient can expect to stay 5-7 days in the hospital.

The Full Goeckerman Treatment

1. Each session begins by applying liquid carbonis detergens (LCD) to the body, extremities, and scalp. The patient remains like this for 2 hours until the application is wiped off with mineral oil. LCD is applied before Phototherapy (step 2) because psoriasis results in scaly patches that reflect light (thereby minimizing the effectiveness of light therapy).

2. The patient is treated with Narrowband UVB Phototherapy (light therapy). The patient stands in a large cylindrical container (Houza®II UV Light Machine) that is layered with fluorescent light tubes and their skin is exposed to a specific dose of Ultraviolet (UV) light. 

3. The patient enters our whirlpool (full body immersion tank) where jet-driven water with antimicrobial agents (chemical substances) remove toxic debris, bacteria, and contaminated materials from the tissue.

4. Topical Steroid Ointments are applied to the whole body

5. Four hours following the treatment the physician evaluates if there are symptoms of burning. If not, the process is repeated (maximum 3 times in a day)

Conditions Treated

Psoriasis