Physicians

The only controlled, connected, and comprehensive solution to treat and monitor patients at home

Predictable and Precise Prescription Dosing

Our single-button, pre-programmed, handheld device effortlessly guides patients through treatment. Our smartphone app manages treatment dosing, frequency and duration in strict adherence to your prescription, based on the AAD/NPF Guidelines and Vitiligo Working Group. Over 95% of patients say Zerigo is easy to use.

Continuous Patient Support

Zerigo Health CarePartners act as the first line of support, providing patients with both technical and treatment support and encouraging treatment adherence with automated reminders and personal contact. All therapy records, including photographs, are HIPAA-compliant and available for you and your patient.

Safe, Standard-of-Care Treatment

Zerigo is FDA-cleared and delivers NB-UVB light, a proven, standard-of-care treatment for chronic skin conditions that is part of published protocols endorsed by major medical societies, including the American Academy of Dermatology, Vitiligo Working Group and the National Psoriasis Foundation.

Improved Practice Efficiency

Zerigo frees your office space and staff to provide other services and procedures while enhancing satisfaction and loyalty for patients with chronic skin conditions.We manage all administrative and billing services, plus patient training, ongoing support, and appointment reminders.

We follow your notification and communication preferences, alerting you to issues such as missed treatments, low satisfaction or complications/side effects.

Visible Results

Zerigo makes it easy for you and your patients to access treatment records, photos, and patient reported outcomes on demand.

  • Psoriasis patients demonstrated results comparable to in-office phototherapy.2
  • A recent study found a 57% mean improvement in the psoriasis severity index (PSI).3
  • 100% of psoriasis patients experienced full lesion clearance when Zerigo was combined with topical steroids.4
  • Vitiligo patients showed improvements in re-pigmentation in as little as four weeks.5
  • Eczema patients may see faster results and reduce or eliminate the need for topical steroids.
Affordable

Zerigo assists patients in obtaining insurance coverage. When not covered by insurance, the Zerigo Health Solution may be covered under FSA or HSA plans. We also offer convenient payment plans.

Highly Satisfied Patients

81% of patients in a recent survey6 rated their Zerigo experience as good, great or life-changing.

Indications and Contraindications

Zerigo narrowband (NB-UVB) therapy is FDA cleared for the treatment of vitiligo, psoriasis, eczema, seborrheic dermatitis and leucoderma on all skin types (I-VI). Usage requires a physician prescription.

Please consider the risks in treating those with lighter skin, taking light-sensitizing medications, and/or taking immunosuppressive agents (such as azathioprine and cyclosporine) with markedly increased risk of UV-induced skin cancers.

Downloadable Forms

For more information on the Zerigo Health Solution, including how to prescribe for your patients, please contact a Zerigo Representative by emailing support@zerigohealth.com or calling 877-738-6041.

Footnotes

 

  1. Yule S, Sanyal S, Ibbotson S et al. Self-administration of hospital based narrowband ultraviolet B (TL01) phototherapy: a feasibility study in an outpatient setting. Br J Dermatol 2013; 169:464–8.
  2. Efficacy study using Clarify System (Unrue E, et al., A novel ultraviolet B home phototherapy system: Efficacy, tolerability, adherence, and satisfaction. Dermatology Online Journal 2019; 25(2)
  3. Unrue ibid.
  4. Data on file.
  5. Zerigo 2020 patient survey.

Frequently Asked Questions

The Zerigo Health Solution

How do I engage with the Zerigo solution?

We’re here to be your partner in providing high-quality, convenient care that adjusts to meet different patient and practice needs. In fact, we’ve designed the Zerigo Health Solution to be hassle-free for physicians. The only thing you must do to start one of your patients on Zerigo therapy is submit a one-page prescription, and we’ll take care of the rest—including checking benefits, submitting medical insurance claims for the Zerigo device, monitoring and supporting your patients, and following up with you with summary progress reports. We’ll ask you to provide us with your notification and communication preferences—we’ll be sure to get in touch with you only when and how you prefer.

What are my responsibilities?

We appreciate your help in selecting patients who are likely to succeed with home phototherapy. Home-based, self-administered care is not for every patient. The greatest success is achieved by motivated individuals who are willing to dedicate daily time to self care. They are comfortable using smartphones, and patience and realistic expectations of therapy are key to high patient satisfaction. While the Zerigo CarePartner team is there to coach and support your patients throughout their treatment journey, we may need to engage you to assist us in emphasizing the importance of adherence to achieve positive results.

Although there are few absolute contraindications to phototherapy, such as history of light sensitivity and genetic skin cancer conditions, relative contraindications include history of skin malignancy, photo-aggravating conditions and prior poor response to phototherapy. Please consider the risks in treating those with lighter skin, taking light-sensitizing medications, and/or taking immunosuppressive agents (such as azathioprine and cyclosporine) with markedly increased risk of UV-induced skin cancers.

We’ll ask for you to provide us with your notification and communication preferences—we’ll be sure to get in touch with you only when and how you prefer.

What is the reimbursement for my practice for prescribing home phototherapy?

Prescribing the Zerigo Health Solution is similar to prescribing a medication. No Current Procedural Terminology (CPT) code would be indicated.

Will patients be reimbursed for the cost of the equipment?

Many insurers cover home phototherapy devices. The Zerigo Health Solution is currently covered by TriCare, Medicare, MultiPlan, and BCBS Massachusetts. The Zerigo Health Solution also may be covered under your patient’s flexible spending account (FSA) or health savings account (HSA).

A Zerigo Health Representative will work with your patients to collect the necessary information, and file claims on their behalf.

If insurance coverage is not available, we also offer a number of other payment methods, including convenient payment plans, to make the Zerigo Health Solution available for all patients.

What role does the CarePartner play and how does this service help me?

Our goal is optimum service to your patients and to you, which will lead to optimum outcomes. The CarePartner support team educates patients about home phototherapy, fosters optimal and effective home treatment, and monitors for adherence and early signs of non-responsiveness or worsening. You select how and when you want us to notify you of issues such as burns, missed treatments, worsening and poor satisfaction with treatment. We remind patients of follow-up appointments with you and need for skin cancer screening surveillance. CarePartners DO NOT practice medicine.

Device

Why were light emitting diode (LED) bulbs used instead of traditional mercury halogen bulbs?

LEDs are smaller and lighter than traditional bulbs, enabling us to develop a compact, battery-operated device. Additionally, LEDs have performance improvements compared to traditional bulbs including elimination of warm-up times, output degradation and replacement parts. LEDs are also environmentally-friendly as they don’t contain mercury which is present in fluorescent bulbs.

How are you able to provide Narrowband UVB output using LED bulbs?

Both our LED technology and traditional mercury halogen bulbs produce light across the therapeutic spectrum of 300-320nm. Mercury halogen bulbs produce a series of peaks with the largest at 311nm, whereas our LEDs produce a single peak around 310nm with a broader spectrum. Although there are slight differences in the spectrum, our devices have been calibrated using a NB-UVB scale, so that customary NB-UVB protocols can be used.

How does treatment with the Zerigo Health Solution compare to in-office treatment?

The Zerigo Health Solution delivers targeted phototherapy; only the affected areas are treated. The Zerigo Health Home Phototherapy Device delivers a high intensity dose, so treatment times may be shorter than in-clinic treatments, depending on the size of the areas treated.

How long are treatment times?

Treatments may take seconds to minutes to deliver depending on skin color, diagnosis, affected body surface area to be treated, and the stage of therapy. As treatment progresses, dosage is often increased to speed healing (in accordance with your prescribed protocol), which adds to overall treatment time. Those with relatively small, scattered areas of involvement or who want additional control for problem areas when taking combination therapies are good candidates for the Zerigo Health Solution.

Why is the device the size that it is?

The device size was designed based on patient input and studies reporting high prevalence of small, scattered lesions in patients with psoriasis, and to support early treatment during onset for patients with vitiligo. When possible, most patients favor a targeted approach which directs therapy to only the affected skin, limiting exposure to the otherwise healthy surrounding skin.

Why does the device enable treatment of different body locations with different doses?

There is a large variability between the optimal dose for different body locations. Body locations that have thicker skin or are darker will tend to have optimal treatment at higher doses. The Zerigo Health Solution automatically optimizes the treatment doses for each body location, based on patient response in the Mobile App, in accordance with the prescribed protocol.

Mobile App

Why does the Zerigo Solution require a smartphone app?

The Zerigo Health Mobile App is the connection between your prescription, our cloud-based software and the handheld device. The Mobile App controls dosing in accordance with your prescription, and enables patients to schedule treatments which fit into their schedules, delivers treatment reminders to encourage adherence, asks patients to track their progress with weekly Progress Checks (including photos), and enables real time communication with CarePartners to support them on their treatment journey.

What are the phone requirements to support the Zerigo Health Mobile App and device?

The most recent versions of Android (Version 8.0+) and iPhone iOS (Version 11.0+) are supported. Your phone must have at least 50 MB of available storage.

Can the Zerigo Health handheld act independently of the mobile app?

No, the Zerigo device is a part of a connected treatment management and monitoring system that requires connection to the Mobile App.

How will my patient know how and when to adjust the dose?

Your prescription protocol is always available for your patient and CarePartner to view. We’ve taken the protocol and translated it into a user-friendly, smart, personalized treatment plan, automatically managed through Zerigo’s proprietary software. We educate patients on the principles of phototherapy and ensure understanding about the dose adjustment process.

Why does the Zerigo Health Mobile App need to access my patient’s calendar?

Patients are able to select treatment days and times that work best for them and are based on your prescribed protocol. Schedule management features within the Mobile App include reminders for light therapy treatments and follow-up visits with you.

Why does the Zerigo Health Mobile App need to access the patient’s camera?

As the old adage goes, “An image says a thousand words.” Photos are the best way to record condition progress. Patients are prompted to regularly document skin lesions, so progress may be viewed easily over time.

How are outcomes measured?

Physicians and patients are the ultimate judges of outcomes—both for clinical results and for quality of life. Zerigo Health provides a wealth of helpful information about treatment and patient response, including photos of treatment locations throughout the phototherapy regimen as well as patient-reported healing progress and treatment satisfaction ratings.

Patient Consultation

Who is the ideal patient?

Those who have psoriasis, vitiligo, eczema or other chronic skin conditions that respond to light therapy are potential candidates for our service. Those with relatively small, scattered areas of involvement or who want additional control for problem areas when taking combination therapies are good candidates for the Zerigo Solution.

Patients must have a smartphone with a recent Android or iOS operating system (Android Version 8.0+ and iPhone iOS Version 11.0+), and must be able to reach treatment areas or have someone who can help.

Motivation and adherence to the treatment regimen are paramount to achieving positive results, so screening for these factors is also recommended.

How can I prescribe Zerigo?

Prescribing Zerigo is as simple as completing a one-page prescription and written order form. To request a prescription form, or for more information on the Zerigo Health Solution, please contact a Zerigo Representative by emailing support@zerigohealth.com or calling 877-738-6041.

How do I educate my patient on what to expect?

We recommend you direct your patient to the Zerigo website to learn more about the Zerigo Health Solution and determine if this may be the right fit. Once a prescription has been submitted, we’ll contact the patient within 2 business days to discuss next steps.

Your patients will not be alone during the home treatment program. A CarePartner will reach out and begin the education and training program, so treatment may begin a few days later when the device arrives.

Patients are connected to you via your prescription and the Zerigo Health Solution helps to ensure safe and efficient home treatments in accordance with your prescription.  A CarePartner will contact you if there are any issues or concerns regarding the patient’s treatment which require your input. CarePartners DO NOT practice medicine.

Articles/Resources

Adherence To a Novel Home Phototherapy System With Integrated Features

Cline A, Collins A , Feldman S, ET AL.
Volume 25 Number 3| March 2019| 25(3): 3

Adherence to treatment for chronic diseases is a global problem with adherence estimated at 50% by the World Health Organization (WHO). The extent of the problem has led to a conclusion that increasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatments.

A cross-sectional, comparative study of home vs in-office NB-UVB phototherapy for vitiligo.

Dillon JP, Ford C, Hynan LS, Pandya AG.
Photodermatol Photoimmunol Photomed. 2017;33:282–283.

Narrowband ultraviolet B (NB-UVB) phototherapy is an effective treatment for vitiligo, resulting in up to 75% repigmentation in 9 months; however, compliance is often poor due to the economic burden and inconvenience associated with this form of therapy. Home phototherapy has been shown to be an effective treatment for a variety of skin conditions, including vitiligo. Despite this evidence, home phototherapy for vitiligo is considered experimental and investigational by health insurance providers. We conducted a comparative study of patients receiving in-office or home phototherapy for vitiligo.

Psoriasis Treatment Cost Comparison: Biologics Versus Home Phototherapy.

Cardwell L, Feldman S, Hyde K, et al.
Am J Pharm Benefits. 2018;10(1):18-21

The economic burden of psoriasis is substantial. It is important to consider the costs to the healthcare system over a patient’s lifetime when they start biologics or home phototherapy. Phototherapy is an effective and economical option for the treatment of moderate to severe plaque psoriasis.

Narrowband ultraviolet B (NBUVB) phototherapy in children with moderate to severe eczema: a comparative cohort study.

Darne S, Leech SN, Taylor AEM.
Br J Dermatol. 2014;170(1):150-6.

Atopic dermatitis can usually be controlled with appropriate skin care and topical steroids or topical calcineurin inhibitors. However, more severe disease can disrupt the life of a child and his or her family. All too often, parents receive repeated courses of systemic steroids, which can cause HPA axis suppression and growth retardation. Systemic immunosuppressives also have undesirable side effects. This study shows that NB-UVB is a useful alternative for childhood atopic dermatitis, with few side effects. Compared with alternatives, it is cost effective and well tolerated, and, most likely, underutilized.

Management of atopic dermatitis: safety and efficacy of phototherapy

Patrizi A, Raone B, Ravaiolo GM.
Clin Cosmet Investig Dermatol. 2015;8:511-520.

Atopic dermatitis (AD) is a common chronic inflammatory skin disease that can affect all age groups. Phototherapy represents a valid second-line intervention in those cases where non-pharmacological and topical measures have failed. This review illustrates the main trials comparing the efficacy and safety of the different forms of phototherapy. Clinicians mainly refer to the indications included in the American Academy of Dermatology psoriasis guidelines devised by Menter et al in 2010. The efficacy of phototherapy (considering all forms) in AD has been established in adults and children, as well as for acute (UVA1) and chronic (NB-UVB) cases. Phototherapy is generally considered to be safe and well tolerated, with a low but established percentage of short-term and long-term adverse effects, with the most common being photodamage, xerosis, erythema, actinic keratosis, sunburn, and tenderness. A carcinogenic risk related to UV radiation has not been excluded. Phototherapy also has some limitations related to costs, availability, and patient compliance. In conclusion, phototherapy is an optimal second-line treatment for AD. It can be used as monotherapy or in combination with systemic drugs, in particular corticosteroids.

Guidelines of care for the management of atopic dermatitis. Section 3. Management and treatment with phototherapy and systemic agents

Sidbury R, Davis DM, Cohen DE, et al.
J Am Acad Dermatol 2014;71:327-49.

Atopic dermatitis is a chronic, pruritic inflammatory dermatosis that affects up to 25% of children and 2% to 3% of adults. This guideline addresses important clinical questions that arise in atopic dermatitis management and care, providing recommendations based on the available evidence. In this third of 4 sections, treatment of atopic dermatitis with phototherapy and systemic immunomodulators, antimicrobials, and antihistamines is reviewed, including indications for use and the risk-benefit profile of each treatment option.

Twenty-year follow-up using a postal survey of childhood vitiligo treated with narrowband ultraviolet-B phototherapy.

Lommerts JE, Njoo MD, de Rie MA, et al.
Br J Dermatol. 2017 Jan 24.

Vitiligo is a depigmenting skin disorder with an estimated prevalence of 1%. Childhood-onset vitiligo occurs in approximately a third of all cases. Early-onset childhood vitiligo tends to be a more extensive and progressive type of vitiligo. Narrowband ultraviolet-B (NB-UVB) phototherapy is an effective treatment option in active vitiligo and leads to >75% repigmentation in 14-75% of childhood cases. Although the European guidelines on vitiligo state that prolonged maintenance with NB-UVB treatment is not recommended because there is a potential risk of photodamage, none of the patients in this study reported melanoma or non-melanoma skin cancer. This study suggests NB-UVB phototherapy may be a safe and effective treatment option in childhood vitiligo and may change the natural course of the disease. More long-term observational and controlled studies are needed to address these important issues.

Randomized, parallel group trial comparing home-based phototherapy with institution-based 308 excimer lamp for the treatment of focal vitiligo vulgaris.

Guan STT, Theng C, Chang A.
J Am Acad Dermatol. 2015;27(4):733-735.

While phototherapy is a treatment of choice for vitiligo, it is time consuming and generally carried out in a health institution. This study compared home-based phototherapy with institution-based excimer. The home based phototherapy group had better efficacy with 72% and 50% in the group achieving good and excellent repigmentation, respectively, in contrast to only 54% and 36% in the excimer group. Although, the difference in response was not statistically significant, the observed differences in efficacy could be explained by the difference in compliance. The patients using home-based phototherapy demonstrated 92% adherence compared to 70% adherence in the excimer group.

The Vitiligo Working Group recommendations for narrowband ultraviolet B light phototherapy treatment of vitiligo.

Mohammad TF, Al-Jamal M, Hamzavi IH, et al.
J Am Acad Dermatol. 2017;76(5):879-888.

Narrowband ultraviolet B light (NBUVB) is an important component of the standard of care in vitiligo treatment. However, there are no consistent guidelines regarding the dosing and administration of NBUVB in vitiligo. In this study, experts in vitiligo treatment make broad recommendations to assist dermatologists in the treatment of vitiligo with NBUVB phototherapy.

Combining biologic and phototherapy treatments for psoriasis: safety, efficacy, and patient acceptability.

Farahnik B, Patel V, Beroukhim K, et al.
Psoriasis Targets and Therapy. 2016;6:105-111.

The efficacy and safety of biologic and phototherapy in treating moderate-to-severe psoriasis is well known. However, some patients may not respond well to biologic agents or phototherapy on their own and may require combination therapy. Skillfully combining a biologic agent and phototherapy may provide an additive improvement without much increase in risks. This study summarizes the current state of evidence for the efficacy and safety of combining biologics with phototherapy in the treatment of moderate-to-severe plaque psoriasis. The vast majority of phototherapy was narrowband ultraviolet B (NBUVB) radiation. Most cases reported enhanced improvement with combination therapy. Serious adverse events throughout the study duration were reported in <3% of the patients. Long-term adverse events cannot be excluded.

Incidence of skin cancers in 3867 patients treated with narrow-band ultraviolet B phototherapy.

Hearn RM, Kerr AC, Rahim KF, et al.
Br J Dermatol. 2008;159:931-5.

Narrow-band ultraviolet B (NB-UVB) phototherapy is a widely used treatment. Psoralen-UVA photochemotherapy (PUVA) increases skin cancer risk and some animal studies have raised the possibility of an increased risk with NB-UVB. This study assessed the effect of NB-UVB exposure treatment numbers on the risk of developing skin cancer. No significant association between NB-UVB treatment and BCC, SCC or melanoma. These reassuring results do not demonstrate the early increase in skin cancers that was found associated with PUVA treatment. However, cautious interpretation is required as the cohort contained relatively few patients who had a high treatment number and because the slow evolution of skin cancers may result in a delayed incidence peak. Ongoing risk assessment is therefore essential.

Guidelines of care for the management of psoriasis and psoriatic arthritis. Section 5. Guidelines of care for the treatment of psoriasis with phototherapy and photochemotherapy.

Menter A, Korman NJ, Elmets CA, et al.
J Am Acad Dermatol. 2010;62:114-35.

Psoriasis is a common, chronic, inflammatory, multisystem disease with predominantly skin and joint manifestations affecting approximately 2% of the population. In this fifth of 6 sections of the guidelines of care for psoriasis, we discuss the use of ultraviolet (UV) light therapy for the treatment of patients with psoriasis. Treatment should be tailored to meet individual patients’ needs. We will discuss in detail the efficacy and safety as well as offer recommendations for the use of phototherapy, including narrowband and broadband UVB and photochemotherapy using psoralen plus UVA, alone and in combination with topical and systemic agents. We will also discuss the available data for the use of the excimer laser in the targeted treatment of psoriasis. Finally, where available, we will summarize the available data that compare the safety and efficacy of the different forms of UV light therapy.