Laser therapy is the treatment of a fungal toenail infection (onychomycosis) , an untreatable infection that changes the appearance and texture of the nail. There are several types of laser treatments, including light and carbon dioxide (CO2). Laser therapy is approved by the US Food and Drug Administration (FDA) for this use.
Nail fungal infections usually require several laser treatments before they go away completely. Laser therapy may require six to 18 months of consecutive treatment to be effective. Although these treatments can cause side effects such as pain and / or bleeding in the surrounding area, they are considered safe .
How does it work
Laser devices emit pulses of energy that generate heat. In the treatment of onychomycosis, the laser is directed in such a way that the heat penetrates through the toenail to the nail bed, where the fungus is present.
For this type of treatment, CO2 or yttrium aluminum garnet (YAG) lasers with wavelengths of 870 nm, 930 nm or 1320 nm are used to raise the localized temperature. In response to heat, the infected tissue gasifies and decomposes, killing the fungus as well as the surrounding skin and nail. The heat from the lasers also has a sterilizing effect, helping to prevent the growth of new fungi .
When the laser is aimed at an area of infection, the heat generated inhibits the growth of the fungus and destroys it.
When used safely, laser treatments do not emit enough energy to destroy all tissue or all infections. For this reason, a new treatment is usually required. Fungal growth is suppressed and some fungal microorganisms are destroyed, but since the infection may partially survive treatment, it is unlikely that it will be completely cured in a single session.
The FDA has approved several types of laser devices for the treatment of onychomycosis, including PinPointe Footlaser, GenesisPlus, and Noveon. According to the approval criteria, these devices can cause "temporary enlargement of clear nails in patients with onychomycosis. "
With laser therapy, most people experience marked improvement, as well as a high cure rate. One study found a 61% cure rate after 16 weeks. Another study showed a 91% clinical improvement and a 30% cure in 180 days .
Laser treatment is associated with high rates of negative cultures, which means that a microscopic laboratory test for yeast infections usually shows no signs of infection after treatment .
Treatment of onychomycosis is considered effective when the symptoms of the infection have disappeared and there are no signs of fungus in cultured samples of the toe or surrounding skin.
Laser treatment versus other options
Laser treatments are often more effective than other treatments for onychomycosis. This infection can be treated with topical (on the skin) antifungals or over -the-counter prescription and oral antifungals . Oral antifungals have systemic side effects and are not completely effective in treating onychomycosis. Topical treatments are usually safe, but not very effective.
Studies show that onychomycosis treatment is improved by approximately 45% with topical medications and 40% to 66% with oral medications .
However, the effectiveness of all these treatments appears to vary. Using them consistently while avoiding side effects can be tedious. Combination treatments can be more effective than a single treatment approach .
What to expect
The initial consultation for laser treatment of onychomycosis includes an evaluation of symptoms. Onychomycosis is usually diagnosed based on the appearance of the nail, but if necessary, a sample can be taken for examination under a microscope.
Your treatment will be prescribed by a healthcare provider, who may be a dermatologist, family doctor, or podiatrist. You may also have a surgical debridement, in which your toenails are trimmed and dead skin is cleaned on the day of the laser procedure or a few days before.
Immediately before the procedure, your foot will be cleaned with a sterile solution and placed in an accessible location to direct the laser. The laser will travel over the affected nails and can even be used on unaffected nails if there is a concern that you may also get a fungal infection.
A pulsed laser or the use of selected wavelengths helps minimize skin heating, reducing the risk of side effects. A session usually lasts 30 minutes or less.
Pain and / or bleeding can occur as the tissue breaks down, but the skin will heal within a few days. Your healthcare professional will explain how to keep your toe clean and dry while it heals.
Signs of improvement
Although in some people the infection will clear up after just one treatment, additional sessions can be scheduled based on the results. Even effective treatment will not immediately remove an infected nail; It may take 12 months for the nail to grow back before you can determine if the treatment was successful .
Signs of improvement include:
- Loss of yellow, white, or brown color to the affected toenails or toenails
- Removal of flaky debris under or on the nail
- Restoration of onycholysis, that is, detachment of the nail from the nail bed underneath.
- Normal shape and texture of new nails without thickening, unevenness or alteration of the shape of the nails.
Get the word of drug information
There are a number of factors to consider when considering treatment options for a toenail fungus infection. Oral medications can cause side effects, and topical medications require constant treatment, often with little improvement.
While laser treatments can be more effective, the time it takes to schedule multiple appointments for repeat laser treatments can be a burden. Cost can also be a factor because some health insurance plans do not cover the full cost of this treatment. As you discuss your options with your healthcare provider, you will need to think about the pros and cons of each of your options.