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Laser Treatment of Fungal Nail
The use of laser in podiatry is not new. For years lasers have been used safely on the foot for several conditions. Although the 1064 laser is FDA approved for the temporary clearing of nails, new lasers are now being used to treat nail fungus. These lasers have some advantages and are approved by the FDA for many other treatments but laser treatment of nail fungus is considered an “off label use”.
The ability of the 1064 laser energy to gently heat the nail bed makes it ideal for the safe and effective desired result of nail clearing. The effects of 1064 nanometer laser energy on nail fungi are two fold and understood in relation to cellular chemical reactions within fungal cells that are necessary for fungal growth and survival. The photo-thermal effect changes cellular metabolism and at increased temperature (42Â°C), cell components are damaged and metabolism is altered. Clinicians report a photo-chemical effect that further compromises fungal cell enzymes and proteins. Lipids in cell membranes are changed in structure and their function of protecting and regulating the internal environment of the cell becomes further compromised resulting in fungal death and nail clearance.
Podiatrists experienced with clinically treating onychomycosis have come to the conclusion that the treatment of fungal nails is a process and the prevention of reinfection is critical to achieving success.
Laser is an excellent choice for patients who do not want to risk taking oral medications.
There are several treatments for nail fungus (onychomycosis). The most conservative is to just thin down the nail every 9 weeks and apply topical medications but this type of medicine does not work well if the whole nail is involved. Oral medications (Lamasil) can be prescribed but elevates liver enzymes and can cause liver damage. Women are warned not to take oral medications if they are going to become pregnant.
The most common cause of brittle yellowing nails is fungal infection. Fungi are dermatophytes that feed on nail keratin. These organisms propagate in a warm, dark and moist environment. There is no better place for nail fungus to reside and infect toes than in shoes. Infected nails have yellowing or white spots on the nails. As the infection develops, nails will get thicker, further discolour and fracture. Progressive infection of additional nails is common.
Signs of Onychomycosis
Thickening of the nail
Build-up of debris under the nail
Changes in texture, loss of shine and clarity
Brittleness and crumbling at the edges of the nail
Small separations of the nail plate from the nail bed