Case Studies In Laser Therapy
- Volume 26 - Issue 1 - January 2013
- 5449 reads
- 2 comments
At the August 7, 2012 follow-up appointment, an examination revealed marked improvement at the second digit, which demonstrated a flatter nail plate without evidence of striations in the nail texture. The left hallux nail also showed improvement with no evidence of discoloration and an adhered nail plate. Superficial lysis was present at the distal hallux. The patient was pleased with progress but requested a second treatment to the left hallux. An additional treatment to the left hallux consisted of exposure of 176 pulses with 142 joules.
The laser I used in these cases was an A.R.C. Fox Laser set at 4 watts at a 1,064 nm wavelength and a pulse length/interval of 200 ms.
In both cases, the use of laser therapy for onychomycosis was effective. The initial treatment eradicated the mycotic infection and cleared the nail. Additionally, without the presence of subungual infection, the nail plate growth was able to restore itself to the underlying surface and provide a more aesthetically pleasing result.
It is also imperative that one follow the proper steps for diagnosis of onychomycosis and avoid using this treatment for contraindicated conditions such as infection, melanoma, cellulitis, osteomyelitis, fracture, melanoma or other pathologies at risk for metastasis.
Podiatrists should consider offering this treatment to patients with onychomycosis. It will not work for all patients and it is essential that you make that clear to patients before initiating treatment. It is also important to educate patients that treating onychomycosis is a process. Remind them that average nail growth is 3 mm/month and that preventing re-infection is as critical to achieving success as the laser treatment itself.
Dr. Torres-Hodges is a Fellow of the American College of Foot and Ankle Orthopedics and Medicine, a Fellow of the American Professional Wound Care Association and a Podiatry Fellow with the Council on Nail Disorders. She is in private practice in Pensacola, Fla.