Laser Care For Onychomycosis: Can It Be Effective?

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Author(s): 
John Mozena, DPM, and Brent Haverstock, DPM, FACFAS

   The Noveon laser uses an infrared light, which causes inactivation of the fungus. The Noveon’s two very specific infrared wavelengths have the unique ability to cause photo damage to microbes at physiological temperatures that can kill them directly or sensitize them to destruction.

   The PinPointe FootLaser is currently undergoing a controlled multicenter study to evaluate its effectiveness. Early studies indicate a clinical response rate of 87 percent.8 There are other laser companies working on fungus destruction but those lasers rely on UVC light, which can have a higher cancer risk.9

   The PinPointe FootLaser uses a single wavelength of light to cause destruction of the fungus cell specifically. The pinpoint laser light passes through the toenail without causing damage to the nail or surrounding skin. The laser has a proprietary pulsed beam that differentially abates pathogens versus healthy tissues, resulting in the inhibition of pathogen growth.

   The patients receive safe, quick treatment with no drugs, no anesthesia and very little or no pain. The PinPointe FootLaser reportedly has minimal risks or side effects.8

   Both lasers are currently being reviewed by the FDA for onychomycosis treatment and their respective treatment protocols. While neither currently has been cleared for a specific onychomycosis indication, the preliminary studies are very promising. Studies have shown not only good efficacy for the lasers but a high safety profile and good adherence as well since only one or a few treatments are required.10 Having a medical procedure that one can perform in one session can provide an enormous cost savings since multiple visits are not necessary.

Sharing Insights From Personal Experience As A Patient

I personally have tried topical, oral and laser treatment on the toenails on my left foot. I found topical medication only mildly effective. Since my onychomycosis is moderate to severe, topical medication is not indicated. Although oral medication did clear my nail significantly, re-infection occurred over time. I again tried oral medication but I experienced pain and tenderness in my liver area. I feel this may have been a gall bladder issue.

   Finally, I tried the PinPointe FootLaser about one year ago. I found significant improvement, especially in my hallux nail. I believe another treatment may be required for a more complete clearing as laser protocols are continuing to develop. I also would not hesitate to have any further treatment with the PinPointe Foot Laser as any health risk seems to be almost nonexistent.

In Conclusion

Podiatrists have always embraced new proven technologies over the last few decades. We have introduced into our practices joint implants, absorbable hardware, arthroscopes, endoscopes and many other innovations. Indeed, new technologies can make a major impact on the lives of our patients.

   Now we are getting a new tool that may either augment our treatment regimen for onychomycosis or perhaps completely replace it. We should not ignore this potentially invaluable tool but put it in our arsenal of treatment ideas. Over time, we may find that laser treatment for onychomycosis may become the standard of care for this pandemic we are facing.

   Dr. Mozena is in private practice at the Town Center Foot Clinic in Portland, Ore. He is a Fellow of the American College of Foot and Ankle Surgeons and is board certified in foot and ankle surgery.

References

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