In regard to the use of laser therapy for onychomycosis and/or other conditions …

I currently own a laser device and use it in practice.
26% (85 votes)
I am planning to purchase a laser device in the next six months.
6% (21 votes)
I am waiting to see further evidence on efficacy before I purchase a laser device.
68% (225 votes)
Total votes: 331
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Dansays: January 6, 2012 at 1:40 pm

A colleague who owns the Pinpointe laser has said the device does not work but if the patients are willing to pay, she will continue to use it!

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Davidsays: January 20, 2012 at 12:03 pm

How unfortunate on both accounts. Does she tell the patients it doesn't work or does she tell the patients it may not help? Obviously, that is a moral issue for her (the doc), but at the end of the day if she can rest peacefully, then she is a better person than I am.

I have a laser, know how to use it well, get pretty good results, have a darn good idea for which patients it will or will not work, and will refuse to treat based on my judgment. Just my opinion but integrity before profits.

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Dr. Steven J. Kaniadakissays: January 20, 2012 at 10:50 am

If the evidence-based results are as biased as the allowed polling selections, then I think there will be predictable outcome thereof.

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Andrew J says: January 20, 2012 at 11:06 am

I have seen several patient failures and also balk at the cost per treatment, which is not covered, and us prohibiting considerations by most people I treat.

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Martysays: January 20, 2012 at 11:08 am

I also have had a Pinpointe device for almost 2 years. It does work. I have had to fine tune my treatment protocol, and the laser itself was updated with new programming in August 2011 that noticeably improved the efficacy.

It also depends on how badly infected the nails are. If the matrix is involved and the nails are badly thickened, you may have a harder time with treatment. It may require an avulsion followed by laser treatment. In very severe cases, the nail may appear dystrophic even after the fungus is eliminated. I have also offered some of my patients oral lamisil in addition to the laser, but no one has wanted it.

Like anything else, it's not 100% effective, but as long as you are upfront with your patients about their chances and you are willing to do a few re-treatments, the majority (better then 80%) are happy with the results.

The other thing to consider is that the infection tends to reoccur. I have my patients come back for six month prophylactic visits to help prevent reinfection. You wouldn't want to have your patients take Lamisil every 6 months for the rest of their lives but to use the laser, there is no safety issue.

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