Toenail fungus (onychomycosis) is a widespread condition. It is estimated to impact 1 in 10 people overall, with this number increasing to 1 in 2 for individuals over 70 years old. It typically causes discoloration, thickening, and brittleness of the toenails, and can lead to discomfort or pain. Laser treatment has emerged as a contemporary solution for this persistent issue.
The Science Behind Laser Treatment
Laser treatment for toenail fungus operates on the principle of delivering concentrated light energy to the affected nail. The laser emits specific wavelengths which penetrate the toenail plate to reach the fungal cells. This light energy is absorbed by the fungal organisms, generating heat that disrupts their cellular processes and inhibits growth and spread. The heating mechanism aims to damage the fungus while minimizing harm to the surrounding nail and skin. Some laser technologies also utilize photochemistry, rather than solely heat, to achieve their therapeutic effects.
What to Expect from Laser Treatment
Laser treatment typically begins with a consultation to assess the infection’s severity. Before the procedure, patients are advised to remove nail polish and clean their feet. During the treatment, a specialized laser device is directed at the infected nails, a generally non-invasive process. Patients commonly report a mild warming sensation or slight discomfort, but the procedure is usually well-tolerated without anesthesia.
Each session typically lasts 10 to 30 minutes, depending on the number of nails affected. Multiple treatment sessions are often necessary, with many protocols recommending three to four sessions spaced several weeks apart. Following treatment, there is usually no downtime, allowing patients to resume regular activities immediately.
Continued post-treatment care is important, including using antifungal sprays for shoes and socks, and keeping feet dry to prevent reinfection. Patients are also advised to avoid applying nail polish to treated nails for a period.
How Effective is Laser Treatment?
Laser treatment addresses the fungal infection within the nail, with reported success rates varying among studies. Some clinical trials suggest success rates for clearing toenail fungus range from 60% to over 90%. The U.S. Food and Drug Administration (FDA) has cleared lasers for a “temporary increase of clear nail” in nail fungus cases. Success refers to the growth of a new, clear nail, rather than instant eradication of the fungus.
Full results become visible gradually as the healthy nail grows out, which can take 8 to 12 months for toenails. Effectiveness can be influenced by factors such as infection severity, specific laser type, and patient adherence to post-treatment care. While some sources indicate laser treatment may have lower cure rates than oral medications, others show comparable or higher success rates in specific studies. Laser therapy can be a suitable option for individuals who may not tolerate oral antifungal medications due to side effects.
Other Treatment Options
Beyond laser therapy, other options are available for treating toenail fungus. Topical antifungal medications, such as medicated nail lacquers, are applied directly to the nail for mild to moderate infections. However, their effectiveness can be limited by their ability to penetrate the thick nail plate to reach the infection.
For more severe or persistent infections, oral antifungal medications like terbinafine or itraconazole are often prescribed. These oral medications work systemically to target the fungus, but they can carry a risk of side effects, including liver damage or interactions with other medications, requiring careful monitoring.
In instances of severe or recurring fungal infections, surgical removal of the nail, either partially or entirely, may be considered. Additionally, preventive measures such as maintaining good foot hygiene, wearing breathable footwear, and avoiding walking barefoot in communal damp areas can help reduce the risk of infection or recurrence.