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Foot Podiatrist Philipp Mann: Laser for treating fungal nail infections
Foot Podiatrist Philipp Mann: Laser for treating fungal nail infections
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Date last updated: 05 Nov 2013
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Calpe News 2016 | Foot Podiatrist Philipp Mann | Treatment fungal nail infections | Calpe Online 24


Laser treatment for fungal nail infections.

I use laser for many things for pain relief in osteoarthritis and Rheumatoid arthritis for resolution of injuries like tendonitis, sprains and bursitis, to speed up wound healing and even sometimes for Verruca.

Although statistics vary it is estimated that the incidence of fungal nail infections (onycomycosis) is between twenty three and thirty five percent in the general population. Fungal nails cause thickening, discoloration (brown/yellow green), crumbly nails which can be painful. Here in Spain where the feet get to see the light of day a bit more often, there may be embarrassment.

Previously the treatment options for fungal nail infections were, paints and lacquers applied daily or weekly until the nail has grown out, which may take up to a year depending on how far down the nail the infection has reached. Oral Terbinofine, Lamisil being the best known of these, a three month course as minimum. There have been concerns with systemic treatments like Lamisil, that it can cause liver damage and over the years I have seen a range of other less serious side effects which have meant that the patient was unable to complete the course. Some practitioners will surgically remove the nail but in order for this to be effective you then need to destroy the nail bed so it will not grow back. This is not a procedure I favor especially if many toes are involved.



A few years back a company developed a laser system for treating fugal nail infections called Pinpoint which used high energy laser. Although met initially with some skepticism (they claimed 88% success rate for a single treatment) and high prices six hundred to eighteen hundred dollars for the treatment, laser for fungal nail took off. The only problem with using high energy laser to kill fungus is that it did so with heat which could be uncomfortable for the patient and potentially damaging to the soft tissue around the nail. Now Low Level Laser (using light rather than heat to kill fungus) is seen as the way forward.
After trailing laser for fungal nails last year I found I was getting good results with about eighty percent success rate. I have now been using laser on fungal nails since January of this year and I am very pleased with the results.

So what does it involve? Well initially the infected nail/s are cut back with nippers and sometimes a scalpel to remove as much infected nail as possible and allow laser light to penetrate the nail bed then laser is applied between four to six minutes per toe, then the treatment is repeated about one to two weeks later and then again at six to eight weeks. Often that is all that is required then just wait for the nail to grow out, although some people will require more sessions depending on their response and the severity of the infection. The cost is forty 5 EUR per session although those with the majority of their nails infected, expect to pay more due to increased time involved.

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