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Laser treatment for nail fungus

Discussion in 'General Issues and Discussion Forum' started by Cameron, Jan 4, 2009.

  1. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
  2. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    A review of lasers and light for the treatment of onychomycosis.
    Ortiz AE, Avram MM, Wanner MA.
    Lasers Surg Med. 2013 Dec 24.
     
  3. Want to see how well laser fungal toenail treatment works? Just read the reviews of the podiatrist who currently does a lot of laser nail fungal treatments here in Sacramento.
     
  4. tonywatson12

    tonywatson12 Active Member

    hi hamish
    once met you in glasgow socp conference.
    Just moving into private practice and was thinking of using laser.
    Have trained with omega on cold therapy systems but unsure of the effects with OM nails.
    talked to a company about the yag lasers but ££££££££ well over what I could afford.
    now looking at the yag laser and power out-put i could get a standard yag for £1000 and seems to do the same.

    what's the lowdown i would be very greatful for any advice
    thanks tony
     
  5. Paul Bowles

    Paul Bowles Well-Known Member

    I'm not talking about that particular Podiatrist as I know nothing about them or what they actually treat. However as people in this thread have demonstrated there are positive outcomes to laser use on OM nails.

    I could apply the bad ratings system to anything in Medicine and i'm sure it would highlight unsuccessful treatments in any management plan or action. I don't believe any of us could say they fix every patient that walks though the front door - and if you honestly believe that then you are dreaming! Whether its orthotics, laser, oral terbinafine, ingrown toenails OR surgery of any kind OR medicine of any kind there will always be poor reports of satisfaction outcomes.
     
  6. tonywatson12

    tonywatson12 Active Member

    so what type of laser works best on om nails?
    any clinical evidence that is not controversial

    thanks
     
  7. Mart

    Mart Well-Known Member


    Ortiz et al published a good review recently of evidence and speculation to date which if you are unfamiliar with this subject should be informative. That way you should be able to navigate the hype, sales pitch and the evidence.

    "In summary, studies of these devices are limited in
    number and quality. Larger randomized, controlled, and
    blinded studies with objective assessments for “cure” of
    onychomycosis are needed. The majority of currently
    utilized laser systems for onychomycosis, such as the Nd:
    YAG laser, are maximally absorbed by water and likely
    result in nonspecific heating of the host tissue and
    suboptimal bulk heating of dermatophytes. Given the
    somewhat promising early results, one can speculate that
    the heating of the host tissue may improve circulation in
    the area, possibly leading to a greater host response. The
    heating of dermatophytes is limited due to extreme target
    temperatures necessary for destruction of the spore and
    hyphae without the destruction of normal tissue; thus,
    leading to fungistatic rather than fungicidal properties.
    Many of the current studies do not address the rate of
    recurrence after therapy, making it difficult to determine
    true efficacy of the technologies. Similar to available oral
    and topical treatments, patients will likely require long term
    maintenance therapy to prevent recurrence. The
    optimal number of treatments, treatment schedule,
    wavelength, and pulse duration remains unclear. Future
    investigation should aim for more selective targets within
    dermatophytes in order to achieve fungicidal rather than
    fungistatic effects."

    Lasers Surg Med. 2013 Dec 24. doi: 10.1002/lsm.22211. [Epub ahead of print]
    A review of lasers and light for the treatment of onychomycosis.
    Ortiz AE, Avram MM, Wanner MA.
    Author information
    Abstract
    BACKGROUND AND OBJECTIVE:
    Onychomycosis is a common fungal infection that affects many individuals. Systemic therapies are effective, but are limited by their side effects and potential for hepatotoxicity. Topical therapies have less serious side effects, yet provide only limited efficacy due to their inability to penetrate the nail plate. These limitations have led to the investigation of laser and light-based modalities as alternative treatment options for onychomycosis. This article will provide an overview and critical assessment of the field of laser and other energy-based treatments for onychomycosis.
    STUDY DESIGN/MATERIALS AND METHODS:
    A literature search was conducted on laser and light-based treatments for onychomycosis.
    RESULTS:
    Early data are promising, however, many of these studies are small or poorly designed.
    CONCLUSION:
    Further evaluation and larger studies are needed to determine the optimal light source, pulse duration, and treatment schedule for long-term success. Lasers Surg. Med. © 2013 Wiley Periodicals, Inc.

    Cheers

    Martin

    Foot and Ankle Clinic
    1365 Grant Ave.
    Winnipeg Manitoba R3M 1Z8
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
  8. tonywatson12

    tonywatson12 Active Member

    reminds me of how acupuncture in podiatry was viewed back in the days before it become popular !
     
  9. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Press release:
    Nomir Medical Announces FDA Clearance for Noveon NaiLaser
     
  10. Bennepod

    Bennepod Active Member

    Dr. Bornstein.

    At the risk of exposing the fact that I have not read all preceeding 18 pages, can you tell me why your combined wavelengths 870 and 930 are more lethal to fungus and why almost everyone else is using 1064?

    Thanks.
     
  11. Dr. Eric Bornstein

    Dr. Eric Bornstein Active Member

    Bennepod:

    The Noveon®, is a near-infrared diode laser system that is specifically designed to use only the 870nm and 930nm wavelengths. This device, combining the 870nm and 930nm energies in a multiplexed beam, has shown a unique antimicrobial action spectrum in-vitro, in vivo, and in 6 human IRB controlled studies. (1-4)

    The device has also completed a 4-site blinded, randomized and IRB approved pivotal study and a 199 patient retrospective study where the data has been approved by the FDA for the treatment of Onychomycosis. With this approval, the Noveon treats "hands free", up to 4 toes simultaneously. The Pivotal study was also published in JAPMA and can be found here: http://www.alnc.com.au/uploads/1/3/3/4/13341286/japma_ii.pdf

    The photo-biological mechanism of action has been published in the prestigious Journal Photochemistry and Photobiology. (1)

    A review of our system vs Nd:YAG lasers has been published in JAPMA. (2)


    1. Bornstein E., Hermans W., Gridley S., and Manni J. Near infrared Photo-inactivation of bacteria and fungi at physiologic temperatures. Photochemistry and Photobiology, Published Online 26 Aug 2009

    2. Bornstein ES: A Review of Current Research in Light-Based Technologies for Treatment of Podiatric Infectious Disease States. Journal of the American Podiatric Medical Association Volume 99 Number 4 348-352 2009

    3. Bornstein, E.S., Y.P. Krespi, A. Robbins, J. Wlassich, E. Sinofsky (2008) Antimicrobial resistance reversal at physiologic temperatures in MRSA in the nares with an 870 nm and 930 nm dual wavelength noveon laser. 2008 Tissue Engineering and Regenerative Medicaine International Society North America Meeting Abstracts.

    4. Bornstein, E.S., A.H. Robbins, M. Michelon (2008) Photo-inactivation of fungal pathogens that cause onychomycosis in vitro and in vivo with the noveon dual wavelength laser system. 2008 New Cardiovascular Horizons Meeting Abstracts.


    The 1064 lasers work via ablation. The ablation interaction has been modified, to act as a laser for OM treatment with a fully thermal ablative interaction.

    This Nd:YAG work has been described by Elewski et al in the following manner:

    New Results Challenge Nd:YAG Laser Effectiveness for Onychomycosis - EXPERT ANALYSIS FROM THE ANNUAL MEETING OF THE AMERICAN ACADEMY OF DERMATOLOGY (2012)

    Boni Elewski MD, conducted in vitro temperature studies, and then treated 10 patients with an Nd:YAG laser, and found that to kill three different types of fungus with an Nd:YAG Laser, the following temperatures and times had to be met.

    - T rubrum 50° C for 15
    - E. floccosum 50° C for 10 minutes
    - Scytalidium 55° C for 5 minutes.


    Human Results:

    " nail temperatures that reach 40-41° C (with an Nd:YAG laser) cause enough pain for patients to pull away, and the maximum nail temperature patients could tolerate was 45° C," said Dr. Elewski, professor of dermatology at the University of Alabama at Birmingham.”

    This means that for the Nd:YAG lasers, you mush heat past the level of possible tissue damage to kill the fungus. The Noveon system is photo-biologic, and does not increase temperatures of the nail past 103F (39 C). This has been peer reviewed and published in JAPMA and Photochemistry. (1,2)

    A series of video’s describing the Noveon can be viewed here:

    1. For doctors seeking to understand how the Noveon works: Noveon Technology http://www.noveoninternational.com/physician/science-video

    2. For doctors who would like to hear from podiatrists using the Noveon Naillaser: Physicians’ Video – http://www.noveoninternational.com/physician/physician-video

    3. For more patient information about the Noveon technology: Patient Video - http://www.noveoninternational.com/physician/patient-video

    Best regards,

    Dr. Eric Bornstein
    Chief Science Officer
    Nomir Medical Technologies
     
  12. Bennepod

    Bennepod Active Member

    Dr. Bornstein
    Thanks for your thorough and speedy reply.
    What are the limitations of the laser? for instance, regarding total dystrophic onychomycosis and endonyx? and other considerations re hypertrophy of nail and pigmentation?

    Thanks again.
     
  13. Dr. Eric Bornstein

    Dr. Eric Bornstein Active Member

    Dear Bennepod:

    We have successfully treated dystrophic onychomycosis, endonyx onychomycosis along with hypertrophic and pigmented onychomycosis.

    To see these cases, please go to the following link, which is our 199 patient (not yet published) retrospective study:
    http://midwest.us.com/images/OM_Retrospective_Study_White_Paper.pdf

    These cases are from various podiatrists in the field that have been using the Noveon for the last two years. In most of these difficult cases, I would not even know where to begin with an Nd:YAG and the temperature/heat issues.

    best regards,

    Dr. Eric Bornstein DMD
    Chief Science Officer
    Nomir Medical Technologies
    www.noveoninternational.com
    ebornstein@nomirmedical.com
     
  14. Mart

    Mart Well-Known Member

    Hi Eric

    The methods and results of your work seem extremely thorough and compelling.

    Published in "Near infrared Photo-inactivation of bacteria and fungi at physiologic temperatures" the blinded, temperature controlled, in vitro kill experiments showed rates of 100% at below 42.5 degree C for T rubrum and C albicans for all six tests. I was unable to find a similar experiment published elsewhere - do you know if this has been tried outside of your study?

    Cheers

    Martin

    Foot and Ankle Clinic
    1365 Grant Ave.
    Winnipeg Manitoba R3M 1Z8
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
  15. Dr. Eric Bornstein

    Dr. Eric Bornstein Active Member


    Dear Martin:

    Nomir Medical has proprietary ownership of the two wavelengths that we use 870nm/930nm, so these experiments have not been done by another group. However, we have done a large amount of side-by-side work (unpublished) that is summarized below against E. coli.

    Nomir Tested Wavelengths and Combinations Against E. coli

    Wavelengths Impact on E. coli
    810 nm alone 8% kill
    830 nm alone 8% kill
    870 nm alone 27% kill
    885 nm alone 23% Growth
    930 nm alone 100% kill
    810 nm + 870 nm 0% kill
    870 nm + 885 nm Mild growth
    810 nm + 930 nm Moderate Growth

    885 nm + 930 nm 18% kill
    870 nm + 930 nm 98% kill

    Only the wavelengths in our unique combination and dose, have shown non-thermal antimicrobial activity.

    As we have published our data in so many different venues (in vitro and in vivo), from 2008-2012, and with the greater podiatric community using our OM device successfully for 2+ years, I am fairly confident of the wavelength's specific chromophore absorption for photo-biologic antimicrobial activity. A list of our publications is below.

    Bornstein, E.S., Y.P. Krespi, A. Robbins, J. Wlassich, E. Sinofsky (2008) Antimicrobial resistance reversal at physiologic temperatures in MRSA in the nares with an 870 nm and 930 nm dual wavelength noveon laser. 2008 Tissue Engineering and Regenerative Medicine International Society North America Meeting Abstracts.

    Bornstein, E.S., A.H. Robbins, M. Michelon (2008) Photo-inactivation of fungal pathogens that cause onychomycosis in vitro and in vivo with the noveon dual wavelength laser system. In Proceedings of the 9th Annual New Cardiovascular Horizons, p.72, New Orleans, LA, September 10–13, 2008. New Cardiovascular Horizons, Lafayette, LA.

    Bornstein E.S. (2009) A Review of current research in light-based technologies for treatment of podiatric infectious disease states. J. of the Am. Pod. Med. Assoc. 99 (4), 348-352.

    Bornstein E.S. (2009) Treatment of onychomycosis using the noveon® dual-wavelength laser. FDA Pivotal Study data presented at Council for Nail Disorders 13th Annual Meeting, San Francisco, CA, March 5, 2009.
    Bornstein E.S. (2009) A Review of current research in light-based technologies for treatment of podiatric infectious disease states. J. of the Am. Pod. Med. Assoc. 99 (4), 348-352.

    Landsman, A. et al. (2010) Treatment of Mild, Moderate and Severe Onychomycosis Using 870nm and 930nm Light Exposure. Journal of the American Podiatric Medical Association • Vol 100 • No 3 • May/June 2010

    Bornstein E., S. Gridley, and P. Wegender (2010) Photodamage to Multidrug-resistant Gram-positive and Gram-negative Bacteria by 870 nm/930 nm Light Potentiates Erythromycin, Tetracycline and Ciprofloxacin. Photochemistry and Photobiology, 2010, 86: 617–627

    Landsman, Adam S., and Alan H. Robbins. "Treatment of Mild, Moderate, and Severe Onychomycosis Using 870-and 930-nm Light Exposure Some Follow-up Observations at 270 Days." Journal of the American Podiatric Medical Association 102.2 (2012): 169-171.

    Thank you for the question.

    If you have interest in the system, our Canadian distributor can be found here:
    http://magne-tec.com/noveon/

    Best Regards,

    Dr. Eric Bornstein
    Chief Science Officer
    Nomir Medical Technologies
    ebornstein@nomirmedical.com
    www.noveoninternational.com
     
  16. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Toenail onychomycosis treated with a fractional carbon-dioxide laser and topical antifungal cream
    Eun-Hwa Lim et al
    Journal of the American Academy of Dermatology; Article in Press
     
  17. newsouth

    newsouth Member

    I would recommend having a close look at Professor's Zalacaín recent studies (2 years using a 1064 40W). Same laser is used of plantar warts (1 session), LLLT and surgery).
    Professor Zalacaín convinced me to buy a laser. He is one KOL that is changing what our profession and daily duties are cause the new students (last of 4 years studies) must now know how to use a laser in order to have the title and graduate. University of Barcelona has developed the laser in conjunction with the manufacturer.
    40W minimum are needed to kill the fungus.
     
  18. Mart

    Mart Well-Known Member

    Hi

    You said

    "40W minimum are needed to kill the fungus"

    please explain - that doesn't make sense.

    Cheers

    Martin
     
  19. Mart

    Mart Well-Known Member

    Hi

    You said

    "40W minimum are needed to kill the fungus"

    please explain why you stated this - it doesn't make sense

    Cheers

    Martin

    Foot and Ankle Clinic
    1365 Grant Ave.
    Winnipeg Manitoba R3M 1Z8
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
  20. newsouth

    newsouth Member

    Yes indeed and it does make sense cause it is the most important part of a laser for this application, it's power. You should get and read the University study to see the clinical evidence.
    Professor has tried different powers during 2 years (and using an atomic microscope for first time for this application) he has demonstrated that less than 40W the fungus would not die at all.
    I believe this is the most complete and rigurous clinical study done in an university for this application with laser in the world.

    More than 150 lasers already installed in Europe.

    Waiting for mine
     
  21. Paul Bowles

    Paul Bowles Well-Known Member

    Do you have a link to this so called peer reviewed rigorous clinical trial which is the most complete in the world?

    The only reason I ask is at 10W 1064nm I can put a hole in gyprock wall from 3 feet away (ok slight exaggeration but you get what I am saying.....)

    ...and i'm pretty sure I have data which shows conclusively that at 1064nm 10.0W 700-1000J application we can eradicate onycomycoses - so I doubt the study shows "anything below" 40W doesn't work, and if it does I am pretty sure we can prove it wrong.
     
  22. Mart

    Mart Well-Known Member

    What do you believe the mechanism is for the effect that you are talking about ? When you talk about power what power are you measuring? Power output of the device doesn't necessary translate into any specific effect which is why your statement is questionable. I can shine a 100 watt light bulb or blast the nail with 1000W sound system it won't kill the fungus. I could contrain that energy within different beam widths and cause localized heating which might then be harmful to the fungus but effect will be a function of time as well as power delivered per unit volume to cause temperature change per unit time or possibly rate of heating. Also a factor is tolerance of host to effect particularly pain. That is why I remain skeptical regarding your comment so far. In a nutshell power output doesn't translate into dose delivered.

    cheers Martin

    Send from my Iphone
     
  23. newsouth

    newsouth Member

    10W does not work at all. And he can prove it scientifically. Next saturday he is giving a conference in Portugal regarding this. Once the study is published (there is only a white paper now) you will be very surprised. A well known University like Barcelona's (which gives master degress to podiatrists from all over the world and is number second in Europe for its studies in podiatry) would not be involved on this. They are currently on a study on plantar warts using this laser.
    Once the study is published ...no rebates
     
  24. newsouth

    newsouth Member

    it seems that you do not understand very well how laser diods work. Power is measured at the end of the fiber.Are you related with podiatry or with engineering?
     
  25. newsouth

    newsouth Member

  26. Mart

    Mart Well-Known Member


    The marketing info you posted when translated stated

    "Thanks the outpost / advanced technology, S30 PODYLAS causes a controlled thermal effect mycotic infections That delete from the nails. The lenergy from the light penetrates the nail trough, raising up the temperature from the microorganism and fungi without reaching deeper Causing damage to surrounding tissue. That's a safe treatment, comfortable and very fast, you can treat a complete foot in only 15 minute"

    This provided no evidence let alone scientific discussion - purely marketing from your link. This is legitimately seen as self serving if you make claims that your product if somehow effective when other aren't without substantiation. Also you cited Bernstein's work which speculated that mechanism is likely associated with mechanisms which are independent of heating - so your comment is inconsistent.

    I am a podiatrist - I do understand the technology at a clinical level - I am concerned about the unsubstantiated claims which are broadcast and feel that this forum response should be critical of that.

    We know that lasers can heat tissue - that doesn't make them effective therapies. We can heat nail and kill microorganisms inside nails using many different methods and technologies. The question is does this heat cause host damage and does host tolerate the heat exposure required to kill microorganism? Measured power output at fiber end doesn't get close to answering that issue because it doesn't address how efficiently that energy is absorbed by the microorganism compared to the host. It also doesn't address the range of effective exposure needed for efficacy.

    Should we focus this thread on plausible speculation and evidence or blind faith and nice looking pictures?

    Cheers

    Martin

    Foot and Ankle Clinic
    1365 Grant Ave.
    Winnipeg Manitoba R3M 1Z8
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
  27. newsouth

    newsouth Member

    Sorry, im stating what I have bought, simple as that and why I did it.
    When the scientifical evidence is published...then you can rebate whatever you think. You should visit the university and ask, ask and keep asking...
    Other professionals can state other opinions, these are my simple thoughts on why I bought it.

    PD: you should not translate, you should learn spanish in order to understand it better and properly cause it is not correct.
     
  28. TPeterson

    TPeterson Welcome New Poster

    Martin's point is that "40 W" is meaningless without specifying the area of the spot. I.e., it's power density, not total power, that matters.

    EDIT: I hadn't read to the current end of the thread when I posted the above. Of course the other objections to the 40-W assertion are also valid: the energy must be absorbed and somehow kill the organism so not only power density but also other characteristics are important. Nevertheless, "power" is not a sufficient characteristic without defining an area.

    EDIT2: BTW, the "incorrect" translation that's quoted above was provided on the referenced website. ;)
     
  29. newsouth

    newsouth Member

    I do not agree at all. Everything matters
     
  30. Mart

    Mart Well-Known Member

    What is incorrect about the translation I posted?

    Perhaps we should consider the scientific evidence BEFORE we market to our patients and be candid with them about what that amounts to.

    Universities are were we get our basic training and are then expected to demonstrate competency which then implies a reliable level of trust. Universities are also expected to provide high quality research.

    As clinicians we should adopt lifelong learning which includes being able and taking time to review theory and evidence as it shifts enabling us to form well considered opinions. This can happen in many arenas including Universities and podarena.

    Sermon over:)

    Cheers

    Martin

    Foot and Ankle Clinic
    1365 Grant Ave.
    Winnipeg Manitoba R3M 1Z8
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
  31. Paul Bowles

    Paul Bowles Well-Known Member

    This statement alone, combined with no peer reviewed evidence leads me to think that either: a) We have a communication issue here b) The figures you quoted in content don't amount to anything c) Marts point stands or d) a combination of a and c....

    Isn't the author of that paper going to be very confounded when he publishes this data and other studies start citing their results at 1064nm 10W at 700J-1000J application.

    You don't have to look far back in this thread to see actual clinical photos of patients who have been treated at 1064nm 10W 700J-1000J to see results - yet you are blanket stating it doesn't work? I'm with Mart on this.... the (W) measure alone means nothing out of context - the light globes in my office are 100W, we have 8 of them in the reception area - all my patients still seem to make it to my office with fungus! How about you provide some more information on your "said" laser system such as peer reviewed evidence or clinical patient cases/information with photos or even said white paper you keep referencing (did I miss you post this?) - because at the moment it looks like you either work for the company, or have just spent alot of money on one of these machines and really want it to work!!!!

    Also I find it borderline offensive to tell someone to "learn" a language so they can understand a reference you posted. In a worldwide community where many of us are bi-lingual we should all do our best to help each other understand the literature presented. Your ignorance of this fact makes me.....

    ...think I am smelling a rat!
     
  32. zsuzsanna

    zsuzsanna Active Member

    I have only had one patient who tried laser treatment SIX times with the same provider without any benefit. She is now taking Terbinafine, and is making good progress.
     
    Last edited: May 26, 2014
  33. zsuzsanna

    zsuzsanna Active Member

    I have only had one patient who tried laser treatment. She had SIX treatments without any effect and gave up. She is now taking Terbinafine (Lamisil) and making good progress.
     
  34. Paul Bowles

    Paul Bowles Well-Known Member

    N=1 isn't really indicative of anything. The next person may post in this thread and say that they only had one patient try laser and it worked after 2 treatments. Again their N=1 clinical view means very little.

    Laser - like terbinafine - is a treatment option/tool. It should be used as such. It is not the be all and end all.

    Management options differ between patients and what works for one person may not necessarily work for others. Even oral terbinafine has a failure rate.
     
  35. MischaK

    MischaK Active Member

    Im not sure if these articles have been shared but they are relatively new,
    I have not fully evaluated the methodological rigor of these studies so I can not comment on their quality.

    Choi, Zheng, Goo, and Cho (2014) completed a non-randomised controlled trial on the anti-fungal effects of a 1444-nm neodymium(Nd): Yttrium–aluminum–garnet(YAG) laser on onychomycosis.

    They conclude that Nd:YAG lasers with a wavelength of 1444 nm are effective at reducing mycotic colony-forming units (CFUs).

    Hees, Jäger, and Raulin (2014) conducted a single blinded study on the treatment of onychomycosis using a 1 064 nm Nd:YAG laser.

    They Concluded that the treatment of onychomycosis with the Nd:YAG laser without removing mycotic nail material can lead to a temporary clinical improvement, a reduction of positive fungal cultures and an improvement of the Onychomycosis Severity Index.

    A quick look a these studies displays limitations of the methodology but they are still worth a read.


    Choi, M.J., Zheng, Z., Goo, B., & Cho, S.B. (2014). Antifungal effects of a 1444-nm neodymium:Yttrium–aluminum–garnet laser on onychomycosis: A pilot study. Journal of Dermatological Treatment, 25(4), 294-297. doi: doi:10.3109/09546634.2012.714455

    http://informahealthcare.com/doi/abs/10.3109/09546634.2012.714455

    Hees, H., Jäger, M.W., & Raulin, C. (2014). Treatment of onychomycosis using the 1 064 nm nd:Yag laser: A clinical pilot study. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 12(4), 322-329. doi: 10.1111/ddg.12292

    http://onlinelibrary.wiley.com/doi/10.1111/ddg.12292/abstract
     
  36. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Lack of efficacy with 1064-nm neodymium:yttrium-aluminum-garnet laser for the treatment of onychomycosis: a randomized, controlled trial.
    Hollmig ST, Rahman Z, Henderson MT, Rotatori RM, Gladstone H, Tang JY.
    J Am Acad Dermatol. 2014 May;70(5):911-7.
     
  37. alessandro costa

    alessandro costa Active Member

    in spain at Zaragoza conference some of our collegue said that they are using laser terapy for onicomicosis with good result, but GOD knows.....
    so yet there are no studies about that right?!

    sincerely, Alessandro
     
  38. Tim Foran

    Tim Foran Active Member

    What I like about using a laser is it gives me another tool to add to my belt. I am not saying it will definitely work on every patient however there is not a definitive treatment available for onychomycosis any way.


    [​IMG]

    [​IMG]

    [​IMG]

    [​IMG]
     
  39. Mart

    Mart Well-Known Member

    Can you speculate why your results are so variable?

    cheers Martin

    Send from my Iphone
     
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