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Laser treatment for nail fungus

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

  1. Cameron

    Cameron Well-Known Member

  2. admin

    admin Administrator Staff Member

    Not according to the New York Times:

    False Start on a Laser Remedy for Fungus
    Full story
     
  3. Admin2

    Admin2 Administrator Staff Member

  4. Frederick George

    Frederick George Active Member

    new? I've been using laser Tx on fungal nails since the early 1980's. Good results, largely dependent on the patients compliance with applying the med BID. ciclopirox olamine solution seems to be a bit more effective than previous meds.

    Certainly safer than oral meds.

    Cheers

    Frederick
     
  5. facfsfapwca

    facfsfapwca Active Member

    Usually fungal nails are due to a weakness in the toenail caused by Trauma. the most common trauma is tight shoes. That's why most women develop fungal or damaged nails on their 1st and especially 5th toenails. This damage is permanent and no medication or laser can reverse matrix cells that have been killed by ischemia caused by tight shoes. The fungus can be cured with lamasil but the damaged nails will still show this damage be more porous and prone to fungus. Seldom does fungus spread from a damaged nail to an adjacent normal nail so the fear of fungus on locker room floors is silly. Fungus is everywhere in our environment. In nail salons frequently the "technicians" (using sterile equipment) push back cuticles opening them up allowing a perfect bed for yeast infections. Again this is not due to dirty equipment but opening up the cuticle. The cuticle is a seal between the skin and the nail and should not be opened.

    Lets all get real when it comes to fungus how many patients have you seen with one or two fungal nails and never had seen it spread for ten or twenty years to adjacent nails. You know it is not contagious. You know the true reason for nail fungus.
     
  6. blinda

    blinda MVP

    Hi facfsfapwca,

    Yep, agree with that. Trauma (tight fitting shoes) plus occlusive footwear is a safe harbour for dermatopyhtes, which is why we witness a rise in incidence during winter months in particular.

    This is a point that many practitioners fail to appreciate; slow tissue growth and poor blood flow mean that onychomycosis is difficult to target. However, the damage is only permanent if the entire matrix has been damaged as healthy nail regrowth is possible if external conditions, which lead to initial infection, are suitably corrected, along with appropriate fungicidal medication.

    Whilst transferral of infection from nail to nail is unlikely, we cannot ignore the important interplay between skin and nail infection. It is well documented that onychomycosis commonly leads to tinea pedis and vice versa (particularly where the nail plate has been subject to trauma). Therefore, the skin can act as a reservoir for pathogenic fungi, so I wouldn`t necessarily declare locker room infection as silly. As facfsfapwca (Please give us an easier pseudonym!?) stated “fungus IS everywhere in our environment” and infection spreading from one site of the body to another is possible, even probable amongst those with a history of relapses and reinfections, that is patients with defective cell mediated immunity that prevents them from mounting an effective host response are predisposed to chronic infection, spread of infection and recurrence.

    Absolutely, the eponychium is often compromised when the cuticle is pushed back in pedicures, leaving a portal of entry for all kinds of opportunistic visitors!

    I agree that fungal infection is not contagious to a proportion of the population (ie those who do posses cell mediated immunity) and, whilst this is straying from the theme of this particular thread, I would greatly appreciate your expansion on what you consider to be the true reason for onychomycosis?

    Cheers,
    Bel
     
  7. facfsfapwca

    facfsfapwca Active Member

    Compromised individuals HIV even Downs syndrome are predisposed to fungal infections.
    nails that have permanently weakened can be improved with lamasil PO but the weakness is still there and will recur in a year or two. Clean or dirty locker rooms won't change this except for HIV or other immunde compromised..
     
  8. facfsfapwca

    facfsfapwca Active Member

    Belinda,

    I am quoting you and correcting you. "the damage is only permanent if the entire matrix has been damaged as healthy nail regrowth is possible if external conditions, which lead to initial infection"

    Nail matrix is a group of cells and when some of them have been killed by ischemia from a tight shoe. They are i repeat "killed". You will always have a line or porous area where the matrix has been "killed". "healthy regrowth" is NOT possible. The nail may regrow free of fungus if treated with PO Lamasil but will always by missing those dead cells and recurrence is always likely depending on the extent of the damage. Even Lamasil has a diagram of a "cured Nail" they show lines and discoloration it is not normal. Why do people say a nail will regrow normally if cells have been killed?
     
  9. facfsfapwca

    facfsfapwca Active Member

    Why do people give the attribute of curing nail fungus with products not indicated for nails? If a topical worked on nail fungus it would be to their advantage to state so in their literature and indications. The only topical so far is Penlac and its cure rate is low.

    Putting plane baby oil (not even tea tree oil) on a nail and debriding it will make it look better. Stating that Baby oil is a cure would seem foolish. So is stating that Teatree oil is just as foolish.

    What is the mechanism for Laser's to cure fungus. Does it bring to life the dead matrix cells? Ha Ha
     
  10. blinda

    blinda MVP

    Hi facfsfapwca,

    Absolutely agree that pts with systemic conditions such as Downs, Parkinsons, DM, etc and those with compromised immunity are predisposed to OM (hence my reference to `patients with defective cell mediated immunity….`) and that recurrence is likely where the nail has been weakened by disturbed matrix function. Yes, the weakness will always be there, but as these individuals are susceptible to spread of infection, I would advise those with suppressed immunity to take reasonable precautions in communal bathing facilities, etc where evidence has shown that tinea infection is possible and compromises the integrity of the skin and may result in secondary bacterial infections.

    I`m not disagreeing with you here, of course any cells that suffer ischaemia/death will not synthesize trichocytes and as the nail bed cornifies the nail grooves lose their normal contour/become porous. I`m sorry I did not make myself clear, I merely meant that any matrix cells that had NOT been damaged are capable of producing a healthier (that is healthier than a fungal infected) nail if external conditions, such as footwear are addressed along with medication, etc, etc.

    Anyway, anyway, anyway we`ve gone off topic here and like you, I would be interested to know;

    :D Does it have resurrective (not sure that`s a word?) qualities? I`m sure if it is at best as effective as Penlac or Amorolfine, the evidence woul dhave been published. Does anyone know of any up to date research on laser tx for OM?
     
  11. facfsfapwca

    facfsfapwca Active Member

    Laser nor anything else can bring dead cells to life. Before i would try a laser I would like a detailed explanation of why it should work and double blind studies (the surgeon doesn't know whether the laser is on or not. I can tear off a fungal nail clean the nail bed there will be no fungus and the new nail will eventually be the same if not worse than the old one. Why would burning the nail change the fact that matrix cells are missing?
     
  12. blinda

    blinda MVP

    Unfortunately wit is often lost in forum speak, I was trying to be ironic :rolleyes:

    I`m in agreement, once the matrix is damaged i fail to see how laser tx will acclomplish anything superior to what is currently advocated in the Cochrane.
     
  13. facfsfapwca

    facfsfapwca Active Member

    "Cochrane" what does this refer to?
     
  14. blinda

    blinda MVP

  15. facfsfapwca

    facfsfapwca Active Member

    I checked on line and searched Cochrane library using Onychomycosis and toenail found no reference to either. It would be great to find evidence based medicine on this topic.
     
  16. admin

    admin Administrator Staff Member

    Here are some clips on this:







     
    Last edited: Sep 22, 2016
  17. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
  18. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Press Release:
    PinPointe™ FootLaser™ Submits Its Breakthrough Laser Treatment For Toenail Fungus To Health Canada For Approval
    22 Jul 2009
     
  19. We'll see about that claim and how true it is and for long it lasts, if it ever occurs in many patients. My advice.....?......don't hold your breath.
     
  20. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    They register a clinical trial to test it.
    Then put out a press release claiming how good it is.

    ...don't figure!

    How often have we seen this pattern? (eg ESWT; MIS; etc)
     
  21. admin

    admin Administrator Staff Member

    Just picked up a news story from Count on News2
    According to the NY Times, the FDA have not cleared the PinPointe Laser for toenail fungus and according to PinPointe's own press release above, the proven succes rate:
    ...don't figure.
     
  22. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Here is another new 7 min clip touting the method:

     
    Last edited by a moderator: Sep 22, 2016
  23. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    What I can't figure out, is that this new laser machine is "new". The claims are that it takes up to a year before the nail fully grows out before the effect is seen after the one treatment that is claimed that is needed. If that is the case, then none of the people above have been using it for a year or more .... if that is the case where are all the testimonials for it coming from? How do they actually know it works that well? ... don't figure? Should this be in the snake oil category?
     
  24. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Press Release:
    Breakthrough Pinpointe™ Footlaser™ Treatment For Toenail Fungus Now Available In United Kingdom

     
  25. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    PodiatryToday are running an online Poll on this:

    In your opinion, can laser care be a viable option for treating onychomycosis?

    As of today, its:
    Yes 40%
    No 60%

    Here are some of the comments posted:
     
  26. Don ESWT

    Don ESWT Active Member

    Has anyone found out what type of laser they are using. I know it is a red light laser but the 1 -20 watt laser I have can ignite paper at a very low setting and burn 5mm deep into wart tissue.

    What are the long term effects of burning the skin through the nail i.e scarring, blood supply cautery at the end capillaries - could lead to greater problems?????

    Don Scott
     
  27. facfsfapwca

    facfsfapwca Active Member

    I HAVE NOT ACTUALLY EVER HEARD A DETAILED DESCRIPTION OF HOW THIS MODALITY WORKS AND THE RATIONALE FOR ITS USE.
     
  28. hamish dow

    hamish dow Active Member

    I thought it about time that I presented myself as one of the practitioners, in this country, operating the PinPointe FootLaser.

    I have read through the posts a couple of times and find it a little odd or disappointing that so many people would want to remain anonymous. I have the courage of my own conviction to be happy to be named; and it is surprising what you can dig up on the medical effects of laser if you try. Even contacting the company directly will get you a professional and warm reception.

    Currently @ 198 + Doctors of Podiatry in America are using this device. A bold move in itself; considering the litigious nature of the country.
    Researching the principal characters involved would be a revelation to many because of their backgrounds in medical research.
    Professor Harris would no doubt be happy to give anyone the benefit of his years in medical research and his involved work with the use of lasers in Otolaryngology; he has a considerable reputation and has much peer review to his credit.

    There is a board of advisors and scientists involved and a serious amount of financial investment, even interest from the American Cystic Fibrosis organisation. I presume that people do not know of any of this, but a simple rudimentary search of the PathoLase site would reveal traces for contact and further research and would even reveal contact details for many of them. John Strisower the man behind this has deeply personal reasons to develop a range of laser technologies to treat many medical diseases, and he has passion and vision. He has made fortunes off his other business interests and committed many of his own millions to the project.
    I consider John to be a serious intellect with a wide vision capable of gathering around him the expertise to make things happen. He certainly seems to demonstrate a level of greater intellect and humility than I see in evidence in close quarter. His CV is of seriously substantial proportions and was an invited participant of the Milken Institute Global Conference in 2009. I could go on about each and everyone involved but I think it better to invite those who have so far demonstrated a a little laziness in their own research to dig a bit more. A short walk for some might be all that is needed. There is even one operating on Scripps Drive.

    So what is it? It is a serious technological variety of medical laser set to operate at 4 watts using a single beam width, fired in measured pulses to target the sensitivity range of the pathogens involved in mycotic nail infections, using a specified treatment protocol.
    More in depth technical details are proprietary and therefore kept by the company. One certainly should not consider using just any old laser in the belief that it is going to do the same thing.
    Elegant debridement is a useful skill to demonstrate prior to delivery. It is designed to penetrate both nail and soft tissue without damage to host tissue but harmful to the range of pathogens involved; Viral, bacterial, mould and fungal.
    The treatment is mainly without discomfort and has no systemic side effects reported at all.
    Perhaps anyone interested could call Dr. Michael Uro in Sacramento he has performed perhaps close to 800 procedures to date, and could be considered the pre-eminent authority on the subject.
    Up to now, when presented with a patient asking for treatment our profession in the UK has only been able to administer remedial palliative care and suggested a range of medications either close to useless or capable of serious side effects. The most serious of all being fatal.
    Patients now have a viable physical treatment to consider, but will be unable to make an informed choice if the podiatrist they have sought to consult omits to mention it.
    The cost seems high but it is a serious piece of cutting edge technology and is not cheap to operate and promote. Is the real problem that our profession has always undersold its skills and when a high tarrif treatment is offered to it, there is a collective lack of self belief that we deserve to have it?
    What would our profession prefer? Perhaps the company deciding that it should be placed with the beauty industry or the dermatologists? Thus removing us again from the chain of real treatment.
    If anyone would like contact details of the principals involved, contact me. They are astonishingly easy to come by. In fact I know one poster already has had contact but seems to not have updated the forum.
     
  29. facfsfapwca

    facfsfapwca Active Member

    Ok brilliant serious people have developed this product. I would like to see their SAT scores to confirm of course.

    What is the mechanism and rationale for its use?

    A Doctor who doesn't understand what and why he is using a modality or procedure thoroughly should not get involved with it.

    I am interested in why it works and am open minded.
     
  30. hamish dow

    hamish dow Active Member

    What do you mean by SAT tests? this seem to refer to "standardized test for college admissions in the United States". So specifically what do you mean?

    What is the mechanism and rationale for its use?
    Much of the Technical spec is proprietary as I mentioned in the previous thread you have moved from and is therefore protected by patent.

    I totally agree that if one does not have any idea about the medium or its applications one should avoid using it. However to repeat what I posted previously on the original post; for really in depth information contact Professor David Harris Senior Research Fellow in Otolaryngology at the University of Washington, Seattle. Dr Harris has expertise in neuroscience, photomedicine and photobiology with over 150 publications in 12 medical specialties. He has chaired 28 Medical/Scientific Conferences and Sessions, and organized over 100 CME training courses for physicians. Since 1980.
    You will find his cv here.
    http://www.patholase.com/sites/all/themes/patholase/downloads/harrisCV2006.pdf
    In all Likelyhood quite why some of it works might be unknown but as each pathogen and cellular component has a tolerance level that it can exist within, the modality takes it beyond its point of survival, thus rendering it non functional. As it opertates at wavelengths of @ 1064 it is in the infrared end of the spectrum and it will largely pass through tissue without causing any harm.
    I am convinced that to answer your very specific question you must go to the source. In all likelyhood
     
  31. I wouldn't call the podiatrists that are charging $800.00 - $900.00 (US) for this procedure, which involves about 10 minutes of the podiatrist's time for the procedure, as being "bold". Rather it seems rather strange to me how a podiatrist could advertise in local newspapers and magazines that their laser "cures toenail fungus" and charge that type of money to a patient [no insurances are covering this procedure] and tell them that they will cure their fungus infection when there is absolutely no scientific evidence of the following:

    1. That PinPointe laser provides mycological cures to all treated toenails in a majority of cases.

    2. That PinPointe laser prevents recurrence of fungal infection of nails within six months to one year following treatment.

    Hamish, do you think it is ethical to perform this expensive of a procedure on a patient knowing full well that 6 months to one year after the procedure that their toenails could again be infected with fungus and need to have another treatment, again for $800.00 - $900.00 cash?

    Unlike some podiatrists, my conscious couldn't allow me to take that kind of hard-earned money from people that have placed their trust in me as a physician for a treatment that has so little medical evidence that it has any long term effectiveness at curing onychomycosis.
     
  32. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    Kevin ... you need to be careful what you say! Remeber that Rothbart fan that emailed us? I got a similar email from the PinPointe Company! I have added it to all the others in my trophy cabinet! (I will need a bigger one soon).

    I am with you. Show me the data and not the hype or the markatroid sales pitch.

    I see the Podiatry Today poll now has 218 votes, with 61% saying no to the question: "In your opinion, can laser care be a viable option for treating onychomycosis?"
     
  33. Craig:

    Since when should we be worried about telling the truth?

    If PinPointe really does have the peer-reviewed research (and which was not funded by PinPointe) to refute my claims, then let them present it here on Podiatry Arena and I will happily retract my statements. If they want equal billing, have them bring their head researcher on here to tell us how good PinPointe really is in curing toenail fungus.

    In the mean time (and I won't hold my breath), I have enough patients here in Sacramento who have called locally about this "fungal toenail cure" procedure and have told me some very interesting stories about this whole process. My guess is that once the word starts to get around on the internet that this treatment really doesn't cure all forms of onychomycosis and that repeated expensive, cash-only treatments are necessary to keep it from coming back, that some of the "laser-luster" will be removed from the eyes of the public regarding this laser "fungal toenail cure".
     
  34. hamish dow

    hamish dow Active Member

    Gentlemen,
    Interesting responses.
    One notion that I find at odds with the actual procedure (by the way do you know first hand what the procedure is in totality?) it takes me @ 40-45 minutes to administer the dosage across all nails not about ten minutes. It can also take me about 20 -30 minutes to debride the nails to the degree that I feel is right prior to treatment. I require time to take photo’s, administration, medical history and two follow up assessments with repeat photographic events. 10 minutes? I think that is so far off the mark. I forgot, I take time to actually talk to my patients and inform them of whatever they need to know too. 10 minutes? In the words of John McEnroe, “you cannot be serious?”

    The patients I am seeing either do not want tot take the serious oral medications, or can’t because of the affects they experience (loss of taste for one was too much to bear and another thought blinding headaches and vomiting a little too much) or are just exercising their own personal choice for ease of treatment. I personally explain their options for treatment and they choose.
    I take time to explain it as a treatment, and no I don’t offer a guarantee; I think no one would offer their patients a guarantee for most things if they are honest, even with a simple antibiotic one would not guarantee it is going to work.

    However it seems that it is not unusual for people to want to try something when all else seems to be failing. I wonder about the ethics of suggesting a patient try a paint, lacquer or cream when one knows that it is about 90% certain to fail. Yet a great many do.

    I think that one ought to describe the possibility of recurrence as a real prospect but unlike you I am less skeptical. Time will tell as you say.

    It has attracted a fair amount of interest and reading has this thread with a small number of different individuals posting. I declare my own vested interest from the start. I have met the principals involved I am inclined to accept what people like Professor Harris has to say on the subject and will bow to his greater knowledge on what lasers are doing.

    I think it is a great idea to bring on “their head researcher”. Obviously you did invite them after you framed your “trophy” and responded to the letter? Though I hope you were more diplomatic and used either their title or name. When was it you invited them onto the forum exactly? Mind you perhaps it might be wise not to suggest they provide you with their SAT scores, then again I am sure he has a highly developed sense of humour. I assume you will be printing your own some time soon too. They never did it when I was a child and if they had mine would probably be very disappointing.

    But I have to say you are a curious couple of fellows. You debunk the company and the science because you say there is a lack of evidence, but you supply no counter evidence and data just opinion. I can see no indication of anyone’s qualifications in laser technology or laser medical research. I know I have non. But I am prepared to accept Prof. Harris as having the credentials he claims to. I take it on trust, just as I do on this site because I have never actually met the people here but assume that you are the people you claim to be and have your credentials as you say you do.
    You refer to your “guessing “ it wont work.
    You print data of lay opinion as if it were meaningful. Which is a bit like saying nine out of ten cat owners said that their cat preferred….. or, 6 out o8 eight women we asked thought that the product reduced the appearance off……
    And then also present the opinion of patients (now we all know that they are seriously prone to misrepresentation particularly with authority figures or am I the only one with this experience in the profession?) who told some interesting stories, as if it were irrefutable fact. Now, to be fair, you have to disclose these stories in their entirety and establish the veracity and the credibility because you expect the same courtesy in return, and it would amount only to heresay
    Regards Hamish
     
  35. Hamish:

    Ciclopirox (Penlac) topic nail lacquer works in about 60% of cases in my experience, has no side effects, costs only about $25/bottle, and will treat two hallux nails for about 2 months. Most hallux nails require 9-12 months of treatment so total cost to patient is $150.00 for a year of treatment, unless they have insurance coverage, which many do. In addition, ciclopirox nail lacquer actually has had multiple scientific studies on its therapeutic effectiveness.

    Please provide us with a list of published research in peer-reviewed journals which show that PinPointe laser cures fungal toenails, as you say it does. In addition, please provide research that states PinPointe laser will prevent recurrence of onychomycosis or, if cure does occur, how long the cure lasts.

    From http://www.drugs.com/pro/ciclopirox-nail-lacquer.html
     
  36. hamish dow

    hamish dow Active Member

    Thanks for that Kevin,
    Ciclopirox is something i have not had any experience with in the UK. Nor have I heard of it being commonly prescribed over here.

    I must have misrepresented myself at some point so I appologise for that, but I am not a PR man for the company, a private practitioner only. I take it no one has invited the company to comment on the forum then?

    I apologise again if I made claims that it cured the condition. Obviously you have my copy close to hand so can you just remind me where I said it? just cut and paste it, that will be fine.

    I take it that the fact that a former President of the Sacramento Valley Podiatric Medical Society, and a member of the California Podiatric Medical Association and the American Podiatric Medical Association (who has been an off-site clinician in the training of University of California at Davis family practice physicians) operates a number of these devices in your immediate area must be a real bone of contention. The company based just up the road in Chico probably is an annoyance that they will not communicate with you, poor show seeing as they are as close to you as they are. Especially more so when that fellow is on Scripps drive too.
    I will make a request to the company to see if they can be of any help. I was going to say more help but they might be in the dark about all this if no one invited them to be part of this discussion.
    So perhaps a little more patience is all that is needed.
    Hamish
     
  37. Hamish You said that you take photos of your patients nails

    Do you have documented before, after, after 6 months after 12 months etc which you can post to see the nail regrowth that have only had laser tx ?

    Also in your practice how many patients do not have +ve results that have contacted you?
     
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  38. hamish dow

    hamish dow Active Member

    The sequence is for me is photo at presentation, post debridement (that needs to be both extensive and aesthetic as one can be) then again at 4 months, 8 months, as part of the inclusive elements of the treatment cost, and @ a year if the patient elects to. Patients make their own choices.

    But it is still new here so the clinical imagery is not available. The protocols are still able to be moified to gain improvement as time moves on.
    These are still the early days of laser treatment. So I do understand some of the thinking of the detractors, but I place myself in the other camp and find the whole thing iMmensely exciting because of the other obvious implications for us as a profession being offered the technology.

    We are the 3rd clinic in the country to invest in the technology and I think there are (possibly) only two in mainland Europe. Lasers are used in air purification and decontamination and in the food industry to erradicate mould, bacteria, viruses and fungus. sympathetic resaeach has been going on for years. This is a modification and crossover application. The dental research that Dr. Harris has been involved with is quite "interesting" too.
    Hamish
     
  39. hamish dow

    hamish dow Active Member

    I am not sure what happened to my last posing I assume one of two things:
    a. I was immoderate in my reply and it was censured
    b. I did not send it properly and the Gods of cyberspace now have it
    In the event of (a) I will rephrase.

    I still think there is a slightly condescending and personal tinge to what is being said to me but accept I might just be sensitive.
    But for all those others who are following this chain with various levels of interest I will say the following:
    There are @192 doctors in America now using this device.
    @13000 plus patients in a 12 month cycle are choosing to try the TREATMENT.

    I went to a lovely town in America called Sacramento to be trained in the simple protocol and operating procedure for the device, and was deemed competent to use it.
    The doctor who instructed me was Dr. Michael Uro, who has performed over 800 of these procedures in the last year.
    Dr. Uro is a doctor of Podiatric Medicine in the Sacramento area working there for over 30 years and he has served as Podiatry Chair of the surgery departments of both Mercy General Hospital and Sutter General Hospital. Not only that he has served as President of the Sacramento Valley Podiatric Medical Society, and is still an active member in the Society. He is a member of the California Podiatric Medical Association and the American Podiatric Medical Association, and has been an off-site clinician in the training of University of California at Davis family practice physicians.
    So I think I was instructed by a competent professional.

    In the pursuit of the efficacy of the treatment and to review success/failure and documented photographic evidence he would be ideal to talk to. He is close to Kevin on Scripps Drive I guess about ½ a mile or so. Would it not be reasonable to have spoken /visited with him?
    I also return to Dr. Harris and his reputation, I do not think he needs to be maligned. He does not sell PinPointe lasers. Plenty of scientists do however have stakes in what they develop, that in itself is quite normal, I have no personal knowledge of his financial situation.

    What I do know is that there is plenty of science behind the science, and that has plenty of peer review. So some of the confidence in the procedure is born out of that.
    Again, I suggest that anyone who is curious, shall we say, about what it is capable of might like to go and get it from the horse’s mouth. It is not hard to contact Dr. Harris directly; even pit your own extensive knowledge of laser capabilities against his. Then post here why he is wrong.
    If this is so wrong why have the Professional Podiatric bodies not censured the 190 or so doctors using it?
    Finally, my very first patient was a solicitor who had been taking prescribed oral medication for over a year to no effect. He accepted the odds on the treatment that I explained to him and he chose treatment with the laser. So I think I have behaved professionally.
    Ultimately I accept that I stand at odds with some individuals and we will have to agree to disagree on what it actually does. I suggest people need to talk to the scientists involved if one does not trust the company involved. But asking each other about it and offering unqualified opinion is fruitless. Probably even mine.
     
  40. admin

    admin Administrator Staff Member

    It wasn't that!
     
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