Treatment of onychomycosis using a submillisecond 1064-nm neodymium:yttrium-aluminum-garnet laser.

Academic Article

Abstract

  • BACKGROUND: Laser treatment has emerged as a novel treatment modality for onychomycosis. OBJECTIVE: We sought to determine thermal response and optical effects of a submillisecond neodymium:yttrium-aluminum-garnet (Nd:YAG) 1064-nm laser on common fungal nail pathogens, and the clinical efficacy and safety of the Nd:YAG 1064-nm laser on onychomycotic toenails. METHODS: A 4-part in vitro and in vivo study was conducted using a Nd:YAG 1064-nm laser. The first portion evaluated 3 different nail pathogens in suspension at 7 heat and time exposures. The second and third parts of the study irradiated pure fungal colonies. The final portion involved an in vivo treatment of toenails over 5 treatment sessions. RESULTS: A fungicidal effect for Trichophyton rubrum was seen at 50°C after 15 minutes, and for Epidermophyton floccosum at 50°C after 10 minutes. Limited growth of Scytalidium was seen at 55°C after 5 minutes. No inhibition was observed after laser treatment of fungal colonies or suspensions. In vivo treatment of toenails showed no improvement in Onychomycosis Severity Index score. LIMITATIONS: The Nd:YAG 1064-nm laser was the only laser tested. CONCLUSIONS: Laser treatment of onychomycosis was not related to thermal damage or direct laser effects. In vivo treatment did not result in onychomycosis cure.
  • Keywords

  • CFU, Nd:YAG, OSI, Onychomycosis Severity Index, colony-forming unit, fungal, irradiation, laser, neodymium:yttrium-aluminum-garnet, onychomycosis, thermal, Adult, Aged, Aluminum, Cohort Studies, Female, Follow-Up Studies, Humans, In Vitro Techniques, Lasers, Solid-State, Low-Level Light Therapy, Male, Middle Aged, Neodymium, Onychomycosis, Pilot Projects, Risk Factors, Sensitivity and Specificity, Treatment Outcome, Trichophyton, Young Adult, Yttrium
  • Digital Object Identifier (doi)

    Author List

  • Carney C; Cantrell W; Warner J; Elewski B
  • Start Page

  • 578
  • End Page

  • 582
  • Volume

  • 69
  • Issue

  • 4