Fungal Nails and Class IV Lasers

What conditions may benefit from Class IV laser on fungal infection?

Fungal nail imgFungal infections may be caused by different types of fungus including species of dermatophyte, candida, mold or perhaps a mixture of these.

Classic fungal infections presentations include:

  • Surface infections (White Superficial Onychomycosis or WSO)
  • End of Nail infections (Distal Lateral Subungal Onychomycosis or DLSO)
  • Root and cuticle based infections (Proximal Lateral Subungal Onychomycosis or PLSO)
  • Thick, deformed fungal nails (Total Dystrophic Onychomycosis or TDO)
  • Dermatophyte, candida, mold or mixed fungal infections

Use of surgical laser aims to temporarily improve the appearance of the effects of onychomycosis infection.

What is it?

LaserClass IV Lasers are examples of surgical lasers. The light emitted in a LASER beam is special in many ways – unique in colour, direction and uniformity for example.  The special properties of the laser beam can be used cause cells and tissues to respond physiologically.

This allow lasers users the ability to undertake a wide range of treatments including the treatment of sports injuries, treat wounds, treat dermatological conditions and undertake surgery.

It is an accepted that management of fungal nail disease (onychomycosis) can utilise the special properties of a Class IV surgical lasers in order to facilitate a temporary improvement in the appearance of the nails.  We utilises a specific laser beam wavelength (or ‘colour’ of light), common in other similar lasers – 1064nm which is an example of an infrared laser.

What does it involve?

In Ontario, when chiropodists or podiatrists use class IV laser they refer to the treatment as laser ‘surgery’.

The laser is passed back and forth over the nail surface in a cross hatch motion.  The beam passes through the nail plate covering the nail surface and the lunula beneath (the portion of nail where the nail grows from).

A session for one single affected nail may last a few minutes, longer if all nails are affected.  The aim would be to cross-hatch all affected nails that appear infected.

Is it painful?

The appointment session is undertaken carefully; safety glasses are worn and measures are taken to use the surgical laser safely – some patients may notice the nail warming or heating. This is due to the effects of the laser on the nail. Our technique helps manage this and most patients experience minimal or mild side effects.   Some may be more susceptible to sensitivity or discomfort including those with darker nails or nails of different thickness.

Does it work?

Fungus is infectious – shoes and socks may harbour fungal spores responsible for a reinfection or new infection. Therefore, laser surgery is cited to ‘temporarily’ improve the appearance of the effects of onychomycosis infection.

Our Top Tip:  A common method is to integrate laser surgery into an overarching onychomycosis treatment plan: combining it within a broader management plan to include other antifungals whilst managing foot hygiene and the ‘shoe-sock’ environment.

We respond to research to tell us the best methodology to employ with laser surgery and onychomycosis.  Some of the presentations of nail fungus may respond differently.

Chiropodists can discuss the conservative and longer term elective solutions for toenails. For those suffering with a toenail problem, then a chiropodist/foot specialist can help develop a plan and give advice. Following assessment chiropodists can discuss if onychomycosis laser nail surgery is appropriate.

For further information on fungal toenails click here

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