Lack of efficacy with 1064-nm neodymium:yttrium-aluminum-garnet laser for the treatment of onychomycosis: a randomized, controlled trial.

Abstract

BACKGROUND:

Laser therapies have been Food and Drug Administration approved for temporary nail plate clearance; however, there is minimal evidence of their long-term efficacy.

OBJECTIVE:

We sought to evaluate the clinical and mycological clearance of toenails treated with 1064-nm neodymium:yttrium-aluminum-garnet laser versus no treatment.

METHODS:

This was a randomized, controlled, single-center trial comparing 2 treatments with 1064-nm neodymium:yttrium-aluminum-garnet laser (fluence of 5 J/cm(2), rate of 6 Hz) spaced 2 weeks apart versus no treatment in 27 patients (N = 125 affected nails) with clinical and mycological diagnosis of onychomycosis. At 3 months, patients were assessed with mycological cultures and proximal nail plate measurements. Patients treated with laser were also assessed with proximal nail plate measurements at 12 months.

RESULTS:

At 3 months, 33% of patients treated with laser achieved a negative mycological culture compared with 20% of the control group (P = .49), and had more proximal nail plate clearance compared with control subjects (0.44 vs 0.15 mm, P = .18), which was not statistically significant. At 12 months, there was no difference in nail plate clearance between laser versus control subjects (0.24 vs 0.15 mm, P = .59).

LIMITATIONS:

Our study was limited by the small sample size and number of treatments.

CONCLUSIONS:

There was no significant mycological culture or clinical nail plate clearance with 1064-nm neodymium:yttrium-aluminum-garnet laser compared with control.

• Authors: S Tyler Hollmig, Zakia Rahman, Michael T Henderson, R Maxwell Rotatori, Hayes Gladstone, Jean Y Tang
• Journal: Journal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 70 Issue 5 Pg. 911-7 (May 2014) ISSN: 1097-6787 [Electronic] United States
• PMID: 24641985 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Topics

• Adolescent
• Adult
• Aged
• Female
• Foot Dermatoses (surgery)
• Humans
• Lasers, Solid-State (therapeutic use)
• Male
• Middle Aged
• Onychomycosis (surgery)
• Retreatment
• Treatment Failure
• Young Adult