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

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.

• Authors: Caitlin Carney, Wendy Cantrell, Judy Warner, Boni Elewski
• Journal: Journal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 69 Issue 4 Pg. 578-82 (Oct 2013) ISSN: 1097-6787 [Electronic] United States
• PMID: 23856649 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Chemical References

• yttrium-aluminum-garnet
• Neodymium
• Yttrium
• Aluminum

Topics

• Adult
• Aged
• Aluminum (therapeutic use)
• Cohort Studies
• Female
• Follow-Up Studies
• Humans
• In Vitro Techniques
• Lasers, Solid-State (therapeutic use)
• Low-Level Light Therapy (methods)
• Male
• Middle Aged
• Neodymium (therapeutic use)
• Onychomycosis (diagnosis, radiotherapy)
• Pilot Projects
• Risk Factors
• Sensitivity and Specificity
• Treatment Outcome
• Trichophyton (radiation effects)
• Young Adult
• Yttrium (therapeutic use)