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J Am Acad Dermatol. 2013 Oct;69(4):578-82. doi: 10.1016/j.jaad.2013.04.054. Epub 2013 Jul 13.

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

Author information

1
University of Alabama at Birmingham, Birmingham, Alabama.

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

PMID:
23856649
DOI:
10.1016/j.jaad.2013.04.054
[Indexed for MEDLINE]

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