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J Am Acad Dermatol. 2014 May;70(5):911-7. doi: 10.1016/j.jaad.2013.12.024. Epub 2014 Mar 15.

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

Author information

1
Department of Dermatology, Stanford University Medical Center, Stanford, California. Electronic address: Stanley.hollmig@stanford.edu.
2
Department of Dermatology, Stanford University Medical Center, Stanford, California.
3
Stanford University School of Medicine, Stanford, California.
4
Berman Gladstone Skin Institute, Walnut Creek, California.

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.

KEYWORDS:

1064-nm neodymium:yttrium-aluminum-garnet laser; onychomycosis

PMID:
24641985
DOI:
10.1016/j.jaad.2013.12.024
[Indexed for MEDLINE]

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