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Heat profiles of laser-irradiated nails
Uwe Paasch1, Pietro Nenoff2, Anna-Theresa Seitz1
1Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig AöR und Medizinische Fakultät der Universität Leipzig, 04103, Germany.
Abstract:
Onychomycosis is a worldwide problem with no tendency for self-healing, and existing systemic treatments achieve disease-free nails in only 35 to 76% of cases. Recently, treatment of nail fungus with a near-infrared laser has been introduced. It is assumed that fungal eradication is mediated by local heat. To investigate if laser treatment has the potential to eradicate fungal hyphae and arthrospores, laser heat application and propagation needs to be studied in detail. This study aimed to measure nail temperatures using real-time videothermography during laser irradiation. Treatment was performed using 808- and 980-nm linear scanning diode lasers developed for hair removal, enabling contact-free homogeneous irradiation of a human nail plate in one pass. Average and peak temperatures increased pass by pass, while the laser beam moved along the nail plates. The achieved mean peak temperatures (808 nm: 74.1 to 112.4°C, 980 nm: 45.8 to 53.5°C), as well as the elevation of average temperatures (808 nm: 29.5 to 38.2°C, 980 nm: 27.1 to 32.6°C) were associated with pain that was equivalent to that of hair removal procedures and was not significantly different for various wavelengths. The linear scanning laser devices provide the benefits of contact-free homogeneous heating of the human nail while ensuring adequate temperature rises.
Insights
Near-infrared laser treatment for onychomycosis (nail fungus) shows potential for fungal eradication by generating significant heat within the nail plate. This study measured nail temperatures during laser irradiation, confirming effective heat delivery for potential therapeutic outcomes.
Area of Science:
- Dermatology
- Biomedical Engineering
- Photomedicine
Background:
- Onychomycosis (nail fungus) is a prevalent global issue with limited spontaneous resolution.
- Current systemic treatments for onychomycosis exhibit variable efficacy, ranging from 35% to 76% disease-free nail rates.
- Near-infrared laser therapy is an emerging treatment modality for nail fungus, hypothesized to work via thermal eradication.
Purpose of the Study:
- To investigate the potential of laser treatment to eradicate fungal hyphae and arthrospores.
- To meticulously study laser heat application and propagation within the nail plate during treatment.
Main Methods:
- Real-time videothermography was employed to measure nail temperatures during laser irradiation.
- 808-nm and 980-nm linear scanning diode lasers, adapted from hair removal technology, were used for contact-free, homogeneous nail plate irradiation.
- Temperature changes were recorded as the laser beam traversed the nail plate over multiple passes.
Main Results:
- Both average and peak nail temperatures increased progressively with each laser pass.
- Mean peak temperatures reached 74.1–112.4°C (808 nm) and 45.8–53.5°C (980 nm).
- Significant average temperature elevations (29.5–38.2°C for 808 nm, 27.1–32.6°C for 980 nm) were observed, comparable to hair removal pain levels.
Conclusions:
- Linear scanning laser devices facilitate effective, contact-free, and homogeneous heating of the human nail plate.
- The achieved temperature increases suggest a viable mechanism for thermal fungal eradication in onychomycosis treatment.
- Further research is warranted to correlate these thermal findings with clinical efficacy in treating nail fungus.
