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A 1,320-nm Nd: YAG laser for improving the appearance of onychomycosis
Arisa E Ortiz1, Sam Truong, Kathryn Serowka
1*Division of Dermatology, University of California, San Diego, San Diego, California; †Private Practice, Los Angeles, California; Departments of ‡Dermatology, and §Surgery, University of California, Irvine, Irvine, California.
Background:
Onychomycosis is a therapeutic challenge because of the toxicities of systemic medications. This has led to the investigation of light-based technologies for safe and effective alternative treatment modalities.
Objective:
The purpose of this study was to determine the safety and efficacy of 4 treatments with a 1,320-nm neodymium:yttrium aluminum garnet (Nd:YAG) laser in improving the appearance of onychomycosis.
Materials And Methods:
This study was a 24-week, single-center randomized placebo-controlled study. Ten subjects were enrolled with culture-proven, bilateral great toenail onychomycosis. The subjects received 4 treatments with the 1,320-nm Nd:YAG laser to the treatment toenail on Days 1, 7, 14, and 60. The control toenail received a sham treatment of cryogen cooling only. Mycologic cultures were obtained at 3-month follow-up visits.
Results:
Fifty percent of mycologic cultures were negative at the 3-month follow-up after 4 laser treatments. Toenails had improvement in subungual debris, hypertrophy, and yellowing. Patient satisfaction was upheld as assessed by the Nail Quality of Life Questionnaire.
Conclusion:
The 1,320-nm Nd:YAG laser may be a safe and effective therapy for improving the appearance of onychomycosis. Additional therapy may be necessary to enhance long-term results. Further investigation needs to explore the optimal treatment settings and the most effective treatment schedule.
Insights
The 1,320-nm neodymium:yttrium aluminum garnet (Nd:YAG) laser shows promise for treating onychomycosis, with four treatments clearing infections in 50% of cases. This light-based therapy improved nail appearance and patient satisfaction.
Area of Science:
- Dermatology
- Medical Technology
Background:
- Onychomycosis presents a therapeutic challenge due to systemic medication toxicities.
- Light-based technologies are being explored as safer alternatives for fungal nail infections.
Purpose of the Study:
- To evaluate the safety and efficacy of four treatments using a 1,320-nm neodymium:yttrium aluminum garnet (Nd:YAG) laser for onychomycosis.
- To assess the impact of Nd:YAG laser therapy on the visual appearance of fungal nail infections.
Main Methods:
- A 24-week, single-center, randomized, placebo-controlled study.
- Ten subjects with bilateral great toenail onychomycosis received four Nd:YAG laser treatments or sham treatments.
- Mycologic cultures and nail appearance assessments were conducted at follow-up visits.
Main Results:
- Fifty percent of mycologic cultures were negative at 3-month follow-up post-laser treatment.
- Significant improvements were observed in subungual debris, hypertrophy, and yellowing of treated toenails.
- Patient satisfaction was maintained, as indicated by the Nail Quality of Life Questionnaire.
Conclusions:
- The 1,320-nm Nd:YAG laser appears to be a safe and effective option for improving the appearance of onychomycosis.
- Additional treatments may be required for long-term efficacy.
- Further research is needed to optimize treatment parameters and schedules for Nd:YAG laser therapy.
