May 10, 2016

Zap That Nail Fungus

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Jordan V. Wang, MBE, and Dr. Christopher B. Zachary, FRCP

Recent studies estimate that about 10% of the population in the United States has nail fungus, with an increasing prevalence seen in older age and those who have certain health conditions including diabetes. With such a common and stubborn problem, newer treatments are now available instead of those often ineffective anti-fungal medications.

Dr. Keyvan Nouri, Director of Mohs, Dermatologic, and Laser Surgery at the University of Miami, recently gave a talk at the American Academy of Dermatology conference on how lasers can be used for the management of this condition. This year’s annual meeting took place in Washington, D.C. and remains one of the largest of its kind for experts in the field.

Although not yet advertised as a definitive cure, lasers are FDA cleared for the temporary increase in clear nail growth for patients with nail fungus. Several wavelengths and various lasers have already gained this regulatory clearance. Currently, their application is becoming increasingly frequent as we begin to see its use spread across the nation.

For those who cannot take oral anti-fungal medications or those who continue to have lasting nail fungus, lasers have proven to be an effective solution. It can be extremely helpful for the many patients who cannot tolerate the oral medications due to ongoing liver damage.

Dr. Nouri offered his personal experiences and also discussed how we can significantly improve outcomes by combining laser treatments with standard anti-fungal medications. Whether these medications are oral or topical, some have noted good results.

While the exact mechanism of action remains a mystery, many physicians believe that lasers work by directly inactivating the fungus by heat, while also improving the immune system by the creation of beneficial reactive oxygen species in the local nail environment.

Femtosecond lasers, which are still on the near horizon, may offer even better results. Be sure to stay updated on their progress to see if new and improved treatments are coming soon.

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