How Does Laser Treatment Work?
Lasers offer a directed pulse of heat to a specific area, and are particularly effective at treating fungal growths while leaving the healthy tissue intact. Not all lasers are the same however, and we will discuss the differences of each.
There are two main types of lasers, and they are either hot lasers, or cold lasers. Cold lasers function by simply shining a light on the area without heating the skin. This light bolsters the body’s immune system, and encourages it to fight the fungus on its own. Additionally, they speed up the regrowth of the nail following the procedure.
However, there is some contention on the effectiveness of cold lasers. Dr. Bruce E. Katz, Director of the Juva Skin & Laser Center in New York, NY, posits that “only hot lasers work because it is the heat from the laser that destroys the fungus.”
Choosing a Laser Treatment
While there are differences between cold and hot lasers, there are also variances in how long the laser is applied. Specifically, most FDA approved laser treatments are delivered in short, rapid pulses, but there are also long-pulse lasers that are not only approved, but effective.
The latest innovation in laser technology— Q-switched lasers— are able to deliver rapid pulses of light in mere nanoseconds for effective treatment. Alternatively, cold-wave lasers utilize two longer wavelengths of laser light to fight off toenail fungus.
In the past there used to be carbon dioxide lasers, however their use is seldom found in modern medicine as they are quite outdated.
Long Pulsed Laser
The first long pulse laser to be approved by the FDA was the PinPointe FootLaser. The way the treatment works is by delivering ultra long pulses of energetic light to the area for about 30 minutes. This allows for the light to deliver less heat to the affected area, but still retain the effectiveness of a traditional laser. Many podiatrists have reported successful treatments when using such technology, such as podiatrist Dr. Bruce Pinker, an Associate at the American College of Foot & Ankle Surgeons.
“I have treated thousands of patients successfully with the PinPointe Laser. We have found it to be highly effective in resolving all types of fungal toenail infections in addition to yeast and mold toenail infections.” says Dr. Pinker. While treating these conditions with PinPointe Laser is effective, there is a problem with its consistent procedure. While other laser treatments require little to no aftercare, long burst laser treatments such as PinPointe Laser require that the patient undergo strict aftercare measures, and according to Dr. Pinker, little to few of the patients that were treated under his care followed through with the instructions given to them.
Another newer addition is the Q-Clear Compact Laser from Light Age, which belongs to the latest class of Q-switched lasers. The treatment takes 4-15 minutes and results are visible after only one session. Also in this class of lasers is the Lightpod Neo from Aerolase. One of the other modern laser techniques is Q-Clear Compact Laser from Light Age. This type of laser belongs to a class of lasers known as Q-switched lasers, and the treatment lasts around 4-15 minutes with visible results after only one session of therapy. Another type of laser in this class is the Lightpod Neo from Aerolase, and it is used by Dr. Katz in tandem with Pro-Nox, which is a pain-reducing nitrous oxide delivery system
Dr. Katz uses LightPod Neo in combination with Pro-Nox, a pain-reducing nitrous oxide system that ensures patient comfort during the treatment. “Usually 5-6 treatments are necessary and are performed every two weeks.” he adds.
There are several options for heat based lasers, and one such option is the Cutera Genesis plus. This laser offers flexibility when dealing with thicker or thinner nails, and sessions last roughly 10-30 minutes.
Another heat laser available is the JOULE ClearSense, and touts a shorter session time of 10-20 minutes with immediate results.
Finally, CoolTouch VARIABreeze utilizes a coolant during the procedure, while also using a laser that adjusts to prevent overheating. The session lasts around 15-20 minutes.
Cold lasers offer some unique benefits to patients that may be preferable to the benefits of a heat laser. One such laser is the LunulaLaser that takes only 4 5-12 minute sessions, but is able to treat the entire nail while remaining odor-free (something that heat lasers cannot claim to offer).
Another cold laser to consider is the Noveon NaiLaser, which is able to treat four toes in one session. However, sessions take about a half-hour, and can require up to four sessions for extreme cases.