Even nowadays, treating nail fungus is often a challenge for both the doctor and the patient. Medicinal treatment (topical and systemic) does not guarantee a 100% cure. Often, medication has to be administered over a long period of time, which increases the likelihood of adverse reactions. The treatment of nail fungus is a lengthy process and patients do not always adhere to the prescribed treatment regimen. All this increases the likelihood of recurrence of infection. In addition, toenails grow slowly, so the effectiveness of treatment can only be judged after 12-18 months. All this has led to the search for new, alternative and safer methods of treating nail fungus.
Already at the end of the 20th century, it was observed that laser treatment of the affected areas of the nail improved the effectiveness of medical treatment. In addition, it destroys the remnants of the infected mass that can lead to the relapse of nail fungus. In 2009, the first scientific studies published in the UK confirmed the effectiveness of laser therapy in the treatment of onychomycosis. Since 2010, this treatment method has become a real breakthrough in the treatment of nail fungal infections.
What is the mechanism of action of the laser in the treatment of nail fungus?
There are 2 main ways in which the laser kills the nail fungus pathogens. As you know, tissues have different thermal conductivities. The laser works by selective photothermolysis – the pathogens absorb most of the heat, while the surrounding healthy tissue absorbs much less. Photothermal and photomechanical damage occurs, leading to the death of the fungus. Surrounding healthy tissues are minimally affected due to poor heat absorption. Thus, in principle, during laser treatment, the nail tissue is heated, which creates a very unfavourable environment for the fungus, which is why it dies.
In addition, the light is absorbed by the pigment of the fungus and free radicals are formed, which kill the fungus.
It has been found that the mechanism of action of certain lasers may differ slightly in the killing of nail fungal pathogens. This is determined by the wavelength of the laser light.
One of the first lasers used to treat onychomycosis was the ND:Yag laser. In 2010-2012, the first large-scale research studies were published, concluding that the effectiveness of this laser for treating nail fungus was as high as 84%. Nevertheless, the ND:Yag laser is not the most popular option for laser nail treatment because of the painful nature of the procedures. This laser works on a photothermal principle, i.e. the fungus is destroyed at high temperatures. Depending on the type of fungus, an operating temperature of between 45 and 50°C must be reached – only at this temperature will the disease-causing fungi be killed. Thermal damage (burning) and necrosis of healthy tissues begins as early as 55°C. Because of the very small temperature difference between the therapeutic effect and the damaging effect, the likelihood of complications and other adverse reactions increases. In addition, studies conducted by the American Academy of Dermatology have confirmed that the nail must be exposed to high temperatures for at least 10-15 minutes continuously to achieve visible improvement. As a result, the procedure cannot be carried out instantaneously (instantaneous high temperatures do not have a fungicidal (i.e. fungus-killing) effect).
Despite the good treatment results, the ND:Yag laser has not gained popularity due to its painful procedures and other discomforts (e.g. burning sensation, redness, swelling). The search for treatment methods that are both effective and comfortable for the patient has begun. In 2012-2014, research data on the next generation diode Noveon laser was published in the scientific literature. Its effectiveness in the treatment of nail fungus is as high as 85%. Moreover, the mechanism of action of this laser differs from that of the ND:Yag laser – the fungus is destroyed by photoinactivation rather than by high temperature. Thus, the Noveon laser treatment of nail fungus is a painless, safe and comfortable procedure for the patient. The Laser Dermatology Centre is the only one in the Baltic States to treat nail fungus with the world’s only Noveon laser.
The new generation Noveon laser is unique in its mechanism of action – the fungus-killing effect is achieved without raising the temperature of the tissues. The light from this laser irreversibly alters the metabolism and structure of the fungus, causing it to die. This is called photoinactivation. The lipid layer of the fungus is particularly sensitive to the light emitted by the Noveon laser. In comparison, human cell membranes are less sensitive, so the surrounding healthy tissue is not damaged during this procedure. The Noveon laser is the only laser in the world that works on the principle of photoinactivation.
Laser treatment of nail fungus is a modern, safe, effective treatment method that has been well received by both doctors and patients. The main advantages of laser nail fungus treatment are:
- No systemic toxicity, no interactions with other medicines the patient is taking
- It is a non-invasive treatment method
- Can be used in patients for whom systemic antifungal therapy is contraindicated (e.g. liver disease, heart failure)
- The procedure is carried out in the doctor’s office, which makes it easier to follow the prescribed treatment regimen (rather than, for example, taking daily medication) and to ensure continuity of treatment
- Can be combined with other treatment methods
- Increases the effectiveness of medical treatment
- The patient remains fit for work after the procedure, without restriction of daily activities
- Low to almost painless procedure with minimal discomfort
- Extremely rare adverse events
- The treatment is short – you can do it on your lunch break!
Benefits of the Noveon laser
- No “human” factor.
Laser nail fungus treatment with older generation lasers used to be based on manual work, where the doctor would carefully work around the affected nail. It is important that there are no untreated areas between the laser treated areas. This is sometimes difficult to ensure, as the diameter of the laser beam varies from 0.1 cm to 0.3 cm depending on the type of laser. For this reason, there is always even a minimal chance that the fungus will remain alive in some areas. What makes the Noveon laser unique is the automated process. This new generation laser illuminates the entire nail area at once, so that all areas of the nail are affected equally. This significantly increases the likelihood of treatment effectiveness and recovery.
- The comfort of the treatment.
Patients who have been treated for nail fungus with older generation lasers can attest to the fact that the procedure is not pleasant. The high temperatures required to destroy the fungus made the procedure painful and increased the likelihood of adverse reactions such as burns.
The fungicidal (i.e. fungus-killing) action of the Noveon laser is based on the principle of photoinactivation. This is a completely different mechanism of action that does not require high tissue temperatures. This makes Noveon laser treatments comfortable, without pain or other unpleasant sensations.
The Noveon laser is the safest of all lasers for treating nail fungus. This laser is class 3B.
According to scientific studies, the Noveon laser has an efficiency of 85%. Patients treated with the NOVEON laser usually see a marked improvement after 3.5 to 4 months.
We cannot guarantee a 100% cure rate, as this method of treating nail fungus has not yet been developed today. However, the Noveon laser is one of the most effective methods for treating nail fungal infections today, with fast and reliable results.
Frequently asked questions about laser treatment of nail fungus
What laser will be used for the treatment?
Two types of lasers are used to treat nail fungus in our centre. The choice of laser is determined by the nail fungus causative agent, the accompanying treatment methods, the number of affected nails and other factors. Laser treatment is discussed individually with the patient in each case.
How long will the procedure take?
The Noveon laser nail fungus treatment takes 16 minutes or more (depending on the number of affected nails).
Will the laser nail fungus treatment be painful?
Noveon laser treatments are more comfortable compared to other laser treatments. The unique mechanism of action, whereby the destruction of the fungus does not require raising the temperature of the tissues, makes the procedure painless. However, the body’s reaction to the procedure is individual, so there may be tingling and a sensation of heat during the treatment.
How many treatments will I need and how often?
Usually 3-4 treatments are prescribed at 3-4 week intervals. The treatment regimen may vary slightly from case to case and will be discussed during the consultation.
When to expect the first results?
When treating nail fungus with the Noveon laser, a significant improvement can be seen after 3.5 – 4 months (depending on the rate of nail growth and the accompanying treatment methods).