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By Dr. Daniel Pero –
As technology advances every year and new developments in medicine bring us the latest treatments for various conditions, both medical and cosmetic, yet another use for our favorite machine called a laser is now upon us. Yes, that scary little creature you may have seen on TV commercials wreaking havoc underneath some hapless victim’s toenail is now succumbing to the simple but discerning use of a safe and nearly painless ray of light wielded by your local foot and ankle surgeon.
LASER is an acronym for Light Amplification by Stimulated Emission Radiation. To the physicist and tech geek this means a lot. But for most people, especially Austin Powers movie fanatics, just the word “laser“ sounds much more cutting edge. Several types of lasers that are utilized at different wavelengths have been employed for years to perform a plethora of treatments on the internal organs and surfaces of our bodies. And with new research and several machines approved by the FDA, we are pleased to announce that lasers can now be used from head to toe, quite literally.
Toenail fungus, or “onychomycosis” is a condition in which a microorganism, one or more of several different species of the Fungi kingdom, invades and disrupts the nail and nail bed of our toes. It feeds on the keratin, which makes up the majority of our nails and outer layer of skin. It causes discoloration, thickening of the nail, lifting of the nail off the nail bed, and sometimes a foul odor or even secondary infections in the surrounding skin, if severe enough.
This condition can be a very embarrassing and lifestyle-changing blemish for some. It can influence your decision whether or not to go bare foot, wear open toe shoes, go swimming in a pool, go to the beach, or stomp grapes to make wine in the traditional fashion. It can also be a serious issue for some people when initiating, or possibly ending, a new intimate relationship.
Clinical observation by a trained professional is usually sufficient for the diagnosis, although some questionable cases or resistant bugs require laboratory testing that can be ordered by a physician. This is usually done as a nail unit biopsy or a fungal culture, both easily obtained at an office visit.
Treatments for toenail fungus have included several different prescription medications dispensed in topical and oral tablet form, as well as a sundry list of home remedies. The oral medications have better results than the topical creams but also come with possible side effects including liver toxicity. With laser technology, some reports have shown about 85% effectiveness with one treatment. And there are no contraindications, drug interactions, black box warnings, or harmful side effects involved with treatment; other than some minor, temporary discomfort cause by heat generated by the laser in the toe, which dissipates almost immediately.
Treatment sessions usually only take about 10-20 minutes, and they should always be preceded by an initial evaluation by the foot specialist performing the treatment. Diagnostic testing may be warranted first, and concomitant topical medication therapy, or other procedures may be recommended at that time, in order to achieve optimal results. It should be noted that results are not immediate, and as the area of new nail grows out from under the cuticle, it will be clear, and as the discolored nail grows out, it is simply clipped away.
The typical toenail fungus sufferer has usually “had it for years, been to several doctors, tried countless over-the-counter and prescription medications, and nothing has worked”. Sometimes this is because another condition is mimicking a fungal infection, or there are additional factors about the nail bed that need to be addressed, and this must be done by an honest professional trained in diagnosing and treating nail disorders, regardless if laser is going to be used as a treatment in onychomycosis.
At the time this article was written, Dr. Pero and Dr. Michel at the Integrative Foot & Ankle Center in West Palm Beach, both residency-trained in several different medical and surgical laser applications, have been performing treatment for infections and other nail disorders, including laser treatment for toenail fungus, for several years in the Palm Beach County area.
INTEGRATIVE FOOT & ANKLE CENTER
Dr. Daniel Pero & Dr. Karl Michel
(561) 293-3439 | www.integrativefoot.com
