New Nd:YAG laser delivery option manages onychomycosis, study shows

Kissimmee, Fla. - The cosmetic and medical aspects of onychomycosis appear to be treated effectively with 1,064 nm Nd:YAG laser therapy, said Jill Waibel, M.D., at the 2012 annual meeting of the American Society for Laser Medicine and Surgery.

According to Dr. Waibel, laser therapy can be a useful option for patients who are either recalcitrant to standard therapies or contraindicated for them.

“The 1,064 nm Nd:YAG laser is showing to be very effective in addressing both the medical and cosmetic issues of onychomycosis and can be implemented when other tried therapies fall short of the mark,” says Dr. Waibel, dermatologist and founder of the Miami Dermatology & Laser Institute, Miami.

ClearSense handpiece
Sciton has developed the ClearSense handpiece, a technology with integrated temperature sensing that delivers 1,064 nm Nd:YAG energy to the nail unit. Using the ClearSense handpiece as the vehicle through which the laser energy is delivered, a cosmetic clearing of the nail can be achieved, as can treatment of the actual fungus, Dr. Waibel says.

Recently, Dr. Waibel conducted a 21-patient study using the ClearSense handpiece for the treatment of onychomycosis, with each patient receiving a total of four treatments spaced one week apart. Results showed that the laser therapy could achieve an aesthetic clearing of the nail as well as negative cultures in 20 out of the 21 patients treated.

“Except for prions, all infectious agents can be killed by heat, and using the therapeutic heat from the Nd:YAG laser is a logical extension of this premise. In our small study we found that 20 of the 21 patients treated with the laser responded very well to treatment. These results are very promising and open the door to a new treatment approach for onychomycosis,” Dr. Waibel says.

Oral options
Though they have a proven efficacy, oral antifungal therapies used in onychomycosis such as terbinafine (Lamisil, Novartis) and itraconazole (Sporanox, Janssen) can have significant adverse events, including potential hepatic toxicity. According to Dr. Waibel, laser therapy with ClearSense may be another promising therapeutic option that patients could try, particularly when other avenues of therapy may be sub-optimal.

“It is still early days, but this new laser approach has the potential to become the future definitive treatment for onychomycosis, as treatments are fast, painless, effective and have no side effects,” Dr. Waibel says.

Disclosures: The study was funded by Sciton.

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