Conflict of interest None.
Treatment of onychomycosis using the 1 064 nm Nd:YAG laser: a clinical pilot study
Article first published online: 14 MAR 2014
© 2014 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.
JDDG: Journal der Deutschen Dermatologischen Gesellschaft
Volume 12, Issue 4, pages 322–329, April 2014
How to Cite
Hees, H., Jäger, M. W. and Raulin, C. (2014), Treatment of onychomycosis using the 1 064 nm Nd:YAG laser: a clinical pilot study. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 12: 322–329. doi: 10.1111/ddg.12292
- Issue published online: 2 APR 2014
- Article first published online: 14 MAR 2014
- Manuscript Accepted: 10 DEC 2013
- Manuscript Received: 27 SEP 2013
Nd:YAG lasers could be a safe and effective treatment modality for onychomycosis, without the side effects of drugs. Long and short-pulsed Nd:YAG lasers were used in this clinical study in a side-comparison manner without removal of onychomycotic nail material before treatment.
Patients and Methods
Big toenails of 10 patients were treated twice in a side-comparison manner with the short-pulsed Nd:YAG laser. Fungal cultures were taken and a histological examination was performed before treatment and after 9 months. Two independent investigators rated clearance using the “Onychomycosis Severity Index (OSI)” and standardized photographs at 3-month intervals.
OSI-Scores decreased for 3.8 (15 %; p = 0.006), 4.8 (19 %; p = 0.0002) and 2.9 points (12 %; p = 0.04) within 3, 6 and 9 months. The positive culture rate at 9 months was significantly reduced to 35 % (p = 0.0003). Classification of severity of onychomycosis showed no change. The difference between the treatment regimens was not significant.
These results suggest that treatment of onychomycosis with the Nd:YAG laser without removing mycotic nail material can lead to a temporary clinical improvement, a reduction of positive fungal cultures and an improvement of the Onychomycosis Severity Index. The treatment regimen should be optimized to be used as an effective antimycotic monotherapy.