Laser Toenail Fungus Removal

Laser procedures are an FDA-cleared treatment for toenail fungus, a nail disorder that, according to the Cleveland Clinic, affects nearly 20% of the U.S. population. Also known as onychomycosis, toenail fungus can make nails turn thick, change their color and shape, and make them crumbly and even painful. Not surprisingly, people also complain that toenail fungus is ugly and embarrassing. 

Laser toenail fungus removal uses specific wavelengths of light to kill the fungus. The light passes through the toenail, without causing damage to the nail or harming surrounding skin. 

It can take 12–18 months for an entirely new toenail to grow out and replace the infected nail, but as it does, the nail will look more normal. 

Several different types of lasers can treat toenail fungus. Some options include: 

• The Genesis Plus and the Pin-Point are Nd:YAG lasers with a wavelength of 1064 nanometers. 
• Lunula is a nonthermal laser that employs two wavelengths of low-level light. 
• Noveon is a diode laser that uses 870 and 930 nanometer near-infrared light.

Laser therapy is safe and painless, though you might feel a warming sensation or a pinprick. It’s a walk-in, walk-out type of treatment that takes less than 30 minutes, with no downtime or side effects. 

Studies support an improvement in toenails after laser treatment. For instance, in a 2017 review of three clinical trials financed by the manufacturer of Lunula, 89% of toenails with mild to severe onychomycosis showed improvement after treatment. In a 2015 study where 82 toenails were treated using a 1064 nanometer diode laser, all nails showed an improvement, ranging from 14% to 56%.  

Despite the growing popularity of laser toenail fungus treatment, the evidence to date hasn’t determined that the treatment is superior to more cost-effective traditional therapies, including over-the-counter and prescription topical medications and prescription oral antifungal medications—though these solutions can have undesirable side effects. 

There are also few studies about the long-term effectiveness and safety of laser toenail fungus treatment. A yearlong study using an Nd:YAG laser didn’t show efficacy when it was used alone (as a “monotherapy,” in medical speak). After 12 months, participants hadn’t achieved remission of their condition, and the visual severity of their toenails worsened in both the laser and nonlaser group. To improve results, laser treatment can be used together with topical products.  

Nail fungus can be stubborn and very difficult to cure. It’s possible to clear a severe infection, but a healthy-looking nail may be unrealistic, according to the American Academy of Dermatology. Still, you can expect the nail to look better and feel more comfortable.

Even after it’s cleared, nail fungus can return. Indeed, FDA approval for lasers has been for the limited indication “temporary cosmetic improvement” of onychomycosis. Taking steps to reduce your risk of another nail infection is key: avoid walking barefoot in public places and use antifungal foot powder every day. And since toenail fungus is contagious, it’s important to get treated to keep the disease from spreading onto other nails. 

RealSelf Tip: Not all cosmetic changes to the toenails are caused by a fungus, so it’s important to get an accurate diagnosis before trying to treat the problem. Treating something that’s pathological as a fungus can make it worse.